Regardless of the type of Medicare coverage enrolled in, there are certain rights everyone is entitled to and responsibilities that must be upheld.
These rights include:
- Fair treatment and non-discrimination
- Access to doctors and hospitals
- Emergency and urgent care when needed
- Knowing what Medicare will and will not cover
- Appealing certain decisions about coverage or payment
- Filing complaints about care
- Having personal information kept private
Medicare beneficiaries are responsible for:
- Knowing when to sign up or change plans
- Reading all letters from Medicare
- Asking questions, if there’s a misunderstanding
- Protecting Medicare cards and number
- Asking doctors and other healthcare providers if they take Medicare before services
- Calling Medicare if a doctor, insurance agent or plan has misled you
If these rights have been violated, there are programs and services in place to assist.
Reporting Medicare Scams
Medicare numbers should be protected as you would a credit card, debit card or bank account information because Medicare fraud is sadly a common occurrence. Be present and aware if allowing someone else to use personal information, enter it on a website or mail it. If sending in a paper application, make sure there is only one with a copy of it and the original is sealed and ready to be mailed before leaving.
If someone is misusing personal information, call:
- 1-800-MEDICARE (1-800-633-4227) (TTY users should call 1-877-486-2048), OR
- Contact the Senior Medicare Patrol Resource Center by calling 1-877-808-2468 or use their online contact form.
- The Fraud Hotline of the U.S. Department of Health & Human Services Office of the Inspector General at 1-800-447-8477, OR
- The Federal Trade Commission’s ID Theft hotline at 1-877-438-4338 (TTY users should call 1-866-653-4261).
Enrolled in the Medicare Wrong Plan
If you are enrolled in the wrong plan by mistake or after receiving misleading information, you may be able to disenroll from the plan and enroll in a new plan that is a better fit for your needs.
There are a couple of scenarios where you have a right to change plans:
- Enrolled in a plan unintentionally;
- Enrolled in a plan based on incorrect or misleading information;
- Enrolled in the same plan or kept in a plan you didn't want.
If you believe that you fall within these scenarios you can contact 1-800-MEDICARE to request a retroactive disenrollment or a Special Enrollment Period.