MY RIGHTS UNDER MEDICARE ADVANTAGE PLANS

Medicare Advantage Plan offers a lot of health care benefits to its members. Alongside are the rights and protections to secure not only your health but also your personal rights. It is important to know not only the benefits but as well as your entitlement as a member. To be aware of what treatment or reception should you deserve. Below are the lists of your rights and protection under the Medicare Program:

  • Medicare team will make sure you’ll get treated all the time with respect and dignity.
  • Privacy is also a priority under this program so your personal and health information will all be kept privately.
  • Fair treatment will be given to you regardless of your race, nationality, age, disability, color, gender, or religion because all the companies that work with Medicare must strictly abide the law.
  • Being able to understand all the information you need and your questions about Medicare will all be answered.
  • You’ll have access to doctors, specialists and health care institutions under Medicare Program.
  • Medicare team will help you with all your concerns to help you with your decisions like what’s the coverage for this program, the benefits and services that will be provided to you, how much costs you’ll have to pay, or how to file a complaint or appeal.
  • Awareness about your treatment choices in layman’s terms to better understand your alternatives and be able to participate in every treatment decision.
  • Receive the best health care services you deserve in a culturally-sensitive way.
  • Even in cases of emergencies, you can also get Medicare services.
  • Have your own decision about the health care payment, coverage of the program’s services, and drug prescription coverage.
  • If you disagree with certain decisions about your services, you can always request for an appeal on the decisions about the coverage of services, your health care payment or drug prescription coverage.
  • File complaints or grievances if you have a problem with the services you received.

How to file for a grievance/complaint?

You have all the right to file a complaint against the quality of services you received or the treatment you get under Medicare Program. Your personal safety is also a priority under this network other than your health security. Ways on filing a complaint will depend on the reason behind your grievances however, provided below is the list on what complaints you can file:

  • You can file a complaint on a doctor, hospital or provider if you felt that there was an improper care or abuse, unsafe hospital conditions like poor housekeeping or the quality of foods being served, and unprofessional conduct or incompetence practice of your doctor.
  • Complaints about the quality of care by your providers like being given by wrong drugs, being operated which are not necessary or could have been prevented by proper medications, being discriminated or treated unfairly, no treatment despite the developed complications, and being sent home even if you’re still in pain or not feeling well.
  • Complaints about the durable medical equipment if it’s not properly working or damaged;
  • And for your health and drug plan like the customer service, access to specialists, information from your plan, drug errors, and problems with an appeal.

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