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Medicare Beneficiaries ► Medicare Rights
Medicare Rights
Medicare QIOs were created by Congress in 1984 to protect
the rights of persons with Medicare and to protect the Medicare Trust
Fund. It is the role of the QIO to investigate quality of care concerns
voiced
by Medicare beneficiaries and to assure that Medicare is paying for medically
necessary care in th appropriate healthcare setting. Since 1984,
Medicare QIOs have been protecting four basic Medicare rights.
- You have the right to receive good quality health care that meets established
standards and guidelines. You may exercise this right if you
have standard fee-for-service Medicare, known as Original Medicare
or if you are enrolled in a Medicare Advantage (formerly Medicare+Choice)
plan such as a Health Maintenance Organization (HMO). For more
information, read Your Quality of
Care Concerns.
- You have the right to be admitted to the hospital when it is medically
necessary. This right extends to persons with Original Medicare.
It does not apply if a person is enrolled in a Medicare Advantage
(formerly Medicare+Choice) plan such as a Health Maintenance
Organization (HMO). For more information, read Hospital
Admission.
- You have the right to stay in the hospital until it is medically safe
for you to leave. This right protects you from being discharged
from the hospital too soon. You have this right if you have
Original Medicare or if you are enrolled in a Medicare Advantage
(formerly Medicare+Choice) plan such as a Health Maintenance
Organization (HMO). For more information, read Early
Discharge.
- You may have the right to continue to receive care from a skilled nursing
facility (SNF), comprehensive outpatient rehabilitation facility
(CORF), or home health agency (HHA) if you are enrolled in
a Medicare Advantage (formerly Medicare+Choice) plan and qualify
for services. For more information, read Termination
of Medicare-Covered Services in SNFs, HHAs and CORFs.
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For more information on your Medicare Rights, you
may access the Medicare publication, Your
Medicare Rights and Protections,
if you have
Adobe® Acrobat Reader®. If you don't have Adobe® Acrobat Reader®,
but would like to download it for free, click on the following link: Download
Adobe® Acrobat Reader®
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