·Federal program
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.
What it offers
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.
Questions that decide eligibility
GiveCare prepares the questions; the program makes the decision. Bring these to the call or the application:
- 01
Does the person receiving care live in California, Illinois, Massachusetts, Michigan, Ohio, Rhode Island, or South Carolina?
Residency is usually the first thing a program checks.
- 02
Does the VA disability rating meet the program’s minimum (our record lists null%)?
- 03
Do the work hours meet the minimum (our record lists null hours)?
- 04
Is there a caregiver-specific department, coordinator, or support line? Ask for it by name.
Many agencies have one that isn’t advertised on the website.
- 05
What documents do you need from us to start an application?
- 06
Is there a waitlist right now, and how long is it?