Rights and Protections

No matter which plan you have, you have important rights in Medicare. Compared to most private health insurance, Medicare has some of the best consumer protections. Learn more in Your Medicare Rights and Protections, an official guide from the U.S. government. This booklet has important information about:

  • Your right to file a complaint
  • Your right to get health care services that you need
  • Where you can get help with your questions

Fraud and Abuse

The SMP Program can help if you suspect you’ve been a target of Medicare errors, fraud, or abuse. Missouri's SMP is run by Care Connection for Aging Services. To report errors, fraud and abuse:

  1. First, call you plan provider. Discuss any questions you have and try to work out your concerns.  
  2. If you are not comfortable calling your provider or if you are not satisfied with the response you received, your SMP can be reached at 1-888-515-6565. You can contact Care Connection for Aging Services directly to report suspected abuse at 1-888-515-6565 or send e-mail to information@GoAging.org.

Discharge Appeals

If you believe you are being discharged too quickly from a hospital, you can request that the decision be reviewed by the state's Medicare Quality Improvement Organization. In Missouri, Primaris provides this discharge appeals service. If you wish to make an appeal, call Primaris toll-free at (866) 902-1813.

Quality of Care Concerns

If you are troubled by the quality of a Medicare service, call 1-800-Medicare (1-800-633-4227). In Missouri, you will be directed to call Primaris. Experts at Primaris will review your medical records to determine if your care met professional standards. 

Examples of quality of care concerns you might report are:

  • Being given the wrong medication, or a medication to which you are allergic, or medications that interact in a negative way.
  • Not receiving treatment after abnormal test results.
  • Being given the wrong blood when a transfusion is ordered.
  • Sustaining a serious injury resulting from a fall while in a nursing home or hospital.
  • Being improperly evaluated for a problem and because of this you did not receive the treatment you needed.
  • Being given the wrong treatment or treatment that you did not need.
  • Developing bed sores because you were not moved regularly.