{"id":251664,"date":"2017-06-02T00:00:00","date_gmt":"2017-06-02T07:00:00","guid":{"rendered":"https:\/\/sdnews.com\/guest-editorial-how-to-file-a-complaint-against-your-medicare-drug-or-health-plan\/"},"modified":"2017-06-02T00:00:00","modified_gmt":"2017-06-02T07:00:00","slug":"guest-editorial-how-to-file-a-complaint-against-your-medicare-drug-or-health-plan","status":"publish","type":"post","link":"https:\/\/test.sdnews.com\/es\/guest-editorial-how-to-file-a-complaint-against-your-medicare-drug-or-health-plan\/","title":{"rendered":"Editorial invitado: \u00bfC\u00f3mo presentar una queja contra su plan de salud o medicamentos de Medicare?"},"content":{"rendered":"<p>por Greg Dill<\/p>\n<p>Having practiced pharmacy for many years, I often find myself talking to people about their Medicare prescription drug, or Part D, plans.<\/p>\n<p>People with Part D usually share their thoughts about a favorite pharmacy or pharmacist, or how their plan offers medicines at affordable prices. Sometimes they report problems with a Part D plan, ranging from the cost of drugs to difficulty in getting a specific medication their doctor prescribed.<!--more--><\/p>\n<p>A first step to correcting problems is always to contact your drug plan (contact information is on the back of your drug card). A call to the plan usually will resolve your issue. If that doesn\u2019t work, you can file a complaint.<\/p>\n<p>You can do that by calling 1-800-MEDICARE or going online at <a href=\"https:\/\/www.medicare.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare.gov<\/a>. Complaints can be made against Part D drug plans as well as Part C health plans, also known as Medicare Advantage plans.<\/p>\n<p>The online <u>Medicare Complaint Form<\/u> is easy to use. Medicare takes the information you send and directs it to your plan. Then we follow up and monitor how well the plan resolves your complaint.<\/p>\n<p>To find the complaint form, go to <a href=\"https:\/\/www.medicare.gov\/\" target=\"_blank\" rel=\"noopener noreferrer\">Medicare.gov<\/a> and locate the blue box near the top of the page that says \u201cClaims &amp; Appeals.\u201d Place your cursor over that box until a dropdown menu appears and click on \u201cfile a complaint.\u201d When the next page comes up, click on \u201cYour health or drug plan.\u201d<\/p>\n<p>You can also lodge a complaint by calling or writing to your plan. Your complaint could involve a problem with customer service, difficulty in getting access to a specialist, being given the wrong drug, or being given drugs that interact in a negative way.<\/p>\n<p>If you file a complaint about your Part D drug plan, certain requirements apply:<\/p>\n<ul>\n<li>You must file your complaint within 60 days from the date of the event that led to the complaint.<\/li>\n<li>You must be notified of the decision generally no later than 30 days after the plan gets the complaint.<\/li>\n<li>If your complaint relates to a plan\u2019s refusal to make a fast coverage determination\u00a0or redetermination and you haven\u2019t purchased or gotten the drug, the plan must give you a decision no later than 24 hours after it gets the complaint.<\/li>\n<\/ul>\n<p>In addition, you can make a complaint if you have a concern about the quality of care or other services you get from a Medicare provider. This includes doctors, hospitals, or other medical providers; your dialysis or kidney transplant care; or a Medicare-certified supplier of durable medical equipment such as wheelchairs, walkers, and oxygen equipment.<\/p>\n<p>How you file a complaint depends on what your complaint is about. For more information, go to <a href=\"https:\/\/www.medicare.gov\/claims-and-appeals\/file-a-complaint\/complaint.html\" target=\"_blank\" rel=\"noopener noreferrer\">bit.ly\/2nomS0c<\/a>.<\/p>\n<p>As a Medicare beneficiary, you also have certain appeal rights. What&#8217;s the difference between a complaint and an appeal?<\/p>\n<p>A complaint is generally about the quality of care you got or are getting. For example, you may file a complaint if you have a problem contacting your plan or if you&#8217;re unhappy with how a staff person at the plan treated you.<img decoding=\"async\" class=\"alignright size-medium wp-image-29160 lazyload\" data-src=\"https:\/\/sduptownnews.com\/wp-content\/uploads\/2017\/05\/web-Greg-Dill-225x300.jpeg\" alt=\"Guest Editorial: How to file a complaint against your Medicare drug or health plan?\" width=\"225\" height=\"300\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" style=\"--smush-placeholder-width: 225px; --smush-placeholder-aspect-ratio: 225\/300;\" \/><\/p>\n<p>However, if you have an issue with a plan&#8217;s refusal to pay for a service, supply, or prescription, you file an appeal.<\/p>\n<p>For more information on appeals, take a look at your \u201cMedicare &amp; You\u201d handbook, mailed each fall to every Medicare household in the country.<\/p>\n<p>Or go online at <a href=\"https:\/\/www.medicare.gov\/claims-and-appeals\/file-an-appeal\/appeals.html\" target=\"_blank\" rel=\"noopener noreferrer\">bit.ly\/1Tykniv<\/a>.<\/p>\n<p><em>\u2014Greg Dill is Medicare\u2019s regional administrator for Arizona, California, Hawaii, Nevada and the Pacific Territories. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).<\/em><\/p>","protected":false},"excerpt":{"rendered":"<p>By Greg Dill Having practiced pharmacy for many years, I often find myself talking to people about their Medicare prescription drug, or Part D, plans. People with Part D usually share their thoughts about a favorite pharmacy or pharmacist, or how their plan offers medicines at affordable prices. Sometimes they report problems with a Part [&hellip;]<\/p>","protected":false},"author":1056,"featured_media":251665,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_seopress_robots_primary_cat":"11555","_seopress_titles_title":"Guest Editorial: How to file a complaint against your Medicare drug or health plan?","_seopress_titles_desc":"","_seopress_robots_index":"","jnews-multi-image_gallery":[],"jnews_single_post":[],"jnews_primary_category":[],"jnews_social_meta":[],"jnews_override_counter":[],"footnotes":""},"categories":[11551,11552,11555],"tags":[],"class_list":["post-251664","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","category-opinion","category-uptown-news"],"_links":{"self":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts\/251664","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/users\/1056"}],"replies":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/comments?post=251664"}],"version-history":[{"count":0,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/posts\/251664\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/media\/251665"}],"wp:attachment":[{"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/media?parent=251664"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/categories?post=251664"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/test.sdnews.com\/es\/wp-json\/wp\/v2\/tags?post=251664"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}