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Level 1 Appeals

Level 1 is the start of the claim appeals process. Level 1 appeals differ based on what Part of Medicare you want to appeal.

Description of Medicare Parts

Parts A & B or “Original Medicare” includes Hospital Insurance (Part A) and Supplementary Medical Insurance (Part B). Hospital insurance (Part A) helps pay for inpatient care in a hospital or skilled nursing facility (following a hospital stay), some home health care and hospice care. Medical insurance (Part B) helps pay for doctors’ services and many other medical services and supplies that are not covered by hospital insurance.

Part C is the Medicare Advantage Plan program. Under the Medicare Advantage program (Part C), Medicare Advantage plans are available in many areas. Beneficiaries with Medicare Parts A and B can choose to receive all of their health care services through one of these Medicare Advantage plans under Part C.

Part D is the Medicare Prescription Drug program. Prescription drug coverage (Part D) helps pay for certain medications doctors prescribe for treatment. Beneficiaries obtain prescription drugs through Medicare Prescription Drug Plans.

Content created by Office of Medicare Hearings and Appeals (OMHA)
Content last reviewed on August 5, 2016