CMS Financial Alignment Ombudsman and Beneficiary Counseling Program (ALN 93.634)¶
CMS cooperative agreement program that funds states participating in Medicare-Medicaid Financial Alignment Initiative demonstrations to operate independent ombudsman programs and one-on-one beneficiary counseling services. The primary beneficiaries are dually eligible (Medicare-Medicaid) enrollees; caregivers and authorized representatives may contact the ombudsman on behalf of an enrolled person. One-on-one counseling (via SHIPs and ADRCs) helps enrollees and their representatives understand insurance options. Seven states ran demonstrations through December 2025; the ALN 93.634 grants are in closeout with no new funding.
Two distinct services: (1) Demonstration Ombudsman Program — independent, state-run ombudsmen serve dually eligible enrollees (and their caregivers or authorized representatives acting on the enrollee's behalf) to resolve problems with Medicare-Medicaid integrated care plans; alert CMS, states, and plans to emerging systemic issues. (2) One-on-one beneficiary counseling — SHIPs and ADRCs conduct outreach, education, and individualized assistance on insurance options and enrollment choices. Both services are free to enrollees. No income or asset test for access. FAI demonstrations ended December 31, 2025; ALN 93.634 grants in closeout with no new state awards.
Some details for this program are still being verified. Check the official source for the most current information.
Services¶
Two distinct services: (1) Demonstration Ombudsman Program — independent, state-run ombudsmen serve dually eligible enrollees (and their caregivers or authorized representatives acting on the enrollee's behalf) to resolve problems with Medicare-Medicaid integrated care plans; alert CMS, states, and plans to emerging systemic issues. (2) One-on-one beneficiary counseling — SHIPs and ADRCs conduct outreach, education, and individualized assistance on insurance options and enrollment choices. Both services are free to enrollees. No income or asset test for access. FAI demonstrations ended December 31, 2025; ALN 93.634 grants in closeout with no new state awards.
How to apply¶
Apply online or find more information at the official program page.