Notice of Medicare Non-Coverage (NOMNC): what it means and what to do

Says a covered service — a nursing-home or rehab stay, home health, or outpatient therapy — is ending on a specific date.

A Notice of Medicare Non-Coverage says a covered service — a nursing home or rehab stay, home health, or outpatient therapy — is ending on a specific date. It's not a denial of a claim; it's a notice that coverage is about to stop.

This is one of the two notices with a same-day fast-appeal option: you can ask an outside reviewer (the QIO, not the plan) to look at the decision before services actually end, and get an answer by the next business day.rule42 CFR 422.626

This notice is required to be delivered at least two days before the service actually ends — not sprung on the family the same day. If it wasn't, that's worth mentioning to the QIO when you call; it doesn't extend your own deadline, but it's a real fact about how the process was supposed to work.

The fast-appeal decision comes from an outside reviewer, not the plan or the facility — that's the whole point of the window being so short. It's designed to get an independent answer before the family has to decide whether to pay out of pocket or lose coverage.

Call the QIO the same day. Say you want to file a fast appeal (expedited determination) of a coverage-ending decision. Give the QIO the date services are set to end, from the NOMNC. Ask them to request the detailed explanation from the plan or facility on your behalf.

Note the deadline. Request the fast appeal by the date and time on the form — no later than noon of the day before your services end.

Know what happens next. The QIO decides by close of business the day after it has all the information it needs. The plan must send a detailed notice explaining why coverage is ending.

You can still appeal through the standard reconsideration process within 65 days of the notice. If the facility bills you for the days, that bill is appealable too.