How long do I have to appeal a Medicare denial?

On Original Medicare, 120 days from the date on the Medicare Summary Notice that shows the denial. In a Medicare Advantage or Part D plan, the first-level deadline is set out in the plan's denial notice — generally around 60–65 days. The notice in your hand always states its own deadline; that date governs.

How do I actually file the appeal?

Original Medicare: follow the instructions on the Medicare Summary Notice — circle the item, sign, attach anything supportive from your doctor, and send it to the address shown (a Redetermination Request form is also available). Advantage/Part D: request a reconsideration in writing to the plan, per its denial letter. In both cases, a supporting letter from your doctor is the single most useful attachment.

Where can I get free help with a Medicare appeal?

Your State Health Insurance Assistance Program (SHIP) provides free one-on-one help with appeals in every state — shiphelp.org or 1-800-MEDICARE for a referral. For denials of ongoing care in a hospital or facility, the notice you receive names a Quality Improvement Organization with its own fast-track process.

Quick Answer · Free to Do

Appealing a Medicare denial, step by step

First, the fact that changes the mood: a large share of first-level appeals succeed — denials are frequently coding errors and missing paperwork, not final verdicts. Appealing is free, you don't need a lawyer for the first levels, and the clock is generous but real. Here's the short version of the machine.

Zuriel KinlockLicensed Health Insurance Agent Updated August 26, 2026 Denials are often reversible

Required disclosures: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is educational, not a recommendation of any specific plan.

The first level, both flavors

Original Medicare: the MSN is the appeal form

Your quarterly Medicare Summary Notice lists what was denied and why. You have 120 days from its date: circle the denied item, sign where indicated, attach supporting records — a doctor's letter saying why the service was medically necessary does the heaviest lifting — and mail it to the address on the notice. That's a "redetermination," and it's reviewed by a contractor who wasn't part of the first decision.

Advantage or Part D: reconsideration from the plan

The plan's denial letter is your instruction sheet — it names the deadline (generally about 60–65 days), the address, and whether you can file online. Ask your doctor for a supporting statement, and if the service is urgent, request an expedited decision — plans must fast-track when a delay could harm you.

If the first level says no

There are five levels, each independent of the last, and persistence genuinely pays. Nothing about filing costs money, and free help exists: SHIP (shiphelp.org) walks people through appeals every day. For "your covered hospital/rehab stay is ending" notices, the fast-track appeal through the named Quality Improvement Organization has same-days deadlines — act on those immediately.

Honest scope note: appeals run between you, your doctor, and Medicare or your plan — an agent isn't a party to them. Where an agent does help is the pattern behind repeated denials: if your plan fights you on the care you actually use, that's a plan-fit problem, and the next enrollment window is where it gets fixed.

Denials keep coming back?

Bring the pattern to a plan review. If the plan is the problem, the fix is a better-fitting plan at the next window — and we'll check your doctors carry over first.

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Important: Smooth Health Solutions is not connected with or endorsed by the United States government or the federal Medicare program. We do not offer every plan available in your area. Currently we represent 0–78 organizations which offer 0–2,613 products in your area. The exact number of organizations and products depends on your ZIP code, county, and plan year. Please contact Medicare.gov, 1‑800‑MEDICARE (1‑800‑633‑4227; TTY 1‑877‑486‑2048), or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. This page is for general education, reflects 2026 amounts published by CMS, and is not a complete description of benefits or a recommendation of any specific plan. Enrollment cannot be guaranteed until an application is accepted by the applicable insurance company or program.