During your hospital stay, you should receive a written copy of An Important Message from Medicare. This form explains your rights as a Medicare patient during a hospitalization. It includes information about your right to file an appeal. It gives you the steps to file an appeal.

You may think you are not ready to leave the hospital. Follow the instructions on the Important Message from Medicare. Call the HQSI Medicare Beneficiary Helpline at 1-800-624-4557 no later than your planned discharge date and before you leave the hospital to file an appeal. (TTY users should call 1-800-752-8420.) This service is free to people with Medicare.

Helpline hours are from 8:30 am to 5:00 pm, Monday through Friday. You can leave a message after hours. An HQSI associate will get back to you as soon as possible, but no later than the next day.

Before You File an Appeal

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• Talk with your doctor. Your doctor may explain why you no longer require care in the hospital. He/she may discuss other kinds of care you can get. You may be able to get help at a nursing home or through home health care.

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• Make sure you have a written notice that explains why you are being discharged. The notice should also show the date that your Medicare coverage ends.

Making an Appeal

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• Call HQSI as soon as possible, but no later than your planned discharge date and before you leave the hospital, if you want to file an appeal. Once you speak to someone at HQSI or leave a message, your appeal has begun.

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• HQSI will review your case. We will notify you, your doctor, and the hospital about the decision first by phone, followed by written notification of the decision.

Outcome of an Appeal

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• If HQSI does not agree that you should leave the hospital, Medicare will continue to pay for your stay. You will only be responsible for your deductible, coinsurance, and non-covered items.

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• If HQSI does agree that you should leave the hospital, the hospital may begin billing you at noon on the day after HQSI’s decision. You do not have to leave the hospital. However, Medicare will not continue to pay.

If You Miss the Deadline to Appeal

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• You have other appeal rights. You can ask HQSI or your Medicare Advantage Plan (if you belong to one) for a review of your care:

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• If you have traditional Medicare, call HQSI at 1-800-624-4557

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• If you belong to a Medicare Advantage Plan, call your plan