Denied Medicare/Medigap Insurance Claims

Consumers with Medicare or Medigap Supplemental Insurance denied nursing care/hospice care benefits

Medicare Supplemental Insurance or Medicare Advantage policyholders who purchased policies prior to 1992 and have been wrongly denied nursing care benefits, may be entitled to additional compensation.

A leading Pittsburgh law firm is investigating possible class action lawsuits against insurance companies who issued Medicare Supplemental Insurance Policies or Medigap Plans and failed to provide nursing care benefits. Qualified consumers are those who resided in a nursing home for more than one year within the last 3 years and were denied reimbursements for nursing care, managed care or hospice care even though they purchased a supplemental insurance policy (prior to 1992) which included benefits for nursing care.

What classifies a Medicare or Medigap Supplemental Policy?

Most Medicare policies do not cover all health care costs. To cover these costs, a consumer either needs supplemental insurance such as a Medicare Advantage Plan (with Medicare Part A or Part B) or a Medigap Policy.

The Medicare Advantage Plan may cover managed care such as hospice care or nursing home stay, extra days in the hospital, Preferred Provider (PPO) care, medical equipment, and medication

A Medigap plan is a supplemental health insurance policy sold by private insurance companies to help pay for services not provided in the original Medicare Policy.

Some Medicare/Medigap Insurance carriers includes: American Association for Retired People (AARP), American Family Insurance, Blue Cross/Blue Shield, Banker's Life, Golden Rule Insurance Company, Mutual of Omaha, Provident Life, Physicians Mutual, State Farm Insurance, Union Fidelity Insurance, United American Insurance Co.

Medicare/Medigap/Medicaid News and Information

Effective January 1, 2006, the Centers for Medicare and Medicaid Services (CMS) will reduce the appeal process from 1000 days to 300 days. Claimants will now have a smaller window to appeal denied Medicare claims and complete the lengthy process.

Medicare insurance premiums will increase 13%, raising premiums to $88 a month. Medicare patients, many who rely on Social Security checks, will also be spending more to enroll in the new drug prescription program. [THE SEATTLE TIMES]

Lawmakers plan to reduce Medicare physician payments by 4.3% in 2006. Many physicians have said they will stop treating Medicare beneficiaries if Congress does not act to reverse the cut. [ASHBURY PARK PRESS]

Medicare patients with immune disorders and immunodeficiencies are having a hard time finding access to affordable life-saving intravenous immune globulin treatments (IVIG). Many doctor's offices have stopped providing specialty drug treatments due to Medicare reimbursement cuts. With the new drug policy going into effect January 2006, consumers worry that only the wealthy will be able to afford the drugs they need. [SAN DIEGO UNION-TRIBUNE]

Register your Medicare/Medigap Claim Complaint

If you or a loved one has suffered from financial hardship due to denied Medicare or Medigap insurance claims, you may qualify for damages or remedies that may be awarded in a possible class action lawsuit. Please fill in our form on the right to submit your complaint.

At, it is our goal to keep you informed about important legal cases and settlements. We are dedicated to helping you resolve your legal complaints.

Last updated January 23 2008

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