How to Get Help with Medicare

Do you have general questions about your Medicare coverage or premiums?  Do you have a complaint to file? There are several state and federal resources available to help you with medicare-related issues and questions including State Health Insurance Assistance Programs, the Medicare Beneficiary Ombudsman, and the Medicare helpful contacts website.

State Health Insurance Assistance Programs (SHIPs)

Every state has a State Health Insurance Assistance Program (SHIP). These programs may have different names (names may vary state to state), but the primary services they offer include personalized counseling and assistance to people with Medicare and their families. A SHIP can help you with items such as:

  • Your Medicare questions, including your benefits, coverage, premiums, deductibles, and coinsurance
  • Complaints and appeals
  • Joining or leaving a Medicare Advantage Plan (like an HMO or PPO), any other Medicare health plan, or Medicare Prescription Drug Plan (Part D)

To find your SHIP for Medicare assistance click here.

Medicare Beneficiary Ombudsman

The Medicare Beneficiary Ombudsman can help with Medicare-related complaints, grievances, and information requests. An ombudsman is a “citizen representative” that is appointed to investigate and resolve complaints made by private citizens against government agencies. You will be able to use the Medicare Beneficiary Ombudsman to find out:

  • What you need to know to make health care decisions that are right for you
  • Your Medicare rights and protections
  • How you can get issues resolved

To contact the Ombudsman, you should call 1-800-MEDICARE (1-800-633-4227) and ask the representative to send your inquiry or complaint to the Medicare Beneficiary Ombudsman. The Ombudsman staff helps make sure that your inquiry or complaint is resolved.

Medicare Helpful Contacts

If you are not sure where to start, you can always visit the Medicare helpful contacts website which will allow you to select your state to find resources near you. To do this, follow the suggested steps below:

  • Visit the website: (can we put the URL here)
  • Select Your State
    • Select your specific organization or the topic of interest. Topics of interest include:  Help with my Medicare options and issues
    • Other insurance programs
    • Complaints about my care or services
    • General health and health conditions
    • Claims and billing
    • Healthcare facilities and services in my area
  • The contact information page will list out the organization(s) name, website and contact information to get you started.
  • Click on ‘Find Contact Information’

Utilize the resources above if you have any Medicare related questions or issues. Make sure to have your questions prepared in advance and document your discussions for future reference.

 

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