Medicare Ombudsman - Helping Advocate On Your Behalf

By: Thomas Wright
Published: Thursday, October 04 2018
Last Updated: 5 years ago

Throughout the course of history, the ombudsman has been known as an advocate, liaison and even protector of those negotiating with a complex and massive entity in the past and up to the present time. Even now, the ombudsman is tasked with gathering necessary and updated information to an individual that can help make a transaction easier to comprehend and navigate throughout.

Among some of the most notable ombudsman programs are the properly vetted civilian go betweens that have authorized access to area commanders in regards to the status of troop or ship movements in the modern era, by which then the ombudsman can pass onto the dependents sans the obvious classified details.

This is also the case with the Medicare Beneficiary Ombudsman (MBO) and Centers for Medicare and Medicaid Service (CMS) Ombudsman programs within the Medicare Patient Advocate Services program. These programs were established in 2003 to advocate for the applicants and beneficiaries throughout the process.

What Is A Medicare Ombudsman?

Both the CMS ombudsman and Medicare ombudsman are both under the Medicare and Medicaid umbrellas. They are tasked with the following per the CMS homepage. Duties include but are not limited to:

  • Protecting a beneficiary when they receive health care.
  • Ensuring a beneficiary receives the care they are entitled to by law.
  • Protecting them from unethical practices.
  • Protecting a beneficiary's privacy. The MBO even provides reports to Congress annually for review and analysis by lawmakers.

Who Provides The Services You Need?

Centers for Medicare and Medicaid Services (CMS) are the umbrella that covers both the Medicare and Medicaid programs respectfully. For those that have internet access, they can narrow their search for services fairly easy at the official site of Medicare. From there, a beneficiary can begin their application process or even find the following within their given location:

  • General and long-term care hospitals
  • Nursing homes
  • Home Health And Supply services
  • Dialysis facilities
  • Inpatient rehabilitation facilities

What Information Is Made Available?

Through the Medicare website, there is a tremendous amount of information that is available for a beneficiary such as medical equipment and health & drug plans among many items. A CMS ombudsman or medicare ombudsman is very highly recommended to assist in these matters if one is not comfortable with the website or internet altogether and has further questions.

Medicare provides a primary phone number with customer service representatives on hand to assist in connecting them to the correct area or to even locate an ombudsman at 1-800-MEDICARE or 1-800-633-4227. TTY users are directed to the phone number 1-800-486-2048.

How It Works

Whether eligible to receive Medicare benefits or not, one is encouraged to apply by any means to ultimately determine what they can attain or even if they qualify.

Again this can be done through the official Medicare website or having a Medicare Ombudsman or CMS Ombudsman assist through the Medicare patient advocate services program if not comfortable with applying online or on their own. The 1-800-MEDICARE would then be considered the best place to start in this instance to locate a nearby office or even set up an appointment with an ombudsman to a beneficiary's home to provide assistance with the application and then the ensuing processing if necessary.

Following the application being submitted, the beneficiary is given what they are eligible for, and then instructions on how to proceed with the Medicare patient advocate services program. Here, the ombudsman is on hand to ensure everything is correct and the beneficiary is handled properly during the program.

How To Contact The Medicare Beneficiary Ombudsman

Contacting an ombudsman is most likely the wisest and safest course to follow if just starting out with the application process for Medicare altogether. A CMS ombudsman can also aid in saving a lot of time and money in the long run by making it all easier to navigate throughout, just as an example. Again a local ombudsman office can be found at the website or by simply dialing 1-800-MEDICARE to be directed or connected by a customer service representative.

The ombudsman program, as always in times beforehand, is there for the single purpose of ensuring that a person's business transactions with an entity are proceeding in a safe and timely manner. They are on-hand for the beneficiary and a handy resource overall when navigating through such a vast program like Medicare.

The best part is that ombudsman and Medicare facilities are both easy to locate across the United States; as the Medicare program, itself continually expands in attempt to counter the growing needs of a rapidly aging population. Thus the enactment of the Ombudsman program by Congress in 2003 to aid and assist the beneficiary so that the individual can ultimately decide what is best for themselves while hopefully experiencing a smooth transaction during the process.