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Beneficiary Ombudsman

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

Page Last Updated: December 17, 2008

 

 
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