Federal agency ยท Centers for Medicare & Medicaid Services
Medicare Beneficiary Ombudsman
A federal office that helps with Medicare complaints and information requests that your plan or 1-800-MEDICARE has not resolved. You reach it by asking a 1-800-MEDICARE representative to send it on.
Know before you go
Congress created this position in 2003 to help with complaints, grievances, appeals and information requests. It is a last stop after your plan and 1-800-MEDICARE, not a first call. The page does not say it can decide your appeal or order a plan to pay, so keep your own appeal deadline.
- Cost
- Not stated. The page lists no fee.
- Where
- Nationwide
- How to start
- Contact your plan first if it is a Medicare Advantage or drug plan problem. If that fails, call 1-800-633-4227 and ask the representative to submit your complaint to the Medicare Beneficiary Ombudsman.
- Phone
- 1-800-633-4227, as printed on the provider's page
- Have ready
- Your plan's answer or denial; The dates and names from earlier calls; Your Medicare number
Where this comes from
- Provider
- Centers for Medicare & Medicaid Services
- Source we read
- https://www.cms.gov/center/special-topic/ombudsman/medicare-beneficiary-ombudsman-home
- Date we read it
- . This is not a fresh check.
- Date the provider printed
- Not displayed
- What we checked
- We read the provider's public page. We have not verified availability, eligibility or outcomes for any individual.
Other starting points
- Program or service
Beneficiary and Family Centered Care Quality Improvement Organizations: find yours
The Medicare contractors that handle fast appeals when hospital or other care is ending too soon, and complaints about the quality of care. Each state is assigned to one of two organizations.
From Centers for Medicare & Medicaid Services
- Program or service
California Department of Managed Health Care: Independent Medical Review
California's regulator for managed care plans reviews denials of medical services, emergency payment and experimental treatment through Independent Medical Review. One form starts either a review or a consumer complaint.
From California Department of Managed Health Care
- Program or service
Center for Medicare Advocacy self-help materials
Downloadable self-help toolkits for Medicare denials involving home health care, outpatient therapy and skilled nursing facility care, from a nonprofit law organization. The page describes materials, not a helpline.
From Center for Medicare Advocacy