Medicare Appeals Phone Number: Who to Call for Help

Is there one Medicare appeals phone number?

There is a main Medicare phone number for questions: 1-800-MEDICARE, or 1-800-633-4227. TTY users can call 1-877-486-2048. Medicare can explain appeal rights, help you understand notices, and direct you to the correct appeal process.

However, there is not always one single phone number that files every appeal. The right contact depends on whether the issue involves Original Medicare, a Medicare Advantage plan, a Medicare drug plan, a hospital discharge, or another type of Medicare decision.

Who should you call first for a Medicare appeal?

Start with the organization that made the coverage or payment decision. In many cases, the denial notice, Medicare Summary Notice, plan letter, or discharge notice will tell you exactly where to send or request the appeal.

Original Medicare: Call 1-800-MEDICARE for help understanding the appeal process, but follow the written instructions on your Medicare Summary Notice or other official notice.
Medicare Advantage or other Medicare health plan: Call your plan using the number on your plan membership card.
Medicare Part D drug plan: Call your drug plan using the number on your plan card or plan materials.
Hospital discharge or ending skilled services: Follow the notice you receive and contact the Beneficiary and Family Centered Care Quality Improvement Organization, or BFCC-QIO, listed for your state.

What number do you call for Original Medicare appeals?

For Original Medicare questions, call 1-800-MEDICARE, 1-800-633-4227. TTY users can call 1-877-486-2048. Medicare can help explain what your notice means and where to find appeal forms or instructions.

For a payment or coverage denial under Original Medicare, the appeal is generally handled according to the instructions on your Medicare Summary Notice or other official decision notice. Keep copies of anything you submit, including the notice, your written explanation, and any supporting information from your provider.

Who do you call for Medicare Advantage or Part D appeals?

If you are in a Medicare Advantage plan, another Medicare health plan, or a Medicare drug plan, call the plan first. The plan must tell you in writing how to appeal, and you can usually find the plan contact information on your member ID card or in your plan materials.

For a Medicare drug plan, the first step may involve asking the plan for a coverage determination if the issue is whether a drug is covered or how it is covered. If you disagree with the plan decision, follow the plan’s appeal instructions and deadlines.

Where can you get free help filing an appeal?

You can contact your State Health Insurance Assistance Program, commonly called SHIP, for free, local Medicare counseling. SHIP counselors can help you understand appeal notices, gather information, and prepare questions before you contact Medicare or your plan.

You may also appoint someone to help with an appeal, such as a family member, friend, advocate, attorney, doctor, or other representative. Medicare has rules for appointing a representative, so use the official form or written request instructions when someone will act for you.

When should you contact the Medicare Beneficiary Ombudsman?

The Medicare Beneficiary Ombudsman helps with Medicare-related complaints, grievances, appeals, and information requests. It is generally for concerns that have not been resolved through Medicare or your plan.

If your concern has not been resolved, you can call 1-800-MEDICARE and ask to have your inquiry submitted to the Medicare Beneficiary Ombudsman. This is not a substitute for meeting appeal deadlines, so continue to follow any appeal instructions in your notice while seeking help.

What information should you have before calling?

Before calling Medicare, your plan, SHIP, or another appeal contact, gather the documents connected to the decision. Having the right information can make the call more useful.

Your Medicare card and Medicare Number
Your plan member ID card, if you have Medicare Advantage or Part D
The denial letter, Medicare Summary Notice, or other decision notice
The date of service, provider name, item, service, or drug involved
Any appeal deadline listed on the notice
Notes or supporting information from your doctor, prescriber, provider, or supplier
The name and contact information of any person helping you with the appeal

Our Process

From First Meeting to Medicare Enrollment

We begin by helping you understand how Medicare works and how the different pieces fit together. We walk through Original Medicare, Parts A and B, Medicare Advantage, Medicare Supplement insurance, and Part D prescription drug coverage, including how formularies, drug tiers, and plan rules can affect your costs.

We also explain dental, vision, and hearing coverage, along with other products that may help fill gaps in your healthcare plan. Depending on your needs, that may include short-term in-home healthcare coverage, hospital indemnity insurance, or coverage designed to provide additional financial support following a cancer diagnosis, heart attack, or stroke.

Once you understand the landscape, we move into the planning stage. That is when we review your doctors, hospitals, prescription drugs, current coverage, and other personal details so we can begin evaluating the Medicare plan options that fit your situation.

Discovery Meeting

We collect information about your doctors, hospitals, prescription drugs, current coverage, and other important details, then discuss your unique situation and priorities. Start your secure Medicare profile.

Create Your Strategy

We review the information gathered during discovery and develop a Medicare claiming and coverage strategy tailored to your circumstances.

Plan Enrollment

Once you are comfortable with the strategy, we help coordinate the appropriate enrollment steps and timing.

Annual Reviews

Medicare plans, costs, formularies, provider networks, and personal circumstances can change. We conduct annual reviews to help determine whether your current coverage still fits.

Request Medicare Planning Information

Official Sources

Talk to Someone | Contact Medicare | Medicare
Verifies the main Medicare contact number, 1-800-MEDICARE, and the TTY number for Medicare help.
Filing an appeal | Medicare
Verifies that appeal steps depend on the type of Medicare coverage and that plan contact information is generally on the plan membership card.
Appeals in Original Medicare | Medicare
Explains Original Medicare appeal procedures and confirms Medicare contact information for appeal-related questions.
Appeals in Medicare health plans | Medicare
Verifies appeal information for Medicare Advantage and other Medicare health plans, including contacting the plan for determinations and appeals.
Appeals in a Medicare drug plan | Medicare
Verifies appeal and coverage determination information for Medicare drug plans.
Medicare Beneficiary Ombudsman (MBO) | CMS
Explains the Medicare Beneficiary Ombudsman’s role in Medicare complaints, grievances, appeals, and information requests.

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