Decision Tools

Know Your Medicare Rights

Tell us what's happening — we'll tell you exactly what protections apply, what the timeframes are, and what to do next. No sales pitch. No guessing.

In Development

This tool is being built.

The Know Your Rights tool will cover 12 key situations — denied claims, losing coverage, Medigap application rights, surprise bills, prescription denials, and more. Each situation returns a plain-English summary of your rights, specific timeframes, and what to do next.

Situations this tool will cover

  • Denied a claim — appeal rights and timeframes
  • Losing employer, Medicaid, or COBRA coverage — SEP and guaranteed issue
  • Doctor leaving your plan — continuity of care rights
  • Medigap application denied — guaranteed issue windows and state birthday rules
  • Surprise bill or balance billing — No Surprises Act protections
  • Nursing home or skilled nursing — discharge appeal rights
  • Home health denial — ABN rights and what to do
  • Prescription denied — formulary exception and step therapy override
  • Plan changing benefits mid-year — what's protected, what's not
  • Turning 65 — guaranteed issue Medigap rights during Initial Enrollment
  • Leaving Medicare Advantage — 12-month trial right and guaranteed issue
  • IRMAA appeal — life-changing event exceptions
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