What if Medicare will not pay for something?
If Medicare refuses to pay for something, they send you a denial letter. The denial says they will not pay.
If you think Medicare should pay, you can challenge their decision not to pay. This is called “appealing a denial.” If you appeal a denial, Medicare may decide to pay some or all of the charge.
The Medicare Advocacy Project (MAP) helps people who may have been unfairly denied Medicare. MAP can give you information, advise you, and sometimes represent you for free. Contact MAP via your local legal services office:
Greater Boston Legal Services (GBLS)
Serving Essex, Middlesex, Norfolk, and Suffolk counties: 617-371-1234; 800-323-3205
South Coastal County Legal Services (SCCLS)
Serving Bristol and Plymouth counties: 800-244-9023; 508-979-7150
Serving Fall River: 800-244-9023; 508-676-6265
Serving Barnstable, Dukes, Nantucket, and Plymouth counties: 800-244-9023; 508-775-7020
Community Legal Aid (CLA)
Serving Berkshire, Franklin, Hampden, Hampshire, and Worcester counties: 855-252-5342
SHINE (Serving the Health Information Needs of Everyone): 1-800-243-4636, press 3
The SHINE (Serving the Health Information Needs of Everyone) Program provides free health insurance counseling services to Massachusetts residents with Medicare or who are about to become eligible for Medicare, and their caregivers. SHINE counselors are trained to handle complex questions about Medicare.
MCPHS University Pharmacy Outreach Program: 1-866-633-1617
The MCPHS University Pharmacy Outreach Program can review your information to find help for your prescription costs. It can also help you understand your Medicare prescription drug plan benefit.
Health Care For All’s Helpline: 1-800-272-4232
Call or fill out the online form. The Helpline is a free service that helps enroll Massachusetts residents into health insurance coverage. In English, Spanish, Portuguese, Haitian Creole, and French.
Medicare: 1-800-MEDICARE
Medicare is a national health insurance program. It is for people who are 65 or older and adults with disabilities.
MassHealth: 1-800-841-2900
The MassHealth program provides comprehensive health insurance — or help paying for private health insurance.
Prescription Advantage: 1-800-243-4636, press 2
Prescription Advantage is a prescription drug insurance plan for all Massachusetts residents age 65 and older, as well as younger people with disabilities who meet income and employment guidelines.