You can file a complaint if you have a concern about the quality of care or other services you get from a Medicare provider. How you file a complaint depends on what your complaint is about.
You can file a complaint about:
- A doctor, hospital, or provider
- Your health or drug plan
- Quality of your care
- Your dialysis or kidney transplant care
- Durable medical equipment
What's the difference between a complaint and an appeal?
A complaint is about the quality of care you got or are getting. For example, you may file a complaint if you have a problem calling the plan or if you're unhappy with how a staff person at the plan has treated you. However, if you have an issue with a plan's refusal to cover a service, supply, or prescription, you file an appeal.
Need help filing a complaint?
Contact your State Health Insurance Assistance Program (SHIP) for free personalized help.
For questions about a specific service you got, look at your Medicare Summary Notice (MSN) or login to MyMedicare.gov. If you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan, you can file an appeal.