YOUR MEDICARE RIGHTS AND PROTECTIONS


Did you know that Medicare has an ombudsman to help you resolve complaints you may have about your healthcare? Congress created the job of Medicare Beneficiary Ombudsman to assist people with Medicare with their inquiries, complaints, grievances, appeals, and requests for information. The Medicare Beneficiary Ombudsman also shares information with Congress, the Secretary of Health and Human Services, and other organizations about what works well and what doesn’t work well to improve the quality of the care you get through Medicare.

If you need help with a Medicare-related inquiry, there are several ways you can get help.

1. Call your plan. If your inquiry is related to your Medicare Advantage (Part C) plan or Medicare Prescription Drug (Part D) plan, contact your plan first using the phone number on your plan member ID card. Your plan is the best resource to resolve plan-related issues.

2. Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. If your concern is related to Original Medicare, or if your plan was unable to resolve your inquiry, contact 1-800-MEDICARE for help.

3. Contact the SHIP. The State Health Insurance Assistance Programs (SHIPs) provide free, high-quality counseling to people with Medicare regarding their benefits, coverage, appeals, and complaints. SHIP counselors are volunteers who often have Medicare themselves, so they know the issues and they’re not trying to sell you anything. Find your local SHIP at https://www.shiptacenter.org/

4. Contact the Medicare Beneficiary Ombudsman. If you have been unable to resolve your concern with your plan or 1-800-MEDICARE, ask a 1-800-MEDICARE representative to submit your complaint or inquiry to the Medicare Beneficiary Ombudsman. The Ombudsman will help to ensure that your inquiry is resolved appropriately.

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