Issue #47: March 2026

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An appeal means asking Medicare or your plan to take a second look at a decision that was made regarding your care.

Getting to Know Your Medicare Rights

Each month, we talk about one of your Medicare rights and what it means for you. Knowing your rights can help you feel more confident about your care.

Let’s say your doctor orders a test, but your health plan says it won’t cover it.

Maybe you just received a bill in the mail for a service you thought Medicare would cover. You feel that this is not right and want to know what to do.

What Can You Do?

We have good news. You have the right to appeal. An appeal is simply a request for Medicare or your plan to take a second look at a decision about your coverage or payment. The process is not difficult, and we have included some helpful facts to guide you.

What Can You Appeal?

You can appeal if Medicare or your Medicare Advantage plan:

• Denies a service, test, or treatment
• Refuses to pay for care you’ve already received
• Stops covering the care you're currently getting
• Denies coverage for a prescription drug

If you believe a decision is wrong, you have the right to ask for a review.

Before starting an appeal, consider calling your doctor’s office or the provider’s billing department.

Sometimes a claim is denied because of a billing error, missing information, or an incorrect code. In those cases, your provider may be able to correct the claim and resubmit it. However, your provider might confirm that a billing issue did not cause the denial. If you still believe Medicare or your Medicare Advantage plan should cover the service, you can move forward with filing an appeal.

Who Handles the Appeal?

Many appeals are handled directly by Medicare or your Medicare Advantage or Part D drug plan. They usually include:

• Coverage decisions
• Payment decisions
• Prescription drug coverage decisions

If you receive a denial notice, read it carefully. It will explain:

• Why your coverage was denied
• How to file an appeal
• The deadline by which to respond

If you disagree with the first decision, you often have the right to request a second review.

Know the Difference

Not all Medicare appeals are handled the same way.

Medicare or Medicare Advantage Plan Appeals

For Medicare or Medicare Advantage plan appeals, you can file directly with Medicare or your plan. Keep in mind that these appeals usually involve coverage, payment, and prescription drug decisions.

Beneficiary and Family Centered Care Quality Improvement Organization (also called BFCC-QIO) Appeals

The BFCC-QIO can review appeals in certain situations, such as:

• You believe you are being discharged from a hospital too soon
• Your Medicare-covered skilled services (such as nursing or physical therapy) are ending, but you think they should continue
• To read more, including other appeals reviewed by BFCC-QIOs, visit our appeals page.

If you receive a notice about services ending, it will explain whether you can request a fast review from the BFCC-QIO. Acentra Health is the BFCC-QIO for 29 states. Visit our helpline page for a list of states we serve, as well as the telephone numbers for your state.

Need Help?

If you’re not sure what to do next, start by calling the number on your insurance card or by following the instructions in the notice you received. Another option is to call your State Health Insurance Assistance Program (SHIP) for free, local counseling.

You don’t have to handle it alone. Knowing your Medicare rights can help you feel more confident about your care.

Talking With Your Doctor About Nutrition and Your Health

Have you ever nodded along during a doctor’s visit, even though you weren’t completely sure what was being said? Maybe you left thinking, “I’m not sure I understood all of that.”

You’re not alone.

March is National Nutrition Month, a time to think about how food and healthy choices support your overall well-being. Conversations about blood pressure, cholesterol, blood sugar, weight, or heart health often include recommendations about diet and lifestyle. Those discussions can sometimes feel overwhelming, especially if they involve unfamiliar medical terms or big changes.

Remember: Your healthcare visits are meant to be a partnership.

If something doesn’t make sense, it’s okay to ask for clarification. You might say:

• “Would you explain that in another way?”
• “What does that mean for me?”
• “What are my options?”

Asking questions helps your doctor and the rest of your healthcare team understand what matters to you.

Before you leave your appointment, take a moment to ask yourself, “Do I understand what we decided and what comes next?”

One helpful approach is called the “teach-back” method. You might say, “Let me make sure I understand. I’m going to reduce salt in my meals, walk three times a week, and come back in a month. Is that right?” This gives your doctor a chance to confirm or clarify the plan.

It can also help to bring a short list of questions to your appointment. Writing them down ahead of time makes it easier to remember what you want to ask.

Making Changes in Your Nutrition

Nutrition conversations can feel personal. Many of us have favorite foods that are part of our family traditions and cultures. The goal is not to give up the foods you enjoy. Instead, it can be about finding balance or making small adjustments.

You might ask:

• “How can I enjoy my favorite foods in a healthier way?”
• “Are there simple swaps I can try?”
• “Can you recommend a dietitian or trusted resources?”

For some conditions, small changes, like adjusting portion sizes, moving more, choosing lower-sodium foods, or cutting back on added sugar, can make a meaningful difference. Your doctor can help you decide what approach is safe and best for you.

What about medications or other useful tools?

Sometimes your doctor may recommend starting a medication. Medication can be important and helpful. However, it’s also okay to ask, “Are there changes I can try first?” or “What lifestyle changes could help before we move to a prescription?”

You may also consider the use of reliable tools that offer heart-healthy and diabetes-friendly recipes, tips for lowering sodium, and ideas for adjusting traditional dishes while keeping their flavor. A registered dietitian can also help you adapt family recipes in a way that supports your health goals.

We’ve gathered nutrition resources, helpful tips, and links to recipe ideas on our National Nutrition Month webpage. You’ll find practical information to help you make small changes while still enjoying the foods that matter to you.

National Nutrition Month is a reminder that healthy changes don’t have to happen all at once. Small steps taken together with your healthcare team can make a meaningful difference.