Your Medicare Rights and Protections, we’ll be talking about your right to get the health care services you need; your right to file a complaint; and where you can get help with your questions. (Reference: Your Medicare Rights and Protections, CMS Publication 10112) This training module was developed and approved by the Centers for Medicare & Medicaid Services (CMS), the Federal agency that administers Medicare and Medicaid. The information in this module was correct as of April 30, 2007.

Click here to begin the presentation!

As a person with Medicare, you have certain guaranteed rights and protections that we’ll be discussing
throughout this module. The topics we will cover include:

• An overview of Medicare rights and protections
• Your rights and protections in the Original Medicare Plan
• Hospital, skilled nursing facility, and home health care rights
• Privacy practices in the Original Medicare Plan
• Your rights and protections in a Medicare Advantage Plan
• Your rights and appeals in a Medicare Prescription Drug Plan
• Where to get more information

If you have Medicare, you have certain guaranteed rights. You have them whether you are in the Original Medicare Plan, in a Medicare Advantage or other Medicare plan, have a Medicare Prescription Drug Plan, or have a Medigap (Medicare Supplement Insurance) policy. These rights protect you when you get health care; make sure you get the health care services the law says you can get; protect you against unethical practices; and protect your privacy.

The Original Medicare Plan is a “fee-for-service” plan. You are in the Original Medicare Plan unless you join a Medicare Advantage Plan or other Medicare plan. Some people in the Original Medicare Plan buy a Medigap policy to help cover the costs Medicare doesn’t pay.

Medicare Advantage Plans include Medicare Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Special Needs Plans,  Private Fee-for-Service Plans, and Medicare Medical Savings Account Plans. Other Medicare plans include Medicare Cost Plans, demonstrations, and Programs of All-inclusive Care for the Elderly (PACE).