You have a right to appeal many decisions a Medicare Advantage Plan may make. Appealable decisions include:

• Failure to approve a treatment or medical procedure.
• Failure to allow a referral to a specialist, either in or out of network.
• Failure to pay charges for non-network medical care such as emergency care, urgently needed care, or care from a non-network provider you believed was or should be covered.
• Attempting to discharge you from a hospital or terminate other medical treatment sooner than you believe to be medically appropriate.

The appeals process is the same, regardless of what is being appealed. A preferred method of starting an appeal is to call from your doctor's office. In any event, your doctor is your strongest ally in the appeal process.

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