CHA Testifies to Congress About Continuing Problems with 1-800-MEDICARE

CHA Testifies to Congress About Continuing Problems with 1-800-MEDICARE

Washington, DC — Medicare beneficiaries and State Health Insurance Assistance Program (SHIP) counselors who help them continue to experience a number of problems, including enduring long wait times and receiving inaccurate information, from 1-800-MEDICARE. Tatiana Fassieux, Board Chair of California Health Advocates, testified how these problems impact Medicare beneficiaries at a hearing of the Senate Special Committee on Aging, “1-800-MEDICARE: It’s Time for a Check-Up,” on Thursday, September 11, 2008. In conjunction with the hearing, ABC News interviewed Ms. Fassieux on Good Morning America. Ms. Fassieux’s written testimony along with the video of the ABC News interview is available online at cahealthadvocates.org.

Over the last year or so, 1-800-MEDICARE became the main point of entry for all questions regarding Medicare, ranging from questions about enrolling in or disenrolling from private Medicare Advantage and Part D plans to claims questions under Part A and Part B. The Centers for Medicare and Medicaid Services (CMS) contracts out the service for 1-800-MEDICARE, expecting the private contractor to handle such a wide range of questions, while at the same time compromising its own direct control over the quality of this service. Although Ms. Fassieux acknowledged that the performance of 1-800-MEDICARE has gradually improved, she stressed that “the rate of unsuccessful calls…is still far too high…It is still hit or miss whether a caller will receive accurate information and/or have their problem resolved.”

Medicare beneficiaries and SHIP counselors have reported wait times of at least 15-20 minutes to speak with a general customer service representative (CSR), and when the CSR cannot answer the question, the caller has to wait another 15-30 minutes to speak with a CSR at a higher level. Many have reported that when they ask to speak to a supervisor, the call is disconnected and the caller has to start over. When a SHIP manager complained about how frequently she has been disconnected, a supervisor at 1-800-MEDICARE admitted that some CSRs hang up when they cannot answer a caller’s question.

In addition to CSRs’ inability to answer questions, some CSRs also give misinformation, which have led some Medicare beneficiaries to pay more, waste time and/or make decisions that do not benefit them. In some cases, such misinformation can be life-threatening. For example, a transplant patient was informed by her pharmacy that she was no longer eligible for her anti-rejection medication. A SHIP counselor called on her behalf to invoke an expedited complaint resolution process to get the anti-rejection medication, but the CSR at 1-800-MEDICARE incorrectly told her no such process exists.

During the interview on Good Morning America, Ms. Fassieux said that when beneficiaries call 1-800-MEDICARE, they are “not getting the level of trained employee or service representative we expect.” Among the recommendations offered to improve the hotline’s service were better training of CSRs and direct access to Medicare Administrative Contractors who handle Part A and Part B claims.

For more information, view Ms. Fassieux’s testimony, “1-800 MEDICARE: Continuing Problems for SHIPs and Medicare Beneficiaries” and the Good Morning America interview online at cahealthadvocates.org.

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California Health Advocates is dedicated to Medicare beneficiary advocacy and education efforts for Californians. (www.cahealthadvocates.org).

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Contact:

Elaine Wong Eakins, Project Manager
510-574-1995

David Lipschutz, Staff Attorney

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

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