Medicare Appeals: Helping Your Clients Through the Process


For most seniors, Medicare is the core component of their health care coverage. Producers and advisors who work the retirement market or have older clients are likely to be called upon to help these clients navigate what can be a confusing and complicated system. One area of Medicare that remains little understood by the average consumer is the appeals process and the rights of Medicare recipients to ask for reconsideration of a decision by Medicare or their Medicare Advantage or Part D plan.

Those professionals who can provide knowledgeable and practical advice regarding Medicare appeals will not only be able to help current clients, but also enhance and grow their practice in this field.

Learning Objectives

Upon conclusion of this course, students will have a solid understanding of

  • how Medicare claims are submitted and reviewed
  • the standards against which Medicare cost and coverage decisions are initially made
  • the situations and circumstances that commonly cause negative Medicare decisions
  • how to appeal negative Medicare decisions for Original Medicare, Medicare Advantage and Medicare Part D plan
  • how to appeal the imposition of an income-related monthly adjustment amount (IRMAA) on Medicare Part B and/or Part D premiums
  • how to appeal the premium penalties for late Medicare enrollments

Designed For

Life insurance producers; financial advisors

Find this course for your license:

License or Certification