Description

Medicare is health insurance for people age 65 or older. Beneficiaries are first eligible to sign up for Medicare three months before they turn 65 and eligible to get Medicare earlier if they have a disability, End-Stage Renal Disease (ESRD), or ALS (also called Lou Gehrig’s disease). Medicare.gov provides information and resources for beneficiaries. The recently redesigned “Get Started with Medicare” section of Medicare.gov helps new customers find the information they need to decide about their coverage, including what Medicare is, the parts of Medicare, how to sign up, costs, understanding choices, and how to use the coverage. The getting started service includes a mailed enrollment package and a letter to encourage people to choose the coverage that best meets their needs. CMS partners with the Social Security Administration to send personalized emails to these customers with important information they need to know during their first year enrolled in Medicare. This year, the agency piloted a free “concierge service” to offer more in-depth assistance to new customers calling 1-800-Medicare.

Why this service was designated

Over 63 million people are enrolled in Medicare insurance. CMS customer research shows that the “New to Medicare” customers do not have as smooth an experience with Medicare Services as existing customers and may need extra support. Those joining the Medicare program are overwhelmed by the information available to them (from both the government and private sector) and are uncertain about what steps they need to take. Medicare enrollment is becoming even more complicated as a larger portion of the population continues to work beyond age 65 when Medicare enrollment begins for most people.

Description

12.2 million consumers were actively enrolled in Marketplace coverage in August 2021, and many more have gone through the journey to coverage over the years, including those who also come to the Marketplace, apply for coverage, and based on their results, are eligible for other coverage programs such as Medicaid and the Children’s Health Insurance Program (CHIP). The eligibility notice is a key touchpoint of consumer journey to Marketplace coverage. It communicates the type(s) of coverage consumers may be eligible to enroll in, the availability of financial help to lower the costs of their premiums or out of pocket expenses, providing deadlines and important next steps for how to enroll if eligible, communicating additional information the program needs by a later date to confirm their results if some information is pending, and ensures consumers understand their rights and how to appeal the eligibility decision.

Why this service was designated

Redesigning the eligibility notice provided after application submission and before enrollment impacts millions of consumers annually who apply for, renew, and update their coverage on an ongoing basis and helps better serve customer service channels that assist consumers through the end-to-end enrollment journey remotely. Eligibility results provide a key step in consumers knowing what coverage and financial assistance they can use to gain or continue critical health insurance.

Description

Recently, CMCS observed that more than 50% of Medicaid.gov site visitors are beneficiaries looking for information on Medicaid eligibility, enrollment, and other information provided by state and local resources. While each state Medicaid/CHIP agency has full responsibility for all aspects of the administration and operation of the Medicaid and CHIP programs, including determining eligibility for and enrollment into their program, Medicaid.gov can help to connect those seeking coverage with resources to determine their eligibility and begin their application.

As the current public health emergency (PHE) ends, CMCS will work to better understand the Medicaid.gov consumer journey in order to improve the website. Improvements will be designed to reduce consumer burden, increase access to eligibility and enrollment systems, and further instill trust in the Medicaid health care system.

Why this service was designated

Medicaid supports health benefits for more than 80 million Americans. In accordance with Executive Order 14058, “Transforming Federal Customer Experience and Service Delivery to Rebuild Trust In Government” CMCS shares the desire to improve the customer experience and increase the quality and efficiency of interactions with Medicaid. Medicaid.gov was launched in December 2011 as a hub for Federal program and policy information about Medicaid, the Children’s Health Insurance Program (CHIP) and the Basic Health Program (BHP). In 2020, Medicaid.gov had more than 7 million unique users and over 17 million page views.

Description

The Health Insurance Exchanges (Marketplace) help uninsured people find health coverage. By filling out an application on Healthcare.gov, consumers find out if they qualify for private insurance plans, Medicaid, or the Children’s Health Insurance Program (CHIP). Web, phone call and post- application satisfaction are measured via survey.

Description

Medicare is health insurance for people 65 or older, people under 65 with certain disabilities and people of any age with End-Stage Renal Disease. Medicare.gov provides information and resources for beneficiaries. Contact center phone call and web satisfaction are measured via survey.