This web site was copied prior to January 20, 2005. It is now a Federal record managed by the National Archives and Records Administration. External links, forms, and search boxes may not function within this collection.
Notice of Privacy Practices for the Original
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU
CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW
By law, Medicare is required to protect the privacy of your personal medical
information. Medicare is also required to give you this notice to tell you how
Medicare may use and give out (“disclose”) your personal medical
information held by Medicare.
Medicare must use and give out your personal medical information to
To you or someone who has the legal right to act for you (your
To the Secretary of the Department of Health and Human
Services, if necessary, to make sure your privacy is protected, and
Where required by law.
Medicare has the right to use and give out your personal medical
information to pay for your health care and to operate the Medicare
program. For example:
Medicare Carriers use your personal medical information to pay or
deny your claims, to collect your premiums, to share your benefit
payment with your other insurer(s), or to prepare your Medicare
Medicare may use your personal medical information to make sure
you and other Medicare beneficiaries get quality health care, to
provide customer services to you, to resolve any complaints
you have, or to contact you about research studies.
Medicare may use or give out your personal medical information for the
following purposes under limited circumstances:
To State and other Federal agencies that have the legal right to
receive Medicare data (such as to make sure Medicare is
making proper payments and to assist Federal/State Medicaid
For public health activities (such as reporting disease outbreaks),
For government health care oversight activities (such as fraud and
For judicial and administrative proceedings (such as in response to
a court order),
For law enforcement purposes (such as providing limited
information to locate a missing person),
For research studies that meet all privacy law requirements
(such as research related to the prevention of disease or disability),
To avoid a serious and imminent threat to health or safety,
To contact you about new or changed benefits under Medicare, and
To create a collection of information that can no longer be traced
back to you.
By law, Medicare must have your written permission (an “authorization”) to
use or give out your personal medical information for any purpose that isn’t
set out in this notice. You may take back (“revoke”) your written permission
at any time, except if Medicare has already acted based on your permission.
By law, you have the right to:
See and get a copy of your personal medical information held by
Have your personal medical information amended if you believe that it
is wrong or if information is missing, and Medicare agrees. If
Medicare disagrees, you may have a statement of your disagreement
added to your personal medical information.
Get a listing of those getting your personal medical information from
Medicare. The listing won’t cover your personal medical information
that was given to you or your personal representative, that was given
out to pay for your health care or for Medicare operations, or that was
given out for law enforcement purposes.
Ask Medicare to communicate with you in a different manner or at a
different place (for example, by sending materials to a P.O. Box instead
of your home address).
Ask Medicare to limit how your personal medical information is used
and given out to pay your claims and run the Medicare program.
Please note that Medicare may not be able to agree to your request.
Filing a complaint, if you believe the Original Medicare Plan has violated
these privacy rights. Filing a complaint won’t affect your benefits under
You can also call 1-800-MEDICARE (1-800-633-4227) to get this information.
Ask to speak to a Customer Service Representative about Medicare’s privacy
notice. TTY users should call 1-877-486-2048.
You may file a complaint with the Secretary of the Department of Health and
Human Services. Visit www.hhs.gov/ocr/hipaa or contact the Office for Civil
Rights at 1-866-627-7748. TTY users should call 1-800-537-7697.
By law, Medicare is required to follow the terms in this privacy notice. Medicare has
the right to change the way your personal medical information is used and given out.
If Medicare makes any changes to the way your personal medical information is
used and given out, you will get a new notice by mail within 60 days of the change.
The Notice of Privacy Practices for the Original Medicare Plan became effective
April 14, 2003.