When you’re picking through Medicare insurance plans this Annual Enrollment Period, you can do so with confidence because you have a set of guaranteed rights and protections in Medicare insurance. These rights protect enrollees and make sure that everyone receives top quality care.
It’s helpful to know what your rights are and where they end so you can be an active participant in your coverage. Your rights can also change depending on what type of plan you have. With that in mind, what are your rights and protections under the Medicare program?
General Rights
Everyone — regardless of age, gender, race, color, — is guaranteed to be treated equally by the Medicare program. This treatment must be respectful and dignified, including access to doctors, specialists, and hospitals. Your personal and health information is also required to be kept private. These identity and privacy protections are key to ensuring that no one is discriminated against when looking for affordable coverage in their golden years.
Everyone — regardless of age, gender, race, color, — is guaranteed to be treated equally by the Medicare program.
You also have rights regarding the quality of your Medicare insurance coverage. Specifically, you have the right to understand the ins and outs of your coverage. This means that you have the right to access the information on Medicare, health care providers, and other facets needed to make informed coverage decisions. If there’s something you are curious or unsure about, you have the right to ask questions and have them answered.
This extends further to you having the right to appeal and file official complaints should something in your coverage not be up-to-par. This overview is only scraping the surface of guaranteed rights and protections throughout the Medicare program. The full text versions of these rights are available on Medicare.gov.
Rights in Original Medicare
Original Medicare’s rights are pretty closely tied with the general Medicare rights and protections. After all, it includes the “original” two parts of the Medicare program. The other extra rights you have as an enrollee in Original Medicare mostly deal with protecting the quality of your coverage. You have the right to see any doctor, specialist, or hospital as long as they participate in the Medicare program.
The other extra rights you have as an enrollee in Original Medicare mostly deal with protecting the quality of your coverage.
You also are guaranteed to have access to certain notices and information. Should you have any coverage concerns, you can appeal coverage or payment decisions that are specific to Original Medicare. Finally, you have the right to purchase a Medigap policy.
Rights in Medicare Advantage
Now, Medicare Part C (Medicare Advantage) plans are a little different. They’re offered by private insurers that are approved by Medicare, so there are a few more protections in place. To help you with choosing your coverage, you’re allowed to request information about the plans prior to enrolling, which the plan is required to provide upon request. You also have the right to choose a health care provider, similarly to Original Medicare. You also can get a treatment plan from this health care provider.
To help you with choosing your coverage, you’re allowed to request information about the plans prior to enrolling, which the plan is required to provide upon request.
The Medicare program ensures you have the right to know how your health care provider is paid by your plan, allowing you to ask your plan specifics if need be. Finally, if you run into any trouble or differences with your plan, you can appeal a coverage decision or file a complaint. Medicare.gov has made your rights for Medicare Part C available in full on their website.
Rights in Medicare Part D
Since Medicare drug insurance plans (Part D) pair up with Original Medicare, they share many of the same rights and protections. The majority of the Medicare Part D protections have to do with coverage issues. If you disagree with your drug plan over coverage or costs, you have the right to request a coverage determination or to make an appeal. Should things escalate, you may also file a complaint with the plan to resolve these differences.
The majority of the Medicare Part D protections have to do with coverage issues.
Under Medicare Part D, the privacy of your drug and health information is guaranteed, allowing you the confidence that your personal information is safe. Your drug plan is also required to send you information that explains your Part D rights when you enroll. Another option is to perform a plan search.
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One of the many benefits of having a Medicare insurance plan is that you have certain rights and protections guaranteed to you by the federal government. With both enforced by both your plans and the government, you can be sure that your coverage is of a certain quality and that you have a real option to ensure it stays that way. That’s why knowing what rights you have is so important.
