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determination

What is determination?

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claim

claim

A claim is an application for benefits provided by your health plan. You must file a claim before funds will be reimbursed to your medical provider. A claim may be denied based on the carrier's assessment of the circumstance.

Who should I contact if I have an issue with my Medicare coverage?

Who should I contact if I have an issue with my Medicare coverage?

You can usually address many Medicare Advantage or Part D enrollment issues by contacting Social Security or 1-800-MEDICARE. But you have to appeal coverage denials directly to your insurer.

What is determination?

Determination refers to a decision by Medicare to deny your claim, pay part of your claim or pay it in full.

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