Entitlement Appeals

Often the Social Security Administration (SSA) and the Centers for Medicare and Medicaid Services (CMS), the Federal agency that administers the Medicare program, make decisions regarding Medicare benefits and beneficiaries that are not medical in nature and are unrelated to coverage of and payment for medical services and items.

OMHA hears appeals of decisions from the Social Security Administration (SSA) that an applicant is not entitled to be a beneficiary of the Medicare program.  The local SSA office makes the initial decision about whether an applicant is entitled to Medicare benefits and on what terms.  SSA may then conduct a reconsideration of that decision.

If your application for Medicare benefits under any part of the Medicare program is denied, you will receive a notice of your rights to appeal that decision to the Office of Medicare Hearing and Appeals (OMHA).

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