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Medicare Beneficiary Ombudsman (MBO)

Helping to resolve your inquiry or complaint

The MBO helps you with Medicare-related complaints, grievances, and information requests. The MBO makes sure you have information related to your Medicare rights and protections and how you can get your concerns resolved.

On this page:

  • About the MBO
  • Beneficiary Rights and Protections
  • Beneficiaries: What to do if you have an inquiry or complaint
  • Other Helpful Resources
  • Downloads
  • Related Links

About the MBO

In 2003, Congress established the MBO position to assist Medicare beneficiaries with their inquiries, complaints, grievances, appeals, and requests for information. The MBO is charged with supporting CMS’ customer service and administration efforts by receiving and responding to beneficiary and other stakeholder inquiries and complaints, working with partners to provide outreach and education to beneficiaries, and providing recommendations for improving the administration of Medicare. The MBO also provides an annual report to Congress. See the Downloads section of this page for links to the published reports.

Beneficiary Rights and Protections

No matter how you get your Medicare, you have certain rights and protections designed to:

  • Protect you when you get health care
  • Make sure you get the health care services that the law says you can get
  • Protect you against unethical practices
  • Protect your privacy

Rights & Protections for everyone with Medicare

Your rights in Original Medicare

Your rights in a Medicare Advantage Plan or other Medicare health plan

Your rights in a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug Plan (MA-PD)

Beneficiaries: What to do if you have an inquiry or complaint

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 Part D or Medicare Advantage (Part C) 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. Call 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) are state programs that provide free local health insurance counseling to people with Medicare regarding their benefits, coverage, appeals and complaints. Find your local SHIP: https://www.shiptacenter.org/
  4. Contact the MBO. 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 MBO. The MBO will help to ensure that your inquiry is resolved appropriately.

Contact MEDICARE

Medicare Helpful Contacts

Medicare Complaint Form (Part C & D only)

Other Helpful Resources

U.S. Department of Health and Human Services Administration for Community Living

The Administration for Community Living oversees the implementation and coordination of disability programs, policies and special initiatives for persons with disabilities.

U.S. Department of Health and Human Services Administration on Aging

The Administration on Aging provides home and community-based services and opportunities to older persons and their caregivers through programs funded under the Older Americans Act.

Downloads Section

Related Links Section

 

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