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New Medicare beneficiaries’ understanding of the Medicare program

Mary A. Laschober, PhD and Gabrielena Alcala-Levy, MA. Health Policy and Program Administration, BearingPoint, 1676 International Drive, McLean, VA 22102, 703-747-6458, mlaschober@bearingpoint.net

CMS began fielding the monthly Survey of New Medicare Beneficiaries (SNMB) in February 2003 to assess its Initial Enrollment Package, Medicare & You campaign, and other informational materials. This study profiles new eligibles, with emphasis on beneficiary subgroups, with respect to their basic knowledge of Medicare benefits and supplemental insurance options, awareness of initial decision requirements, sources and usefulness of information, and supplemental insurance holdings. The mail-administered SNMB yields approximately 300 completed interviews per month. The cross-sectional sample consists of new Medicare eligibles 65 years old living in the 50 states, DC, and Puerto Rico. It is pre-stratified by M+CO availability, then by resident state and beneficiary characteristics. Frequency and contingency tables were produced for the first six months of data (n=1,901). Statistical significance tests of differences in proportions were conducted to detect variation in subgroup responses. Key findings include: A sizeable number of new eligibles are aware of several important Medicare features (e.g., Medicare does not pay all health care expenses (88%), right to decline Medicare Part B (75%), and ability to purchase a Medigap plan (78%)). Many are also familiar with their IEP package (89%) and Medicare Handbook (82%). However, relatively few are aware of the Medicare HMO option (56%), right to appeal Medicare decisions (58%), coverage of preventive care services (25%), the Medicare Savings Programs (47%), and the six-month Medigap guarantee (40%). Awareness of Medicare’s toll-free number (50%) and website (40%) is also relatively low. Overall, 86 percent of respondents had supplemental insurance when surveyed. However, there is a significant overlap among Medicare HMO enrollees, and those with employer-sponsored coverage, who had a Medigap policy. Some traditionally vulnerable subgroups (racial/ethnic minority beneficiaries, those in poor health, and low-educated individuals) are substantially less likely to report understanding Medicare features, are less able to effectively use information, and had no supplemental insurance when surveyed. Implications of the study strongly suggest room for improving information distribution to a sizeable group new to Medicare. SNMB findings can be used to investigate whether knowledge differences are related to intensity, complexity, or mode of message delivery. Additionally, the findings can be used as benchmarks to assess the early impact of specific or general CMS communication interventions and to aid in intervention design. Differences among beneficiary subgroups signify a continuing need to segment and target Medicare communications, particularly to individuals often in most need of understanding Medicare benefits, rights, and choices.

Learning Objectives:

Keywords: Medicare, Communication Effects

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Medical Care Section Poster Session #1

The 132nd Annual Meeting (November 6-10, 2004) of APHA