Programs that provide a hotline, website or other mechanisms that persons with Medicare and the public at large can use to report health care providers or beneficiaries who make false statements or representations which result in an unauthorized payment by the Medicare program to themselves or another. Also included are organizations that accept and investigate reports about fraudulent entities that misrepresent themselves as approved Medicare Part D Prescription Drug Plans; approved plans that use aggressive marketing tactics, discriminate against a beneficiary (e.g., prevent them from signing up for a plan based on their age, health status, race or income), entice beneficiaries to enroll in a more costly plan than they require, or erroneously charge beneficiaries for medication provided under the plan they have selected; or pharmacies that provide a different drug than the one prescribed by the physician. Examples of Medicare fraud include incorrect reporting of diagnoses or procedures to maximize payments; billing for services, medical supplies, equipment or medications not provided; misrepresentation of the dates and descriptions of services or medications provided, the identity of the recipient or the individual furnishing services; and billing for noncovered or nonchargeable services as covered items. Also included are programs that provide consumer education, counseling and assistance with the objective of helping people identify instances of fraud.

Programs that offer information and guidance for older adults and people with disabilities regarding their health insurance options with the objective of empowering them to make informed choices. Included is information about benefits covered (and not covered); the payment process; the rights of beneficiaries; the process for eligibility determinations, coverage denials and appeals; consumer safeguards; and options for filling the gap in Medicare coverage (Medigap supplement insurance). Also available is information relating to an individual's eligibility for benefits and assistance with evaluating their options and enrolling in a Medicare plan (A, B, C, and/or D) that will best meet their needs. These programs also address coordination of benefits when beneficiaries have other types of health insurance in addition to Medicare (e.g. Medicaid, employer coverage or retiree insurance) and provide counseling and assistance regarding the subsidies that are available to low income beneficiaries enrolled in the Part D Prescription Drug Benefit (which help pay for Part D premiums and reduce the cost of prescriptions at the pharmacy) and the Medicare Savings Programs which help pay for Medicare out-of-pocket costs. They may also provide information about Medicaid and the linkages between the two programs, referrals to appropriate state and local agencies involved in the Medicaid program, information about other Medicare-related entities (such as peer review organizations, Medicare-approved prescription drug plans, Medicare administrative contractors), and assistance in completing related Medicare insurance forms.

Entities that are responsible for hearing appeals and resolving grievances that have been filed by people who have applied for or are receiving benefits through the Medicare program (including the Part D Prescription Drug Benefit and the subsidies that are available to low income beneficiaries enrolled in the Part D Benefit) and believe that an adverse action has been wrongly taken, including coverage denials, discrimination, violation of rights and/or failure to take an appropriate action.

Programs that maintain information about community resources that are appropriate for a specific target group or human services sector (for example, youth programs or addiction services) and which link individuals who are in need of specialized services with appropriate resources and/or which provide information about community agencies and organizations that offer specialized services.

Individuals who are generally between the ages of 18 and 25 depending on the ages that specific programs use for qualification.

Individuals, age 65 and older or younger than age 65 with a disability, who have hospital, medical and prescription drug insurance through the federally-funded Medicare program.