Fact Sheet

Background: Medicare, enacted in 1965, originally provided health care coverage to Americans 65 or older. The program expanded in 1972 to include Americans living with disabilities. Medicare was administered by the Social Security Administration until 1977 when it was transferred to the Health Care Financing Administration within the Department of Health and Human Services. The Health Care Financing Administration was renamed and restructured into the Centers for Medicare & Medicaid Services, which is working to help beneficiaries and their caregivers become more active participants in their health care decisions.

Since 1998, people with Medicare have had access to a number of information resources to help them with their health plan choices. These include the Medicare & You handbook, mailed annually to beneficiary households; a toll-free telephone line, 1-800-MEDICARE (1-800-633-4227); and a consumer Internet site, www.medicare.gov. However, CMS research continues to show that few beneficiaries understand their coverage options or costs associated with Medicare, Medigap, or Medicare+Choice. In fact, over half of all Medicare beneficiaries surveyed said that they know little to nothing about the availability and benefits of Medicare+Choice plans.

In an effort to help seniors and disabled Americans who rely on Medicare, CMS is expanding and enhancing these resources to provide more detailed information to help them make more informed choices about their health plan options.

"Helping You Help Yourself"

The Bush Administration has been working to clarify the information available to nearly 40 million people with Medicare and their family members and to make it much easier to find. An enhanced educational and advertising campaign to enable each beneficiary to make informed decisions about important health care matters, and to be an active participant his or her own health care is being launched with a multi-media advertising campaign. The Theme of the campaign is "helping you help yourself."

The advertising campaign includes television, radio, print and internet ads in English and Spanish . The ads are designed to tell people with Medicare that they can get answers to questions about their options in Medicare, health plans and coverage, nursing homes, Medigap plans, or ways to stay healthy, by calling 1-800-MEDICARE (1-800-633-4227, TTY/TDD 1-877-486-2048), going to www.medicare.gov or the Medicare & You 2002 handbook.

The $30 million ad campaign is directed primarily to people with Medicare, and secondarily to their caregivers, or others who help with their health care decisions, such as family and friends. About 70 percent of the media placement are national TV ads. About 30 percent of the campaign are print ads, Spanish language television and radio, and Internet advertising. CMS projects that about 95 percent of all Medicare beneficiaries will see the ads at least 30 times during the two month campaign, from October 15 through the week of December 9, 2001.

The Medicare Toll-Free Telephone Line

CMS has enhanced 1-800-MEDICARE (1-800-633-4227) to serve beneficiaries 24 hours a day, seven days a week. One thousand new customer service representatives have been added to ensure that callers get all of their questions answered. The telephone line also provides pre-recorded information which can help callers request information about health plans in their area, copies of the Medicare & You handbook in English or Spanish or answers to the most frequently asked questions.

Customer service representatives are available to help answer general Medicare questions and questions related to Medicare health plan choices, handle requests for plan comparison information and plan disenrollment forms and make referrals to other information sources where appropriate. The service accommodates both English and Spanish-speaking callers and offers a TTY line (telecommunications device for the speech and hearing impaired): 1-877-486-2048.

The Medicare Internet Site

CMS maintains a web site of information for beneficiaries and other interested individuals: www.medicare.gov. The site has won awards for clarity, accessibility, and ease of use including a gold award in a competition among both private and government web sites. Launched in 1998, www.medicare.gov receives millions of hits each month. Information on the site currently includes the Medicare & You handbook, a continually updated calendar of Medicare & You activities occurring across the country, lists of resources for beneficiaries and people who work with beneficiaries, and general information about Medicare.

The website hosts nine separate databases to help individuals, including Medicare Health Plan Compare, Nursing Home Compare, Dialysis Facility Compare, Medigap Compare, which all contain detailed comparisons about facilities and choices available county-by-county. Other information databases include a list of Medicare participating physicians, medical equipment suppliers, a local Medicare events calendar and information about available prescription drug assistance programs. And a new tool to help people with Medicare make more informed choices about all their health plan options is the Medicare Personal Health Plan Finder.

Medicare Health Plan Compare Improvements

Since 1998, CMS has reported on the assessments of beneficiaries enrolled in Medicare managed care plans to help other beneficiaries make their selections through the Medicare Consumer Assessment of Health Plans Surveys (CAHPS) at www.medicare.gov. This survey was created in partnership with the Agency for Healthcare Research and Quality.

For the first time, CMS is now reporting on the experiences and assessments of beneficiaries enrolled in Original Medicare. CMS has also improved the validity of the information collected on each Medicare+Choice plan by including the views of beneficiaries who chose to leave their plan and adding them to the views of the traditional population of those choosing to stay. About 12 percent of beneficiaries in 2000 chose to leave their health plans. (This number does not include beneficiaries who were affected by a Medicare+Choice health plan withdrawal.)

CMS is holding itself to the same standards of reporting on beneficiary assessments that it requires for Medicare+Choice organizations. By reporting this information, CMS intends to facilitate comparison between these two health care delivery systems. The results of the surveys for Original Medicare, and for managed care plans have been adjusted to account for true differences in beneficiary experiences rather than differences in demographics of the beneficiaries in each system.

The data reported was collected during the fall of 2000. The surveys contained specific questions about a beneficiary's health care experiences including the ability to get needed care, to get care quickly, to communicate with the doctor, and how a beneficiary would rate the health care provided and the health plan. Surveys were in English and Spanish. Of beneficiaries surveyed, the survey was completed by 83 percent of people managed care plans, by 55 percent of those who chose to leave their health plan, and by 64 percent of those enrolled in Original Medicare.

The survey found neither delivery system outdid the other. Respondents said managed care plans rated higher for communicating with one's doctor; Original Medicare rated higher on getting the care that was needed.

The Other www.medicare.gov Information Databases:

Medicare Personal Health Plan Finder walks people with Medicare through a series of questions to help them make choices about the various health plan choices that are available to them in their communities. Based on the answers, the tool computes the relative out of pocket expenses of all Medicare health plan options, including Medicare+Choice plans, Medigap plans and Original Medicare. The tool is entirely confidential. No record of the "conversation" is kept.

Nursing Home Compare contains detailed quality information about individual nursing homes across the country.

Medigap Compare explains supplemental insurance and compares the 10 different insurance plans that are available to most people with Medicare.

Dialysis Compare compares the services offered at dialysis centers across the country.

Prescription Drug Assistance Programs are compiled in the most extensive, nationally complete list anywhere. Beneficiaries can check the programs that offer free or discounted rates for medicines and the qualifications necessary to take advantage of those programs. A list of contact names and phone numbers is supplied, along with contact information to help fill out applications.

The Medicare & You Handbook.

The Medicare & You handbook is mailed annually in the fall to all Medicare beneficiary households and each month to new Medicare enrollees. The handbook includes an overview of Medicare, Part A and B coverage, including preventive health services, copays, premiums, rights and protections, and other basic information of interest to beneficiaries. The Medicare & You 2002 handbook answers basic questions about Medicare, Medicare+Choice, Medigap, and more.

2001 Medicare+Choice Local Plan Information

In Fall 2001, for year 2002, Medicare beneficiaries will receive a supplemental mailing of area-specific Medicare+Choice plan comparison information, as CMS works to inform seniors about their Medicare health plan options, and respond to questions raised in a recent lawsuit.

A booklet with local Medicare+Choice plan information will be mailed to each Medicare household in zip codes where at least one Medicare + Choice plan is available. The Medicare+Choice local plan information booklets will be mailed through the United States Postal Service no later than October 15, 2001.

The new mailing supplements the mailing of the Medicare & You 2002 handbook, which is currently being received by millions of Medicare beneficiaries across the country. There are 26 different editions of both Medicare & You 2002 that include local information and the supplemental booklet will reflect that local information.

Regional Education About Choices in Health Campaigns (REACH)

Each of CMS' 10 regional offices and coalitions of local partner organizations are conducting educational and outreach efforts at the regional, state and local levels. Many of these activities are targeted to meet the needs of specific groups such as African-Americans; American Indians; Latinos; Asian and Pacific Islanders; caregivers; beneficiaries with disabilities who are eligible for both Medicare and Medicaid; and rural beneficiaries. Part of this outreach includes public presentations and exhibits at local health fairs and other health-related events. Information about these activities is available on the Local Medicare Events Calendar on www.medicare.gov.

REACH works face to face with beneficiaries in town hall meetings, special educational seminars, and individual counseling sessions. Local and national partners in this effort include the Leadership Council of Aging Organizations, the American Association of Health Plans, AARP, the National Council of Senior Citizens, the National Rural Health association, the National Council on Aging, the National Hispanic Council on Aging, the National Caucus and Center on Black Aged, the Older Women's League, the Social Security Administration, the US. Administration on Aging, State Health Insurance Assistance Programs.