Claims, Appeals, and Complaints

Although it’s rare, you may need to file a claim or appeal, or make a complaint.

Man in pink shirt talking on phone

Claims

If you need to request payment for a Medicare service or item, in most cases you can file a claim. You should only need to file a claim in very rare cases.

Appeals

If you disagree with a coverage or payment decision by Original Medicare, your Medicare health or drug plan, you can file an appeal.

Complaints (Grievances)

If you have concerns about the quality of your care or other services, you can file a complaint.

If you need someone to file a claim, appeal or complaint on your behalf, you’ll need to fill out an Authorization to Disclose Personal Health Information form. Download this form in Spanish. This form allows Medicare to discuss your personal health information with the person or persons you have chosen to help you.