U.S Code last checked for updates: Nov 07, 2024
§ 1395b–3.
Health insurance advisory service for medicare beneficiaries
(a)
In general
(b)
Outreach elements
The beneficiary assistance program shall provide assistance—
(1)
through operation using local Federal offices that provide information on the medicare program,
(2)
using community outreach programs, and
(3)
using a toll-free telephone information service.
(c)
Assistance provided
The beneficiary assistance program shall provide for information, counseling, and assistance for medicare-eligible individuals with respect to at least the following:
(1)
With respect to the medicare program—
(A)
eligibility,
(B)
benefits (both covered and not covered),
(C)
the process of payment for services,
(D)
rights and process for appeals of determinations,
(E)
other medicare-related entities (such as peer review organizations, fiscal intermediaries, and carriers), and
(F)
recent legislative and administrative changes in the medicare program.
(2)
With respect to the medicaid program—
(A)
eligibility, benefits, and the application process,
(B)
linkages between the medicaid and medicare programs, and
(C)
referral to appropriate State and local agencies involved in the medicaid program.
(3)
With respect to medicare supplemental policies—
(A)
the program under section 1395ss of this title and standards required under such program,
(B)
how to make informed decisions on whether to purchase such policies and on what criteria to use in evaluating different policies,
(C)
appropriate Federal, State, and private agencies that provide information and assistance in obtaining benefits under such policies, and
(D)
other issues deemed appropriate by the Secretary.
The beneficiary assistance program also shall provide such other services as the Secretary deems appropriate to increase beneficiary understanding of, and confidence in, the medicare program and to improve the relationship between beneficiaries and the program.
(d)
Educational material
(e)
Notice to beneficiaries
(f)
Report
(Pub. L. 101–508, title IV, § 4359, Nov. 5, 1990, 104 Stat. 1388–137; Pub. L. 108–173, title IX, § 900(e)(6)(G), Dec. 8, 2003, 117 Stat. 2374.)
cite as: 42 USC 1395b-3