What are my appeal rights under Medicare Advantage plans?
You can file an appeal if your plan will not cover a service that you think should be covered. If you believe that waiting for a decision about a service could seriously harm your health, ask, or have your doctor ask, the plan for an expedited decision. If your appeal request qualifies for an expedited decision, Aetna must make a decision and notify you of its decision within 72 hours. Appeal requests that do not qualify for expedited processing will be processed under the Medicare Appeals guidelines and timeframes. See your membership materials for details about your Medicare appeal and grievance rights or visit Medicare Advantage – Appeals and Grievances.
