The Medicare Beneficiary Ombudsman is a person who reviews complaints (also called “grievances”) and helps resolve them. They make sure information about: your Medicare coverage, your Medicare rights and protections, and how you can get issues resolved is available to all people with Medicare. To contact the Medicare Beneficiary Ombudsman: call 1-800-MEDICARE.
The Medicare Beneficiary Ombudsman shares information with the Secretary of Health and Human Services, Congress, and other organizations about what works well and what doesn’t work well to improve the quality of the services and care you get through Medicare.
The Medicare Beneficiary Ombudsman works with the organizations like State Health Insurance Assistance Program (SHIP) and Quality Improvement Organization (QIO) to help resolve your issues in a timely way.
SHIPs and QIOs provide information and counseling to help you with:
- Your Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance.
- Complaints ("grievances").
- Appeals.
- Problems joining or leaving a Medicare Advantage Plan (Part C) (like an HMO or PPO), or any other Medicare health plan, or Medicare Prescription Drug Plan (Part D).
For more information:
- Visit www.medicare.gov/ombudsman/resources.asp.
- Call your state's QIO or SHIP.
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