Medicare Advantage 101: New policy series explains Medicare Advantage and its role within the Medicare system.
Medicare Rights Center Releases Medicare Snapshot
— Highlights Beneficiary Experience with Medicare Advantage Denials of Coverage and Appeals —
New York, NY—Today, the Medicare Rights Center released its first Medicare Snapshot: Stories from the Helpline, spotlighting Medicare Advantage (MA) plan denials of coverage and appeals issues as experienced by a typical caller to Medicare Rights’ national helpline. Over one-third of all callers to the helpline express difficulty managing coverage denials and appeals. While there is limited public data on how well MA plans address appeals and grievances, what information is available suggests there is significant room for improvement.
“Roughly 30 percent of the 50 million people with Medicare are currently enrolled in a Medicare Advantage plan,” said Joe Baker, President of the Medicare Rights Center. “Many people with MA plans have a positive experience with their plan; yet, we find that managing denials of coverage remain a consistent concern for many MA enrollees.”
To address common issues with denials of coverage and appeals, Medicare Snapshot outlines key improvements to Medicare private health plans, including:
For those denied coverage for a service by their MA plan, Medicare Snapshot offers this advice:
Medicare Snapshot: Stories from the Helpline is available at: https://www.medicarerights.org/policy/priorities/medicare-snapshot-october-2014.