Consumer health assistance programs, also known as ombudsman programs, educate patients and consumers about their health care rights and responsibilities, including insurance coverage, and identify, investigate and resolve complaints about health care coverage and services. The programs consist of three main types:
- State health insurance assistance programs that provide information, counseling and assistance on a wide range of Medicare, Medicaid and Medigap matters.
- Medicaid ombudsman programs to educate current and potential Medicaid beneficiaries about managed care plans.
- General health care ombudsman programs, created by states in response to the increasing complexities of both public and private health insurance.
- The project team established collaborative networks among the three main types of consumer health assistance programs, serving nearly 1,000 such programs nationwide.
- Partnership staff provided technical assistance services to strengthen consumer health assistance programs in all three networks and to stimulate cross-network communication and information sharing.
- The project team established the Health Assistance Partnership to help state health insurance assistance programs enhance their capacity to serve Medicare beneficiaries and their caregivers. Staff provided education and technical assistance through:
- User-friendly materials about Medicare and related health coverage.
- Annual conferences.
- A weekly electronic newsletter on timely issues and important topics.
- A Web site featuring numerous resources and tools.
The Robert Wood Johnson Foundation (RWJF) supported this unsolicited project with a grant of $5,359,435 to the Families USA Foundation, the organization's charitable entity.
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