Guides · Last reviewed October 14, 2026

How to appeal a Medicare denial

Medicare Advantage members have 65 days from the plan's denial notice to ask for a reconsideration. In Original Medicare, file by the date printed on your Medicare Summary Notice, which is generally 120 days after you receive it.

Medicare Advantage (Part C)

• File a reconsideration with your plan within 65 days of the initial denial notice.
• The plan generally decides within 30 days for care you haven't received, 60 days for payment, and 72 hours for a fast appeal.
• If the plan still denies, the case can move to an independent review entity.

Original Medicare

• File a redetermination request by the date on your Medicare Summary Notice (MSN).
• The Medicare contractor generally decides within 60 days.
• If you miss the deadline, you can still file late with a good reason.

Free help

Your State Health Insurance Assistance Program (SHIP) offers free, unbiased Medicare counseling. A letter from your doctor explaining why the care is needed strengthens any appeal.

Common questions

Sources

• Medicare.gov: Appeals in Medicare health plans
• Medicare.gov: Appeals in Original Medicare

Billmira is a self-help information tool, not a law firm, and this isn't legal or medical advice. Rules change and plans differ; check the official sources above and your own documents.