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Mountain Views-News Saturday November 22, 2025 
1010 
Mountain Views-News Saturday November 22, 2025 
HOW TO APPEAL A MEDICARE COVERAGE DENIAL 

Dear Savvy Senior,
What steps do I need to take to appeal a denied 
Medicare claim? Frustrated Retiree 
Dear Frustrated, 

If you disagree with a coverage or payment 
decision made by Medicare, you can appeal, 
and you’ll be happy to know that many appeals 
are successful, so it’s definitely worth 
your time. 


But before going that route, talk with the doctor, hospital and Medicare to see if you can spot the 
problem and resubmit the claim. Many denials are caused by simple billing code errors by the doctor’s 
office or hospital. If, however, that doesn’t fix the problem, here’s how you appeal. 

Original Medicare Appeals 

If you have original Medicare, start with your quarterly Medicare Summary Notice (MSN). This statement 
will list all the services, supplies and equipment billed to Medicare for your medical treatment 
and will tell you why a claim was denied. You can also check your Medicare claims early online at 
MyMedicare.gov, or by calling Medicare at 800-633-4227. 

There are five levels of appeals for original Medicare, although you can initiate a “fast appeal” if you’re 
getting services from a hospital, skilled nursing facility, home health agency, outpatient rehabilitation 
facility or hospice, and the service is ending. 

You have 120 days after receiving the MSN to request a “redetermination” by a Medicare contractor, 
who reviews the claim. Circle the items you’re disputing on the MSN, provide a written explanation 
of why you believe the denial should be reversed, and include any supporting documents like a letter 
from the doctor or hospital explaining why the charge should be covered. Then send it to the address 
on the form. 

You can also use the Medicare Redetermination Form. See CMS.gov/Medicare/CMS-Forms/CMSForms/
downloads/CMS20027.pdf to download it or call 800-633-4227 to request a copy by mail. 

The contractor will usually decide within 60 days after receiving your request. If your request is denied, 
you can request for “reconsideration” from a different claims reviewer and submit additional 
evidence. 

A denial at this level ends the matter, unless the charges in dispute are at least $190 in 2025. In that 
case, you can request a hearing with an administrative law judge. The hearing is usually held by videoconference 
or teleconference. 

If you have to go to the next level, you can appeal to the Medicare Appeals Council. Then, for claims 
of at least $1,900 in 2025, the final level of appeals is judicial review in U.S. District Court. 

Advantage and Part D Appeals 

If you’re enrolled in a Medicare Advantage health plan or Part D prescription drug plan the appeals 
process is slightly different. With these plans you have only 65 days to initiate an appeal. And in both 
cases, you must start by appealing directly to the private insurance plan, rather than to Medicare. 

If you think that your plan’s refusal is jeopardizing your health, you can ask for an expedited (fast) 
request, where a Part D insurer must respond within 24 hours, and Medicare Advantage health plan 
must provide an answer within 72 hours. 

If you disagree with your plan’s decision, you can file an appeal, which like original Medicare, has five 
levels. If you disagree with a decision made at any level, you can appeal to the next level. 

For more information, along with step-by-step procedures on how to appeal Medicare, go to Medicare.
gov/claims-appeals and click on “File an appeal.” Also make sure to keep photocopies and records 
of all communication with Medicare, whether written or oral, concerning your denial. 

Need Help? 

If you need help filing an appeal, you can appoint a representative (a relative, friend, advocate, attorney 
or someone else you trust) to help you. Or contact your State Health Insurance Assistance 
Program (SHIP), which has counselors that can file your appeal for you for free. To locate your local 
SHIP, go to ShipHelp.org or call 877-839-2675. 

Send your questions or comments to questions@savvysenior.org, or to Savvy Senior, P.O. Box 5443, 
Norman, OK 73070. 

WINTER WELLNESS AND COMMUNITY 
STRENGTH FOR LOCAL SENIORS 

Winter in Sierra Madre, Pasadena, Arcadia, and 
Altadena is usually a quieter season marked by 
cooler mornings and familiar routines. This year, 
however, many seniors in our foothill communities 
continue to feel the impact of the Januaryfires that caused loss, disruption, and uncertaintyfor neighbors and friends. 

For those who were displaced or lost their homes, 
winter can feel especially challenging. Maintaining 
health during this time is important, even 
amid change. Dressing in layers, staying warm 
indoors, and keeping regular meals and hydration 
can support both physical and emotional 
well-being. Gentle movement, such as stretching 
or short walks when possible, may help relieve 
tension and improve sleep. 


Safety remains a priority, particularly during rainy weather. Slippery sidewalks and uneven surfaces 
can increase fall risks, especially in areas affected by cleanup or rebuilding. Taking extra time, wearing 
supportive footwear, and using mobility aids when needed can help prevent injury. 

Emotional wellness is just as important as physical health. It is normal to feel grief, anxiety, or fatigue 
after experiencing loss. Staying connected—through phone calls, community gatherings, faith groups, 
or senior programs—can provide comfort and reassurance. Local libraries, senior centers, and community 
organizations continue to offer resources, activities, and a welcoming place to connect. 

For those fortunate to be in their homes, this season offers an opportunity to check in on neighbors, 
offer a listening ear, or lend a helping hand. Small gestures of kindness strengthen the resilience that 
defines our communities. 

As recovery continues, may this winter be a time of care, compassion, and quiet strength. Together, 
seniors across Sierra Madre, Pasadena, Arcadia, and Altadena can move forward—supported, remembered, 
and never alone. 

SENIOR HAPPENINGS 

HAPPY BIRTHDAY! DECEMBER Birthdays* 


Maria Decker, Nancy Dorn, Prudence Levine, Pat Karamitros, Joan 
Hufnagel, Mary Alice Cervera, Carol Horejsi, Helen Reese, Levon 
Yapoujian, Toni Buckner, Lottie Bugl, Sheila Wohler, Nan Murphy,
Eleanor Hensel, Sylvia Curl, Elizabeth Levie, Gayle Licher, CindyBarran, Melissa Stute, Hanna Jungbauer, Sheila Woehler.
To add your name to this distinguished list, please call the paper 
at 626.355.2737. YEAR of birth not required 

OUT TO PASTOR 

A Weekly Religion Column by Rev. James Snyder 

ANOTHER CHRISTMAS DOWN THE 
CHIMNEY 


If I have counted correctly, this is my 74th Christmas. Believe me, Ido not remember all of them. The only thing is how much money I 
spent on all of those Christmases. 

I know Christmas is filled with rituals. As a young person, I grew up on rituals. Our best 
ritual was on Christmas. 

For instance, the day before Christmas, my father would get a real Christmas tree. On 
Christmas Eve, we would all gather to decorate it. Then, on New Year’s Day, we would 
take down the decorations, and my father would move the tree outside to the backyard. 
Our backyard was filled with Christmas trees. 

The day before Christmas, my mother and I would go Christmas shopping from early 
morning until late afternoon. She knew every shop and exactly what to buy in each. She 
worked on that list for months and was excited to receive all the gifts on it. 

I remember one Christmas, after a full day of shopping, our car was packed with presents. 
I don’t know how much my mother spent, but it must’ve been a lot. 

On our way home, my mother remembered something she had forgotten. 

She turned around and went back to a store for Christmas cards she had forgotten. We 
both went in, and my mother bought about 20 cards. As we left, she sighed and said,
"Son, it’s been a busy day—I’m glad it’s over. I can’t wait to get home." I agreed. 

We would take these Christmas presents home, and when my siblings and I went to 
bed, my dad and mom would wrap all the gifts and put them under the tree. 

As we approached the car, I noticed one of the back doors was not fully closed. 

“Mom,” I said, “did we leave the back car door open?” 

Mother looked and said, “We sure did not leave any door open.” 

When we went into the store for the Christmas cards, the car was filled with all kinds of 
Christmas presents we spent all day collecting. 

When we got to the car and opened the door, the inside was empty. All our Christmas 
shopping for the day had disappeared. My mother looked inside the car and could not 
believe what she saw. Or, maybe I should say she couldn’t believe what she wasn’t seeing. 

Suddenly, my mother sighed, and tears ran down her cheeks. She looked at me and said,
“Oh, what are we going to do?” It was too late to shop again, the stores closed early, and 
shopping time was over. 

My mother stood just staring into that car for what felt like forever. I could feel her grief 
hanging heavily between us. I didn’t know what to do. I felt helpless, wishing I could 
comfort her, but no words seemed right. Someone broke into our car and stole all our 
Christmas presents, leaving us with nothing but shock and a deep, hollow ache. 

On our way home, my mother was relatively quiet. Usually, she’s quite the chatterer, but 
today she hardly spoke at all. 

We got home, walked into the living room, and saw the Christmas tree waiting to be 
decorated. Dad greeted us and said, “Where’s all the Christmas presents?” 

Without saying anything, my mother walked in and sat down, and was quiet for a few 
moments. Then she looked at my father and said, “Someone stole all our Christmas 
presents while we were in the last store.” 

My father just stared at her, shook his head, and said quietly, “What are we to do now?” 

After a relatively quiet dinner that night, we went into the living room and began 
decorating the Christmas tree. No one talked as usual; we just put together all the 
decorations. 

That Christmas really stands out in my mind because it was the only one with no presents 
under the tree. On Christmas morning, we woke up and sat around the tree as 
usual, but there were no Christmas presents under the tree. 

That was the strangest Christmas our family ever had. 

I thought it was strange that no one in our family ever mentioned that Christmas over 
the years. I guess I’m the only one who actually mentioned it. We all think of it, I’m sure. 
But it was one of the worst Christmas days we ever had as a family. 

We celebrated Christmas as usual, and Mother had a wonderful Christmas dinner for 
us. We sat around the table trying to sing Christmas carols. It was hard, but we decided 
to move forward and celebrate our family rather than dwell on our missing Christmas 
gifts. 

No matter how difficult the Christmases have been since that time, none of them has 
equaled the sadness of that Christmas. 

Reflecting on that Christmas recently, an encouraging verse of scripture came to mymind. 

“Why art thou cast down, O my soul? and why art thou disquieted within me? hope 
thou in God: for I shall yet praise him, who is the health of my countenance, and myGod” (Psalms 42:11). 

Not everything turns out the way we plan. I haven’t had a Christmas like this, but there 
have been times when I thought everything was going the wrong way. It’s times like this 
that I need to focus not on what’s going wrong but on God. My faith in God gets me 
through every problem no matter how difficult. 

Dr. James L. Snyder lives in Ocala, FL with the Gracious Mistress of the Parsonage. 
Telephone 1-352-216-3025, e-mail jamessnyder51@gmail.com, website www.jamessnyderministries.
com. 

Mountain Views News 80 W Sierra Madre Blvd. No. 327 Sierra Madre, Ca. 91024 Office: 626.355.2737 Fax: 626.609.3285 Email: editor@mtnviewsnews.com Website: www.mtnviewsnews.com