Get help with your rights & protections
If you feel your rights have been violated, you can contact these offices and programs for help:
- The Medicare Beneficiary Ombudsman
- The Competitive Acquisition Ombudsman (CAO)
- Your State Health Insurance Assistance Program (SHIP)
- The Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO)
- Your State Survey Agency
The Medicare Beneficiary Ombudsman
The Medicare Beneficiary Ombudsman helps you and your representatives with questions and complaints. They make sure information is available to help you:
- Make health care decisions that are right for you.
- Understand your Medicare rights and protections.
If you’ve called 1-800-MEDICARE (1-800-633-4227) with a question or complaint about Medicare but still need help, ask the 1-800-MEDICARE representative to send your question or complaint to the Medicare Beneficiary Ombudsman. You can also provide feedback to the Ombudsman to help improve your experiences.
The Competitive Acquisition Ombudsman (CAO)
The Competitive Acquisition Ombudsman (CAO) helps resolve your Medicare complaints (and those from suppliers in competitive bidding areas) about certain:
- Durable medical equipment
Whenever you have a complaint about equipment or supplies covered by the Competitive Bidding Program , you should first contact your supplier so they can address the issue. If you still need help after contacting your supplier, call 1-800-MEDICARE.
Need help after calling 1-800-MEDICARE?
Ask the representative to send your question or complaint to the CAO. The CAO responds to individual and supplier questions or issues, and helps make sure all Medicare complaints are resolved.
State Health Insurance Assistance Program (SHIP)
SHIPs are state programs that get money from the federal government to give local health insurance counseling to people with Medicare. SHIPs aren’t connected to any insurance company or health plan. They provide free, personalized counseling to you and your family to help with these and other Medicare questions:
- Your Medicare rights
- Billing problems
- Complaints about your medical care or treatment
- How Medicare works with other insurance
- Finding help paying for your health care costs
Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO)
The BFCC-QIOs are committed to helping you get the care you need with Medicare. They review Medicare complaints and monitor your quality of care to improve the effectiveness, efficiency, economy, and quality of health care services. They can help you with:
- Filing appeals
- Complaints (grievances)
- Quality of care reviews
- Medical necessity reviews
State Survey Agency
State Survey Agencies oversee health care facilities that participate in Medicare and Medicaid. They inspect health care facilities and investigate complaints to ensure these facilities meet health and safety standards. Contact your State Survey Agency if:
- You have a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home.
- You’re concerned about the health care, treatment, or services that you or another person got or didn’t get in a health care setting.
Your State Survey Agency can also help with things like:
- Poor care
- Not enough staff
- Unsafe or unsanitary conditions
- Dietary problems
Contact your State Survey Agency for more information.