If you’re in a
or other Medicare health plan, in addition to the rights and protections for all people with Medicare, you have the right to:
- Choose health care providers within the plan.
- Get a treatment plan from your doctor.
- If you have a complex or serious medical condition, a treatment plan lets you directly see a specialist within the plan as many times as you and your doctor think you need.
- Women have the right to go directly to a women's health care specialist without a referral within the plan for routine and preventive health care services.
- Know how your doctors are paid.
- When you ask your plan how it pays its doctors, the plan must tell you.
- Medicare doesn't allow a plan to pay doctors in a way that could interfere with you getting the care you need.
- Request an appeal to resolve differences with your plan.
- File a complaint (called a "grievance") about other concerns or problems with your plan.
- Get a coverage decision or coverage information from your plan before getting services.
To learn more about your rights and protections, read your plan’s membership materials, or call your plan.