Your rights in Medicare health plans

If you’re in a 

Medicare Advantage Plan (Part C)

 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.