Where to turn when a letter isn't enough
Explaining the rule and drafting the request gets most cases moving. Sometimes a case goes past what a letter can fix — Social Security has no fixed deadline to decide, or your case has reached a formal hearing level. Here's exactly who to call for each situation, and what to say.
Free help, nationally
Every state has a free, unbiased Medicare counseling program (SHIP), and the Medicare Rights Center runs enrollment casework specifically. 1-800-MEDICARE and your local Social Security field office are both free to call.
Situations
The 60-day deadline to request reconsideration has passed
Social Security's own 60-day window (65 days from the notice date, with the standard 5-day mailing presumption) to request reconsideration has passed with no request recorded.
- Ask whether a late reconsideration request can still be accepted for good cause, and explain specifically why the request is late.
Good cause for late filing is a real, intended part of this process, not a technicality — a specific, honest explanation of what happened is what a late request needs.
Your case has reached a formal hearing level
From here on, your case is heard by an Administrative Law Judge, the Medicare Appeals Council, or a federal court — a more formal process where getting help from an attorney or advocate becomes worth strongly considering.
- Ask whether they take Medicare entitlement/enrollment hearing-level cases, and whether a free or low-cost consultation is available.
The Medicare Rights Center's own enrollment casework is well-regarded specifically for this kind of case.
CaseWhy Appeals is an independent product of CaseWhy LLC, not affiliated with or endorsed by Medicare, CMS, or the Social Security Administration. Nothing here is legal advice. No referral fees; the directories linked above are free, independent resources.