Activities of the Ombudsman
The Office of the Medicare Ombudsman's (OMO) core tasks as mandated by Congress
are to receive complaints, grievances, and requests for information from people
with Medicare; provide help regarding complaints, grievances, and requests for
information and submit an annual report of OMO activities to Congress and the
Secretary of Health & Human Services (HHS) that includes the Ombudsman's
recommendation for improvement in the administration of the Medicare Program.
The following links will help people understand how the Medicare Ombudsman is
working to ensure people with Medicare get the information and help they need to
understand their Medicare options, and to apply their rights and protections.
How the Medicare Beneficiary Ombudsman Works for You
Medicare Modernization Act 2003 - Section 923
As part of the MMA Act of 2003, Section 923, Congress mandated the creation of
the Medicare Beneficiary Ombudsman position to ensure that people with Medicare
get the information and help they need to understand their Medicare options and
to apply their rights to protections. To view Section 923 and the MMA Act in its
entirety, please
click here
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What People with Medicare Need to Know
The Office of the Medicare Ombudsman (OMO) was established in accordance with
Section 923 of the Medicare Modernization Act of 2003. As part of OMO's ongoing
efforts to improve communication, the links listed below will supply people with
Medicare with up-to-date announcements regarding changes in Medicare procedures,
benefits and other processes that may be time-sensitive in nature.
Ask Medicare
- The Ask Medicare
web page provides information, tools and materials to assist caregivers and
their loved ones in making informed healthcare decisions. On the web page you
can also sign up to receive a free Ask Medicare eNewsletter by email every other
month that highlights topics important to caregivers.
MyMedicare.gov
- A free, secure
online service for accessing your Medicare information. This site allows people
with Medicare to register a username and password, then access their personal
Medicare information such as claim status (excluding Part D Claims), order a
duplicate Medicare Summary Notice (MSN), as well as other functions.
Keep It With You: Personal Medical Information Form
Although the "Keep It With You" (KIWY) Personal Medical Information Form was
designed for people who need care during disasters and similar situations, the
tool helps individuals maintain concise personal medical records by listing
medications, medical conditions, and other health related information. It is
important for health care workers to have a simple and reliable way to learn
information about past and new health concerns for people receiving help.
Inquiries and Complaints
This section provides beneficiaries with assistance on understanding and
activating the processes regarding how to file an inquiry, complaint, grievance,
or appeal across different areas of Medicare. In this section, beneficiaries can
access a fact sheet, find contact information to conduct business, and get
answers to most frequently asked questions by Medicare beneficiaries.
General Inquiries about Medicare
How to Contact 1-800 MEDICARE
Frequently Asked Questions
Local Insurance Counseling
State Health Insurance Assistance Program (SHIP) Fact
Sheet
Locate a SHIP by State
Medicare Complaint Processes
Original medicare Plan(Part A & Part B)
1-800 Medicare Billing Questions Fact Sheet
Frequently Asked Questions
Medicare Advantage Plans (Part C)
Medicare Advantage Complaint Process Fact Sheet
Locate Your Plan to File a Complaint
Frequently Asked Questions
Prescription Drug Coverage (Part D)
Prescription Drug Benefit Complaint Process Fact
Sheet
Locate Your Plan to File a Complaint
Frequently Asked Questions
Quality of Care (Quality Improvement Organization (QIO) )
QIO Quality of Care Fact Sheet
Locate a QIO by State
Frequently Asked Questions
Quality of Care (State Survey Agencies)
Quality of Care Complaint Process Fact Sheet
Locate a State Survey Agency by State
Frequently Asked Questions
End Stage Renal Disease (ESRD)
ESRD Complaint Process Fact Sheet
Locate an ESRD Network by State
Frequently Asked Questions
Fraud & Abuse
To Report Fraud & Abuse
Fraud & Abuse Fact Sheet for Part D
Medicare Appeal Processes
Original Medicare Plans
Original Medicare Plan (Part A&B) Appeals Fact Sheet
Frequently Asked Questions
Medicare Advantage Plans
Medicare Advantage Plans (Part C) Appeals Fact Sheet
Locate Your Plan to File an Appeal
Frequently Asked Questions
Medicare Prescription Drug Coverage
Medicare Prescription Drug Coverage (Part D) Fact
Sheet
Locate Your Plan to File an Appeal
Frequently Asked Questions
Other Helpful Resources
Brochures, Fact Sheets, and Other Publications
Coordinating Medicare Benefits with Other Health
Insurance
General Information on Medicaid
Glossary
of Medicare Terms
Helpful Contacts
Medicare
Acronyms
Medicare Card Replacement
Medicare & You Handbook
U.S. Department of Health & Human Services -
Administration on Aging
U.S. Department of Health & Human Services - Office
on Disability
Frequently Asked Questions
Medicare
Social Security Administration