Below is a curated directory of official government resources and MediPrimer's own guides, organized by function. Every external link goes to a federal or state .gov website, SHIP (the official State Health Insurance Assistance Program), or NAIC (the National Association of Insurance Commissioners). All phone numbers are official. If you don't see what you're looking for, Getting Help can point you to local assistance.
Get Free, Unbiased Help
Medicare Personal Help Line
1-800-MEDICARE (1-800-633-4227) | TTY 1-877-486-2048 | medicare.gov
Free, official, unbiased support from Medicare specialists. Questions about enrollment, coverage, costs, appeals, or switching plans. Open year-round.
State Health Insurance Assistance Program (SHIP)
1-877-839-2675 | shiphelp.org
Free counseling for Medicare beneficiaries, available in every state. Local advisors help you understand your coverage, compare plans, and file complaints. No sales pressure.
Eldercare Locator
1-800-677-1116 | eldercare.acl.gov
Connects older adults and caregivers to local resources: aging agencies, home-care providers, legal aid, and community programs. Run by the Administration for Community Living.
MediPrimer: Getting Help
mediprimer.org/getting-help.html
An overview of free assistance programs, how to choose a counselor, and what to expect. Includes tips for navigating complex enrollment or appeals situations.
MediPrimer: SHIP Directory
mediprimer.org/ship-directory.html
Find your state's SHIP office and local counselors. Includes phone numbers, hours, and what to bring when you reach out.
Apply for or Enroll in Coverage
Medicare Enrollment
Check eligibility, apply online, and manage your enrollment. Includes Original Medicare (Parts A & B), Part D (prescription drug), and Medigap enrollment.
Social Security (SSDI, Retirement, and Medicare)
1-800-772-1213 | ssa.gov
Apply for Social Security Disability Insurance (SSDI), retirement benefits, and get help with automatic Medicare enrollment. Workers with disabilities at any age and retirees at 62+ start here.
Healthcare.gov (ACA Marketplace)
Apply for ACA Marketplace coverage, check subsidies, and find plans from private insurers. Open Enrollment (typically Nov 1–Jan 15) and special enrollment periods for qualifying events.
State Medicaid Programs
mediprimer.org/state-medicaid.html
Apply for Medicaid or CHIP in your state. Eligibility and enrollment vary significantly by state; this directory has links to each state's portal and phone number.
Insure Kids Now (CHIP)
Find and apply for CHIP coverage for children and teenagers. Includes links to state programs and a live chat helpline.
MediPrimer: Enrollment & Deadlines
mediprimer.org/enrollment.html
Understand Open Enrollment, Special Enrollment Periods, Initial Enrollment Period, and why deadlines matter. Includes consequences of missing deadlines.
MediPrimer: Enrollment Calendar
mediprimer.org/enrollment-calendar.html
Key dates for Medicare, Medicaid, CHIP, and ACA Marketplace enrollment throughout the year at a glance.
Compare & Choose Plans
Medicare Plan Finder
Compare Original Medicare, Medicare Advantage, Medigap, and Part D plans side by side. Shows premiums, deductibles, coverage details, and out-of-pocket costs for your area.
Healthcare.gov Plan Comparison
Compare ACA Marketplace plans by premium, deductible, provider networks, and drug formularies. Shows estimated subsidy eligibility and out-of-pocket maximums.
MediPrimer: Choosing Coverage
mediprimer.org/choosing-coverage.html
A neutral framework for evaluating plans: how to weigh premiums vs. deductibles, in-network vs. out-of-network, and network size. Includes worksheets and common pitfalls.
MediPrimer: Plan Types
mediprimer.org/plan-types.html
What's the difference between Original Medicare, Medicare Advantage, HMO, PPO, and PFFS? This overview explains how each plan type works and what you pay.
MediPrimer: Medigap (Supplemental Insurance)
How Medigap works, which plans cover what, and how to shop for the best rate. Includes enrollment windows and when you have guaranteed-issue rights.
Understand Costs & Get Help Paying
Medicare Cost Finder
Look up specific doctors, hospitals, and providers to see what Medicare will pay and what you might owe. Helps estimate out-of-pocket costs before you enroll.
Benefits.gov Eligibility Screener
Check your eligibility for Medicare Savings Programs (MSP), Extra Help with Part D costs, and other federal assistance programs based on income and resources.
Extra Help (Low-Income Subsidy for Part D)
1-800-MEDICARE (1-800-633-4227) | ssa.gov
If you have limited income and resources, apply for Extra Help to reduce your Part D premiums and out-of-pocket drug costs. Administered by Social Security.
Medicare Savings Programs (State Medicaid)
mediprimer.org/state-medicaid.html
Qualify for help paying Medicare premiums and cost-sharing through your state Medicaid program. Income limits vary by state; apply through Medicaid, not Medicare.
MediPrimer: Understanding Your Costs
Breakdown of premiums, deductibles, copays, coinsurance, and out-of-pocket maximums. Explains how each plan type sets costs and what drives them up or down.
MediPrimer: Getting Help Paying
mediprimer.org/getting-help.html
Overview of federal and state assistance programs: Extra Help, Medicare Savings Programs, Medicaid, CHIP, and charity programs. How to apply and what you'll need.
Check Eligibility
Benefits.gov Eligibility Screener
Answer a short set of questions to find programs you may qualify for, including Medicare assistance, Medicaid, SNAP, housing, and utility programs.
Medicaid Eligibility by State
Medicaid eligibility varies widely by state. Look up your state's income limits, asset limits, and which populations are covered.
Healthcare.gov Eligibility Tool
Check if you qualify for ACA Marketplace coverage, estimate your subsidy, and see if you're eligible for Medicaid or CHIP in your state.
Medicare Eligibility at 65
1-800-MEDICARE (1-800-633-4227) | medicare.gov
Most people become eligible for Medicare automatically at 65 if they have worked at least 40 quarters. Check your eligibility status and enrollment options online.
Social Security Disability Insurance (SSDI)
1-800-772-1213 | ssa.gov
Workers with disabilities at any age can qualify for SSDI, which includes automatic Medicare eligibility after 24 months of benefits. Apply online or by phone.
MediPrimer: Coverage Basics
mediprimer.org/coverage-basics.html
Who qualifies for Medicare, Medicaid, CHIP, and ACA Marketplace coverage. Covers age, disability status, citizenship, immigration status, and income tests.
MediPrimer: Medicaid Eligibility
mediprimer.org/medicaid-eligibility.html
Detailed overview of how Medicaid eligibility works, expansion states vs. non-expansion, and special programs like presumptive eligibility and continuous enrollment.
File a Complaint or Appeal
Medicare Appeals & Complaints
1-800-MEDICARE (1-800-633-4227) | medicare.gov
File an appeal if Medicare or your plan denies a service or payment. Five-level appeal process for Original Medicare; separate process for Medicare Advantage and Part D.
State Insurance Departments
mediprimer.org/insurance-departments.html | naic.org
File a complaint about any health insurance company, Medicare Advantage plan, or Part D plan with your state regulator. Directory of all state departments and their contact info.
Report Fraud or Abuse
1-800-HHS-TIPS (1-800-447-8477) | oig.hhs.gov
Report suspected Medicare fraud, billing errors, or provider abuse to the HHS Office of Inspector General. Confidential hotline available 24/7.
State Health Insurance Assistance Program (SHIP)
1-877-839-2675 | shiphelp.org
Free help navigating appeals, complaints, and coverage disputes. Local SHIP counselors can help you prepare your case and follow up with your plan.
MediPrimer: Your Rights
Overview of your rights as a Medicare or Medicaid member, including the right to appeal denials, request explanations, and file complaints.
MediPrimer: Appeals & Timelines
mediprimer.org/appeals-timelines.html
Step-by-step explanations of the appeals process for each program: Medicare Original, Medicare Advantage, Part D, Medicaid. Includes deadlines and what happens at each stage.
MediPrimer: How Do I…?
Quick answers to common questions: how do I switch plans, appeal a denial, report fraud, change doctors, or request an exception to a coverage rule?
Track Policy & Rules Changes
CMS Newsroom
Official announcements from the Centers for Medicare & Medicaid Services about rule changes, new programs, funding, and policy updates.
Federal Register
Public comments and final rules for Medicare, Medicaid, CHIP, and ACA. Search for specific programs or policies and track rulemaking in real time.
Medicare.gov Updates
Up-to-date rates, deductibles, and premium information for each year. Also tracks deadline changes and new coverage decisions.
MediPrimer: Policy Changes
mediprimer.org/policy-changes.html
Summaries of major rule changes, rate announcements, and new policies affecting Medicare, Medicaid, CHIP, and the ACA Marketplace. Plain-language explanations.
MediPrimer: CMS Updates
mediprimer.org/cms-updates.html
How programs are governed: who makes the rules, the annual rulemaking process, and how policy affects you.
For Professionals
CMS.gov Provider & Industry Resources
Guidance for healthcare providers, health plans, brokers, and navigators on billing, coding, compliance, and program operations.
Medicaid.gov for States & Plans
Technical resources, guidance, and tools for state Medicaid agencies and managed care organizations managing Medicaid and CHIP programs.
MediPrimer: Health-Plan Operations
mediprimer.org/operations.html
Overview for insurance executives and compliance teams on how Medicare Advantage and Medicaid managed care plans operate, report data, and manage risk.
MediPrimer: Providers & Billing
Overview for healthcare providers: how Medicare and Medicaid pay, how to bill correctly, and how plans audit claims and manage networks.
MediPrimer: Brokers & Advisors
For insurance agents and advisors: regulations governing broker compensation, enrollment help, and how to stay compliant while assisting clients.
MediPrimer: Case Managers & Navigators
mediprimer.org/navigators.html
For social workers, case managers, and certified application counselors: how to help members navigate enrollment, coverage, and appeals processes.
MediPrimer: Star Ratings
mediprimer.org/star-ratings.html
How CMS rates Medicare Advantage and Part D plans, what's measured, and how ratings affect plan operations and payments.
MediPrimer: Risk Adjustment & Quality Reporting
mediprimer.org/risk-adjustment.html
How Medicare Advantage risk scores work, why coding accuracy matters, and how plans measure and report quality outcomes.
MediPrimer: Claims, Coding & Billing
mediprimer.org/claims-coding.html
Technical overview for providers and compliance staff: how to code accurately, what Medicare and Medicaid accept, and how to reduce denials.
State Directories
State Medicaid & CHIP Agencies
mediprimer.org/state-medicaid.html
Links to each state's Medicaid and CHIP portal, phone number, and enrollment information. Eligibility and programs vary significantly by state.
State Health Insurance Assistance Program (SHIP)
mediprimer.org/ship-directory.html | shiphelp.org
Local SHIP counselors in every state, US territory, and the District of Columbia. Free, unbiased Medicare help for anyone 65+. Find your local office and phone number.
State Insurance Departments
mediprimer.org/insurance-departments.html | naic.org
File complaints about health insurance companies, Medicare Advantage plans, or Part D plans with your state regulator. Directory and contact info for all states.