Waiting for the Wrong Answer 1-800-Medicare

AsclepiosYour Weekly Medicare Consumer Advocacy Update Waiting for the Wrong Answer September 11, 2008 • Volume 8, Issue 37 There are two basic problems with 1-800-Medicare, the toll-free consumer hotline for people with Medicare: (1) It takes too long to talk to a live person, and (2) When a live person does get on the line, they often give out incorrect or incomprehensible information. The consequences of this shoddy service are numerous, but in general, bad advice on a Medicare problem means consumers pay much more out of pocket than they should and they do not receive the health care they need. Today, Senator Gordon Smith, Republican of Oregon, called Kerry Weems, acting administrator of the Centers for Medicare & Medicaid Services, and John Curtis, CEO of Vangent, the contractor running 1-800-Medicare, before the Senate Special Committee on Aging to see if improvements could be made to the hotline’s service. Senator Smith’s staff had spent hundreds of hours cataloguing the bad information given out by 1-800-Medicare operators and demonstrated that during peak hours, the typical caller waits much longer than the 8.5 minute average hold time touted by CMS. At the hearing, the Medicare Rights Center and other advocacy groups testified that the misinformation from 1-800-Medicare continues, as do frequent half-hour waits for a live customer service representative. Weems promised the committee that average wait times for the hotline would be lower when the annual enrollment period for the Part D drug benefit begins this fall, and new initiatives would reduce the number of people holding for a customer service representative. However, little was said that would give consumers confidence that much-needed improvements in operator training will be forthcoming, or that the scripts used by operators will be jargon-free and provide callers with the help they need in language they can understand. One suggestion in this regard—that CMS employ the expertise of State Health Insurance Assistance Programs (SHIPs) and counselors at the Medicare Rights Center to develop consumer-friendly scripts and effective training programs for hotline operators—is worth pursuing. People with Medicare deserve accurate and understandable information about the increasingly complex coverage choices they face. CMS should make an effective consumer hotline the centerpiece of a renewed focus on helping their customer base—people with Medicare. Medical Record “Another client from New York called 1-800-Medicare to enquire about enrolling in Medicare Part B. She is 70 years old, enrolled in Part A, and has employer-sponsored insurance. The customer service representative told the client that she would not be able to enroll in Part B until the following January, that coverage would not begin until July, and that she would be subject to a late enrollment penalty. All of the information provided by the representative was wrong. After calling the Medicare Rights Center and being given accurate information, the client went to her local Social Security Office to begin the process of enrolling in Medicare Part B.” (Testimony to Senate Special Committee on Aging, Medicare Rights Center, September 2008) “Feedback from advocates, community partners, and Congress is welcome and incorporated on a regular basis in order to improve and sustain our call center operations. CMS will continue to work with our partners in the coming months to ensure that 1-800-Medicare maintains its place as a valuable resource for all people with Medicare.” (Testimony of CMS Acting Administrator Kerry Weems before the Senate Special Committee on Aging, September 2008)