July 24, 2008
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Family Center on Technology and Disability
Medicare, Managed Care and AAC Devices
Funding Augmentative and Alternative Communication (AAC) Devices Through Medicare
The Decision Making and Appeals Process for HMO and Other Medicare+Choice Participants
This booklet describes the managed care program. It provides answers to the most common questions a Medicare beneficiary, family member, service provider or advocate may have regarding the Medicare decision making and appeals steps that apply to AAC device payment claims:
- • What documentation or proof has to be submitted?
• Where should information be sent and who reviews it?
• How is the review conducted (on the record; by telephone; in person)?
• How long will the review take to decide?
• Can I win at this at this decision making or appeal level?
• What do I do next and how long do I have to do it?
• What help is available?
• What can I do if the process does not follow the outline provided here?