Medicare: Your Rights

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Transcript: There are many resources to help you navigate Medicare benefits, Medicare complaints, and ensure the quality of care as well as health and safety standards. The State Health Insurance Assistance Program (SHIP) offers free one-on-one assistance for eligible individuals, their families, and their caregivers. SHIP has counselors to help you understand your Medicare coverage and how it works with other benefits you may have. They can help you evaluate your benefits and explore plan options during Medicare Open Enrollment periods. They can offer guidance on your Medicare rights, and help find financial support for prescription medications and other expenses. You can find the nearest SHIP office by visiting www.shiphelp.org. Medicare Beneficiary Ombudsmen (MBO) work with organizations like SHIP to help with Medicare-related complaints, grievances, or appeals. They can help with appeals if Medicare has denied payment, and they can handle requests for information. The MBO can also help if you have issues while joining or leaving a Medicare Advantage plan. You can contact the MBO by calling Medicare and asking a representative to submit your complaint or question to the MBO. The representative will listen to your concerns and provide you with information and support. They may ask you questions to better understand your issue or complaint, so it’s a good idea to be prepared with information about your situation like medical bills or correspondence from your healthcare providers. Once they have all the information, they will assign your case to a MBO who will review your case and contact you to make a plan to resolve your issue. Additionally, Beneficiary and Family-Centered Care Quality Improvement Organizations and State Survey Agencies oversee healthcare facilities, by handling quality of care complaints, and ensuring health and safety standards are met. Beneficiary and Family-Centered Care Quality Improvement Organizations (BFCC-QIO) handle complaints about the quality of care for people with Medicare. They also review appeals if you or your healthcare provider believe that your Medicare coverage is ending too soon while you are in the hospital or another healthcare setting. You can file a complaint if you are unhappy with a doctor, hospital, or other healthcare provider, or if you have concerns about the quality of care, durable medical equipment, or your Medicare plan. You can contact them by visiting www.medicare.gov/contacts. State Survey Agencies oversee healthcare facilities that participate in Medicare and/or Medicaid. They inspect healthcare facilities and investigate complaints to ensure that they meet health and safety standards. If you have concerns about things like abuse, neglect, mistreatment, poor care, not enough staff, unsafe or unsanitary conditions, or dietary problems in a healthcare facility, you can contact the State Survey Agency. You can contact them by visiting www.medicare.gov/contacts. If you would like to submit feedback about your Medicare plan, you can visit Medicare.gov and select “File a complaint” under “Claims and Appeals.” [The screen fades to show a thumbnail of a faded white background of a doctor holding hands with another individual] Deaf. Healthy. DeafHealth. Learn more at www.deafhealthaccess.org. [The screen fades to show a thumbnail of a blue lighthouse] Paf. Patient Advocate Foundation. www.patientadvocate.org.]