A Medicare Advantage plan’s denial of post-acute rehabilitation or skilled nursing care is not necessarily final. Recent federal investigations found high denial rates for certain types of post-acute care, but plans overturned a substantial share of denials when patients appealed. It's important to understand why these denials occur and the practical steps for challenging them, including requesting the denial in writing, gathering supporting medical records, asking a doctor or facility to document medical necessity, requesting an expedited appeal when appropriate, and seeking free assistance through the State Health Insurance Assistance Program.
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