1. Concerns About Quality of Care
If you have concerns about the quality of care and other services you get from a Medicare provider, you can:
- File a complaint (sometimes called a “grievance”).
- Get help from End-Stage Renal Disease (ESRD) Networks and State Survey Agencies if you have complaints (grievances) about your dialysis or kidney transplant care.
Visit Medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to learn more about filing a complaint. TTY users can call 1-877-486-2048.
2. Privacy Rights Violations
If you believe your privacy rights have been violated, you may file a privacy complaint with:
- The Centers for Medicare & Medicaid Services (CMS): Visit Medicare.gov or call 1-800-MEDICARE.
- The U.S. Department of Health and Human Services (HHS), Office for Civil Rights (OCR): Visit HHS.gov/hipaa/filing-a-complaint.
Filing a complaint won’t affect your coverage under Medicare.
3. Discrimination Complaints
If you think you’ve been subjected to discrimination in a CMS program or activity, including issues with getting information in an accessible format, you can file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
- Online:
HHS.gov/civil-rights/filing-a-complaint/complaint-process/index.html - By phone:
Call 1-800-368-1019. TTY users can call 1-800-537-7697. - In writing:
Send information about your complaint to: Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
4. Suspected Fraud
If you suspect Medicare is being charged for a service or supply that you didn’t get, or you don’t know the provider on the claim, call 1-800-MEDICARE.
You can also call 1-800-MEDICARE if you believe your Medicare Number has been used fraudulently.
5. Marketing Violations
Call 1-800-MEDICARE to report any plans or agents that:
- Ask for your personal information over the phone or email
- Call to enroll you in a plan
- Visit you unexpectedly
- Use false information to mislead you
You can also call the Investigations Medicare Drug Integrity Contractor (I-MEDIC) at 1-877-7SAFERX (1-877-772-3379).
6. Medicare Beneficiary Ombudsman
If you have a concern that hasn’t been resolved by Medicare or your plan, ask 1-800-MEDICARE (1-800-633-4227) to submit your inquiry to the Medicare Beneficiary Ombudsman. TTY users can call 1-877-486-2048. Visit Medicare.gov to learn more.
Additional Tips
- Check Your Medicare Summary Notice (MSN): Review your MSNs to be sure you got all the services, supplies, or equipment listed.
- Secure Your Medicare Account: Log into (or create) your secure Medicare account at Medicare.gov to review your Medicare claims.
- Contact Your Local Senior Medicare Patrol (SMP): For more information about Medicare fraud, visit Medicare.gov/fraud or contact your local SMP. Learn more about the SMP and find help in your state by going to smpresource.org or call 1-877-808-2468.
By following these steps, you can effectively file a complaint and protect your rights as a Medicare beneficiary.