This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Review it carefully.
The law requires Medicare to protect the privacy of your personal medical information. It also requires us to give you this notice so you know how we may use and share ("disclose") the personal medical information we have about you.
We must provide your information to:
- You, someone you name ("designate"), or someone who has the legal right to act for you (your personal representative)
- The Secretary of the Department of Health and Human Services (HHS), if necessary
- Anyone else that the law requires to have it
We have the right to use and provide your information to pay for your health care and to operate Medicare. For example:
- Medicare Administrative Contractors use your information to pay or deny your claims, collect your premiums, share your benefit payment with your other insurer(s), or prepare your "Medicare Summary Notice."
- We may use your information to provide you with customer services, resolve complaints you have, contact you about research studies, and make sure you get quality care.
We may use or share your information under these limited circumstances:
- To State and other Federal agencies that have the legal right to get Medicare data (like to make sure Medicare is making proper payments and to help Federal/State Medicaid programs)
- For public health activities (like reporting disease outbreaks)
- For government health care oversight activities (like investigating fraud and abuse)
- For judicial and administrative proceedings (like responding to a court order)
- For law enforcement purposes (like providing limited information to find a missing person)
- For research studies that meet all privacy law requirements (like research to prevent a disease or disability)
- To avoid a serious and imminent threat to health or safety
- To contact you about new or changed Medicare benefits
- To create a collection of information that no one can trace to you
- To practitioners and their contractors for care coordination and quality improvement purposes, like Accountable Care Organizations (ACOs)
We must have your written permission (an "authorization") to use or share your information for any purpose that isn't set out in this notice. We don't sell or use and share your information to tell you about health products or services ("marketing"). You may take back ("revoke") your written permission at any time, unless we've already shared information because you gave us permission.
You have the right to:
- See and get a copy of the information we have about you.
- Have us change your information if you think it's wrong or incomplete, and we agree. If we disagree, you may have a statement of your disagreement added to your information.
- Get a list of people who get your information from us. The listing won't cover information that we gave to you, your personal representative, law enforcement, or to pay for your care or for our operations.
- Ask us to communicate with you in a different manner or at a different place (for example, by sending materials to a PO Box instead of your home address).
- Ask us to limit how we use your information and how we give it out to pay claims and run Medicare. We may not be able to agree to your request.
- Get a letter that tells you about the likely risk to the privacy of your information ("breach notification").
- Get a separate paper copy of this notice.
You may file a privacy complaint with:
- The Centers for Medicare & Medicaid Services (CMS). Visit Medicare.gov, or
- The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR). Visit hhs.gov/hipaa/filing-a-complaint.
Filing a complaint won’t affect your coverage under Medicare.
To speak to a Customer Service Representative about our privacy notice, call 1-800-MEDICARE.
The law requires us to follow the terms in this notice. We have the right to change the way we use or share your information. If we make a change, we'll mail you a notice within 60 days of the change.
The Notice of Privacy Practices for Original Medicare became effective September 23, 2013.