Prepare for a Medicare plan service call

Before the call

Decide whether you need an explanation, an account correction, a coverage decision, review of a denied service or prescription, help with customer service, or instructions for an appeal or complaint.

During the call

Ask for:

1. the representative's name or identification;
2. a call reference number;
3. a plain-language explanation;
4. the document or rule supporting the answer;
5. the next action;
6. who is responsible; and
7. the deadline or expected response date.

Repeat the answer back in your own words before the call ends.

Appeal or complaint?

Medicare explains that an appeal generally addresses a refusal to cover or pay for a service, supply or prescription. A complaint, also called a grievance, generally addresses the quality of care or the way a plan is providing service.

After the call

Record the date, time, number called, representative, reference number, answer, promised action and deadline. A reference number documents the contact; it does not prove the issue was resolved.

Protect private information

Do not post Medicare numbers, medical details, account credentials or claim information in public comments or ordinary social messages. Confirm the required permission if another person is helping.