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Appeal guide · Medicare

Medicare denials

Medicare denials follow a federally-defined 5-level appeal process. Most beneficiaries stop at level 1. The higher levels, particularly the Independent Review Entity and ALJ, reverse a meaningful share of cases.

What gets denied

  • Skilled nursing facility (SNF) coverage
  • Home health services
  • Durable medical equipment (hospital beds, oxygen, mobility)
  • Hospice eligibility
  • Inpatient vs. observation status
  • Part D drug coverage (separate ladder)

Common denial reasons

  • Plan claims criteria for SNF / home-health not met
  • DME deemed 'not medically necessary' or 'convenience'
  • Inpatient stay reclassified as observation (lower coverage)
  • Drug not on plan formulary or step therapy required

How we approach the appeal

File at level 1 within 60 days. Begin level-2 paperwork immediately on receipt of level-1 denial. The ALJ level (level 3) is where the most complex reversals happen,Medicare provides a federal judge to hear the case by phone.

Filing window

60 days between each appeal level. Level-3 ALJ requires the case value to exceed $190 (2026), multiple denials can be consolidated to meet this threshold.

Typical recovery

$1,000 – $100,000+

Documents we'll ask for
  • · Denial / determination letter
  • · Medicare card
  • · CMS-1696 Appointment of Representative form (we provide)
  • · Treating physician's records
  • · Care plan or facility records

Got a medicare denial?

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This page provides general information about appeal strategy. It is not legal advice. Outcomes depend on documentation, plan terms, and timing.