You can file a complaint (also called a "grievance") if you have a concern about the quality of care or other services you get from a Medicare provider. How you file a complaint depends on what your complaint is about.
You have a complaint about:
- A doctor, hospital, or provider
- Your health or drug plan
- Quality of your care
- Your dialysis or kidney transplant care
- Durable medical equipment
What's the difference between a complaint and an appeal?
A grievance is a complaint about the way your Medicare health plan or Medicare drug plan is giving care. For example, you may file a grievance if you have a problem calling the plan or if you're unhappy with the way a staff person at the plan has behaved towards you. However, if you have a complaint about a plan's refusal to cover a service, supply, or prescription, you file an appeal.
Need help filing a complaint?
Contact your State Health Insurance Assistance Program (SHIP) for free, personalized help.
Note
For questions about a specific service you got, look at your Medicare Summary Notice (MSN) or go to MyMedicare.gov. If you disagree with a coverage or payment decision made by Medicare, your Medicare health plan, or your Medicare Prescription Drug Plan, you can file an appeal.
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