Skip to main content
U.S. flag

An official website of the United States government

Here’s how you know

Dot gov

Official websites use .gov
A .gov website belongs to an official government organization in the United States.

HTTPS

Secure .gov websites use HTTPS
A lock (LockA locked padlock) or https:// means you’ve safely connected to the .gov website. Share sensitive information only on official, secure websites.

  • About HHS
  • Programs & Services
  • Grants & Contracts
  • Laws & Regulations
  • Radical Transparency
  • Big Wins
Breadcrumb
  1. Home
  2. About
  3. Agencies
  4. OMHA
  5. The Appeals Process
  6. Level 4 Appeals
  • Office of Medicare Hearings and Appeals (OMHA)
  • The Appeals Process
    • Level 1 Appeals
    • Level 2 Appeals
    • Level 3 Appeals (OMHA)
    • Level 4 Appeals
    • Level 5 Appeals
    • Legal Authorities
    • Case Processing Manual
  • Filing an Appeal
    • Coverage and Claims Appeals
      • Medicare Beneficiary and Enrollee Appeals and Assistance
      • Escalation Rights
    • Your Right to Representation
    • Appeals Status Lookup
    • Forms
    • Glossary
    • FAQs
  • About OMHA
    • Organizational Chart
    • Workload Information and Statistics
  • Contact OMHA
  • Work for Us
  • Whistleblower Protections and Non-Disclosure Agreements
  • Notice of Non-Discrimination

Level 4 Appeals

If you are not satisfied with your Level 3 decision or dismissal, you may request that the Medicare Appeals Council (Council) review OMHA's decision.

The Council:

  • Conducts the Level 4 appeal, and is
  • Part of the Departmental Appeals Board of the Department of Health and Human Services (HHS), and is
  • Independent of OMHA and its adjudicators.

Note:  A party does not have the right to seek Council review of an OMHA adjudicator's remand to a QIC, dismissal of a request for review of a reconsideration dismissal, or affirmation of a QIC's dismissal of a request for reconsideration.

How to request a Medicare Appeals Council (Council) Review

A written request is required to obtain a Council review.  You may send a letter or file electronically.  For more information on how to file and what case identifying information is required, see the Council website.

Submitting your request

You may mail your request to:

Department of Health and Human Services
Departmental Appeals Board, MS 6127
Medicare Appeals Council
330 Independence Avenue, SW, Room G-644
Washington DC 20201

You may also fax your request for review to (202) 565-0227.

Please note that the Office of Medicare Hearings and Appeals is responsible only for the Level 3 claims appeals and certain Medicare entitlement appeals and Part B premium appeals. OMHA is not responsible for levels 1, 2, 4, and 5 of the appeals process. OMHA provides additional information on other levels of appeals to help you understand the appeals process in a broad context.

Content created by Office of Medicare Hearings and Appeals (OMHA)
Content last reviewed July 3, 2017
Back to top

Subscribe to Email Updates

Receive the latest updates from the Secretary and Press Releases.

Subscribe
  • Contact HHS
  • Careers
  • HHS FAQs
  • Nondiscrimination Notice
  • Press Room
  • HHS Archive
  • Accessibility Statement
  • Privacy Policy
  • Budget/Performance
  • Inspector General
  • Web Site Disclaimers
  • EEO/No Fear Act
  • FOIA
  • The White House
  • USA.gov
  • Vulnerability Disclosure Policy
HHS Logo

HHS Headquarters

200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll Free Call Center: 1-877-696-6775​

Follow HHS

Follow Secretary Kennedy