What do I need to know to request a Medicare hearing with an Administrative Law Judge (ALJ)?
You have the right to appeal any issue not decided entirely in your favor regarding your Medicare eligibility, enrollment, premium, or coverage of items or services under Part A & B, Part C, or Part D of the Medicare program. You can request a hearing at Level 3 if you are dissatisfied with the decisions made at Level 2 of the appeals process. You will also have to meet the amount in controversy (AIC) requirement. The AIC is the value of your claim. In 2010, the AIC must be $130 or more for an ALJ hearing at Level 3 of the Medicare appeals process. At each level, you will receive written instructions on how to continue to the next level of appeal if you wish to do so.
