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Level 5 Appeals








  
  
    

  
      



If you disagree with your Medicare Appeals Council (Council) Level 4 decision and the amount in controversy is at least $1,840 (2024) (or $2,000 for reconsiderations issued by a Quality Improvement Organization), you may file a civil action in your local Federal District Court. The notice of decision from the Council will give you information about filing a civil action. This is the last level of appeals – Level 5

Please note that your request must be filed with the Federal District Court within 60 days of receiving the Medicare Appeals Council decision.

*Please note that the Office of Medicare Hearings and Appeals is responsible **only** for the Level 3 claims appeals and certain Medicare entitlement appeals and Part B premium appeals. OMHA is not responsible for levels 1, 2, 4, and 5 of the appeals process. OMHA provides additional information on other levels of appeals to help you understand the appeals process in a broad context.*

                    
  


Content created by Office of Medicare Hearings and Appeals (OMHA) Content last reviewed January 3, 2024 Back to top
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