Not Covered

These denials mean Medicare has determined the service falls outside your plan’s coverage. Appeal prospects vary widely depending on whether the exclusion is absolute or based on specific circumstances.

• Medicare Benefit Limit Reached: What to Do Next
  Medicare says you have reached the maximum covered days or dollar amount for a service. Learn about benefit periods, lifetime reserve days, and your remaining options.
• Medicare Denied a Free Preventive Service
  Medicare denied or charged you for a preventive service. Learn which screenings are covered, why a charge may apply, and how to check the billing.
• Medicare Denied Claim: Covered Under Different Part
  Medicare denied your claim because the service should be billed to a different part of Medicare (A, B, C, or D). Learn why this happens and how to get it resolved.
• Medicare Denied Claim: Wrong Care Setting
  Medicare denied your claim because the service was provided in the wrong care setting. Learn about place-of-service requirements, observation status, and how to appeal.
• Medicare Denied Your DME — Appeal Guide & Checklist
  Medicare denied your DME — usually a missing written order, face-to-face visit note, or supplier problem. Appeal checklist + what to ask your doctor.
• Medicare Drug Plan Won't Cover Your Medication
  Your Part D plan turned down the drug your doctor prescribed. Ask your prescriber to send the plan a supporting statement — that starts a 72-hour clock.
• Medicare Says Another Insurance Should Pay First
  Medicare says another insurer should pay first. Learn how to check payer order, correct insurance records, and protect your claim appeal deadline.
• Medicare Says This Service Is Not Covered
  Medicare denied your claim because the service is not covered under your plan. Learn why this happens, whether you have appeal rights, and what to do about the bill.