Department  of  Health and Human  Services 
OFFICE  OF 
INSPECTOR  GENERAL 
1993  MEDICARE  BENEFICIARY 
SATISFACTION:  MICHIGAN 
AUGUST  1993  OEI-05-92-00390  EXECUTIVE  SUMMARY

PURPOSE 
This  inspection  was conducted  to compare  Michigan  beneficiary  satisfaction  with  the 
Medicare  program  to beneficiary  satisfaction  nationwide. 
BACKGROUND 
Medicare  is a Federal  health  insurance  program  for individuals  age  65and  older  and 
for certain  categories  of disabled  people.  The  Health  Care  Financing  Administration 
(HCFA)  within  the  Department  of Health  and  Human  Sezvices has  responsibility  for 
the  Medicare  program.  Private  health  insurance  companies  called  intermediaries  and 
carriers  contract  with  the  Federal  Government  to sexvice claims  for Medicare 
payment.  In Michigan,  Blue  Cross  and  Blue  Shield  of Michigan  serves  as both 
intermediary  and  carrier. 
Due  to reports  of problems  with the  Michigan  Medicare  Part  B Carrier,  HCFA 
requested  that  the  Inspector  General  conduct  a satisfaction  survey  of Michigan 
beneficiaries  in comparison  to beneficiary  satisfaction  levels nationwide. 
FINDINGS 
Overa& the responses of Michigan benejiciarin  are similar to those offered by 
benejkiaries  nationally. 
Seventy-five  percent  of beneficiaries  nationwide  and  72 percent  of Michigan 
beneficiaries  think  the  Medicare  program  is understandable.  Eighty-three  percent  of 
national  and  82 percent  of Michigan  respondents  said  they were  very or generally 
satisfied  with the  way Medicare  processed  their  claims. 
Howeveq  Michigan benejkiari.es are ik  satirjkd  with the service thq  receive when they 
caU the& cani.er. 
Twenty-two  percent  of Michigan  beneficiaries  compared  to  14 percent  of national 
beneficiaries  said  they were  dissatisfied  with the  service  they  received  the  last  time 
they  called  their  carrier.  Michigan  beneficiaries  most  frequently  mentioned  The line 
was busy, as a problem  when  calling  the  carrier. 
Alvo, more Michigan than national beneficiaries consider the camkr a soume of 
infoirnatibn about Medicare,  bti  freer  actually contact  the came~ 
Forty  percent  of Michigan  beneficiaries  say they would  go to the  carrier  for 
information  about  Medicare  compared  to 32 percent  nationally.  However,  only 24 
1  percent  of  Michigan  beneficiaries  say they have  called  the  carrier  in the  past 
compared  to 29 percent  nationally. 
CONCLUSION 
Our  survey and  past  Contractor  Performance  Evaluation  Program  scores  indicate  that 
beneficiary  telephone  service  in Michigan  could  be  improved. 
ii  TABLE  OF  CONTENTS

PAGE 
Executive  SUMMARY  . . . . ..o  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..o...i

INTRODUCIION  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...1

FINDINGS  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...4

Overall,  the  responses  of Michigan  beneficiaries  are  similar  to those  offered  by

national  beneficiaries  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..4

Michigan  beneficiaries  are  less satisfied  With carrier  telephone  service  . . . . . . . . . .  5

More  Michigan  beneficiaries  consider  the  carrier  asourceof

information  about  Medicare,  but  fewer  actually  contact  the  carrier  . . . . . . . . . . . .  7

CONCLUSION  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ...8

APPENDICES

k  Bibliography  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  A-1

B:  Methodology  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  B-1

C.  Non-response  analysis  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  c-1

D:  Questionnaire  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  D-1
 INTRODUCTION

PURPOSE 
This  inspection  was conducted  to compare  Michigan  beneficiary  satisfaction  with the 
Medicare  program  to beneficiary  satisfaction  nationwide. 
BACKGROUND 
Medicare l+ngram 
Medicare  isa  Federal  health  insurance  program  forpeopleage65  andolder  and  for 
certain  categories  of disabled  people.  Nationally,  Medicare  serves  approximately  33 
million  people  known  as beneficiaries.  There  are  approximately  1.2 million  Medicare 
beneficiaries  in the  State  of Michigan. 
The  Medicare  program  has two parts.  Part  A (hospital  insurance)  helps  pay for 
inpatient  hospi~al care,  some  inpatient  care  in a skijled  nursing  facility; sfilled  home 
health  care,  and  hospice  care.  A person  entitled  to Medicare  automatically  receives 
this coverage.  Part  B (medical  insurance)  covers  physicians  services,  outpatient 
hospital  services,  and  other  medical  services  and  supplies.  Part  B is optional. 
Beneficiaries  desiring  this coverage  pay a monthly  premium.  Both  Part  A and  Part  B 
have  deductible  and  coinsurance  requirements.  Beneficiaries  must  pay these  either 
out  of pocket  or through  supplemental  insurance  coverage. 
The  Health  Care  Financing  Administration  (HCFA)  within  the  Department  of Health 
and  Human  Semites  (HHS)  has responsibility  for the  Medicare  program.  However, 
other  organizations  share  in Medicares  administration.  Private  health  insurance 
companies  contract  with the  Federal  Government  to setice  claims  for Medicare 
payment.  Insurance  companies  that  handle  Part  A claims  are  called  intermediaries. 
Those  handling  Part  B claims  are  called  carriers.  In Michigan,  Blue  Cross  and  Blue 
Shield  of Michigan  seines  as both  intermediary  and  carrier. 
Past studies 
In  1989 and  1991 the  Inspector  General  conducted  national  surveys  of Medicare 
beneficiaries  to assess their  awareness  of and  satisfaction  with various  aspects  of the 
Medicare  program.  In addition,  the  Inspector  General  conducted  similar  surveys  of 
beneficiaries  in Georgia  and  New Jersey.  The  HCFA  requested  both  of these  State 
surveys due  to reports  of beneficiary  dissatisfaction  with the  Part  B carriers  in those 
States.  See  Appendix  A for a bibliography  of related  Inspector  General  reports. 
1
 Michigan 
In  1990, HCFA  received  a petition  of approximately  1,500 signatures  from  the 
Advocacy  Organization  for Patients  of Providers  located  in East  Lansing,  Michigan. 
The  organization  asked  HCFA  to provide  an alternative  carrier  to administer  the 
Medicare  program  in Michigan  due  to the  poor  quality  of service  provided  by the 
Michigan  carrier.  In response  to this petition,  HCFA  undertook  a survey  of physicians 
in Michigan  to gauge  their  satisfaction  level with the  Michigan  carrier. 
Annually,  HCFA  measures  carrier  performance  through  the  Contractor  Performance 
and  Evaluation  Program  (CPEP).l  The  overall  performance  rate  for the  Michigan 
carrier  dropped  from  96 percent  in Fiscal  Year  (FY)  1990, to 90 percent  in FY  1991. 
Also, the  CPEP  rate  for the  Michigan  carrier  in the  specific  function  of claims 
processing  dropped  to  72 percent  in FY  1991 from  90 percent  in FY  1990.  A carrier 
that  attains  a score  of fewer  than  70 percent  on a functional  criterion  is considered  to 
have  failed  that  criterion.  In  1992, the  overall  CPEP  rate  rose  back  up  to 96 percent, 
and  the  rate  for the  specific  function  of claims  processing  rose  to  100 percent. 
Due  to the  petition,  the  past  CPEP  rates  and  other  reports  of problems  with the 
Michigan  carrier,  HCFA  requested  that  the  Inspector  General  conduct  a satisfaction 
survey of Michigan  beneficiaries  in comparison  with beneficiary  satisfaction  levels 
nationwide.  The  Office  of Inspector  General  conducted  its last national  sumey  in 
1991.  Because  1992 was an election  year  and  much  media  attention  was focused  on 
health  care  issues, Medicare  beneficiaries  attitudes  about  Medicare  might  have 
changed.  Therefore,  to more  accurately  compare  the  satisfaction  of national  and 
Michigan  beneficiaries,  we conducted  the  Michigan  survey at the  same  time  as the 
1993 national  survey.  See Medicare  Z3enefkia~  Satisfaction:  1993, 0EI-04-92-O0480. 
METHODOLOGY 
Sunq 
We  selected  a random  sample  of 1,283 Michigan  beneficiaries  from  Medicare  Part  B 
claims  submitted  in calendar  year  1991.  We  mailed  surveys to these  beneficiaries  in 
February  1993.  After  the  initial  mailing,  we sent  a reminder  letter  followed  by a new 
survey to those  who  did not  respond. 
We  received  and  entered  into  a database  1,057 sumeys,  a response  rate  of 82 percent. 
Forty-seven  blank  surveys were  returned  for various  reasons  and  not  entered  into  our 
lThe  CPEP  is a review  and  appraisal  system which  uses results  and  output 
oriented  measures  based  on standards  and  criteria  required  by Section  1816(f) of the 
Social  Security  Act.  The  CPEP  is intended  by HCFA  to enhance  contractor 
performance  and  is reported  in the  Annual  Contractor  Evaluation  Report. 
2  database.  See  Appendix  B for more  about  the  methodology.  Appendix  C contains  an 
analysis  of respondents  vs. non-respondents. 
Comprkon 
The  same  survey form  was administered  to both  national  and  Michigan  beneficiaries. 
A copy of the  questionnaire  with the  Michigan  vs. national  responses  is in Appendix 
D.  We  compared  national  and  Michigan  beneficiaries  responses  using  a Chi-square 
test  of independence  along with  a statistical  test  comparing  the  difference  between 
binomial  proportions  to determine  whether  the  geographic  location  of a beneficiary 
influences  their  satisfaction  with Medicare  as measured  through  the  survey.  The 
geographic  location  of a beneficia~  acts as a proxy for the  carrier. 
SCOPE 
We  did not  design  a survey to specifically  measure  Michigan  Medicare  beneficiaries 
satisfaction  with the  Michigan  Part  B carrier.  Rather,  the  survey measures  beneficiary 
satisfaction  with Medicare  semices  overall,  including  both  Parts  A and  B.  Questions 
20-25 in the  questionnaire  most  directly  address  Part  B carrier  functions. 
This inspection  was conducted  in accordance  with the  Quality  Standards  for 
Inspections  as developed  by the  Presidents  Council  on Integrity  and  Efficiency. 
3
 FINDINGS

Ove@  the  responses  offered  by Michigan  beneficiaries  are  similar  to those  offered

by national  beneficiaries.

Seventy-five  percent  of beneficiaries  nationwide  and  72 percent  of Michigan

beneficiaries  think  the  Medicare  program  is understandable.  Also, of the  proportion

of national  and  Michigan  beneficiaries  who have  used  hospital  and/or  home  health

services  in the  past,  approximately  60 percent  of both  understood  what  Medicare  paid

for the  last  time  they  used  the  service.  Sixty-four  percent  of national  and  65 percent

of Michigan  beneficiaries  knew before  taking  the  survey that  Medicare  limits how

much  doctors  can  charge  for specific  services.  Thirty-eight  percent  of national  and  39

percent  of Michigan  respondents  say that  the  best  way to inform  them  of Medicare

changes  is to mail  them  a new Medicare  handbook.  Thirty-four  percent  of

respondents  in both  groups  say the  best  way to inform  them  of Medicare  changes  is to

mail  them

pamphlets  about  the  changes.

Both  national  and  Michigan  Figure  1

beneficiaries  offered  positive 
responses  about  Medicare 
Beneficiaries Are Satisfied with Claims Processing 
claims  processing.  Eighty-
110 
three  percent  of national  and 
la  Legend 
82 percent  of Michigan   
respondents  said they were  w 1  SSS2	   Nathmal 
Michigan 
very or generally  satisfied 
with the  way Medicare 
processed  their  claims.  Nine 
percent  of national  and  11 
percent  of Michigan 
beneficiaries  were  neither 
satisfied  nor  dissatisfied  with  9  11 
the  way Medicare  processed 
their  last  claim,  Only 4  satisfii  neither  dissatisfiednotyetpaidclaim 
Sy Pe?cultalp 
percent  of national  and  5 
percent  of Michigan 
respondents  were  generally 
or vexy dissatisfied  with their  last  claims  processing. 
4
 Equal  numbers  of national  and  Michigan  beneficiaries  experienced  the  same  problems
. 
with their  last Medicare  claim  for a doctors  visit: 
Table  1 
, 
Problem  National  Michigan 
I did not  have  a problem  with my  65%  66% 
Medicare  claim. 
I did not  understand  what  part  of my  15%  14% 
claim was paid  and why. 
I did not  understand  the  notice  (EOMB)  13%  15% 
Medicare  sent  after  processing  my claim. 
Medicare  took  too  long to pay the  claim.  9%  8% 
I did not  understand  why Medicare  8%  6% 
denied  the  claim. 
I had  difficulty getting  information  from  3%  2% 
Medicare  on the  status  of my claim. 
There  are  some  questions  where  the  differences  between  Michigan  and  national 
respondents  are  statistically  significant 2.  The  following  differences  in this report  focus 
on the  beneficiarys  contact  with the  carrier.  See  Appendix  D for a COPYof the 
questionnaire  with  a breakout  of all Michigan/national  responses. 
Michigan  beneficiaries  are less  satisfied  with  the  service  they  receive  when  they  call 
their  carrier. 
Twenty-two  percent  of Michigan  beneficiaries  were  dissatisfied  with  the  sexvice they 
received  the  last time  they  called  their  carrier  compared  to  14 percent  nationally  (see 
Figure  2.)  Furthermore,  while  74 percent  of national  beneficiaries  were  satisfied 
with the  service  they  received,  only 60 percent  of Michigan  beneficiaries  were  satisfied. 
2Unless  otherwise  noted,  all differences  from  this point  on reported  between 
Michigan  and  national  beneficiaries  are  statistically  significant. 
5  Figure  2 
BENEFICIARY  SATISFACTION 
00  With
Senke  When Caillng the Carrier 
74 
76 
m   
m  %zl  Na;m~ 
 
00  Michigan 
; 
66 
60

46

40

Sa

w

2s  22

20

14

15 
10I

K. 
Satisfii  neither  diss&isfied 
---mP 
When  asked  what  specific  problems  they might  have  had  when  calling the  carrier,  51 
percent  of national  compared  to 39 percent  of Michigan  beneficiaries  said, I did not 
have  a problem  with the  service  I received.  Michigan  beneficiaries  most  frequently 
mentioned  The  line was busy, as a problem  when  calling  the  carrier.  Figure  3 shows 
the  problems  and  percentages  mentioned  by national  and  Michigan  beneficiaries. 
Figure  3 
~Beneficiaries  Problems Wkh Calling the Carrier 
Natkmsl  Michigan 
No Fmblenm  39 
I*  I 
27  Puton HoldToo Lono  33 
I*  I 
17  CanllkihgA luwen  20
I@ I 
10  cuuutiatundmtmd~  11 
I@ 10  Fef80n&WOlNkqo Ot M1001M  9
P  I 
I@
9  Couldnt GotQudon Anawued  14 
I 
6
 Three  times  more  Michigan  beneficiaries  (10 percent)  than  national  beneficiaries  (3 
percent)  also said they  had''other''  problems  when  calling  the  carrier.  Among  these 
other  problems,  the  amount  of time  and  phone  calls it took  to solve the  problem  was 
most  often  stated.  This was most  completely  expressed  by a beneficiary  who wrote,  It 
took  10 phone  calls and  2 visits to a local  office  over  5 months  to finally find someone 
to explain  and  take  action  to get a check  processed  for a claim  from  November  1991. 
There  were  no national  beneficiaries  who expressed  this type  of problem  in the  other 
category. 
More  Michigan  beneficiaries  consider  the  carrier  a place  to go  for information  about 
Medicare,  but  fewer  actually  contact  the  carrier. 
Forty  percent  of Michigan  compared  to 32 percent  of national  respondents  consider 
the  carrier  a source  for information  about  Medicare.  However,  both  Michigan  and 
national  beneficiaries  (about  55 percent)  most  often  listed  The  Medicare  Handbook  as 
their  source  for information  about  Medicare. 
Although  more  Michigan  beneficiaries  consider  the  carrier  as a place  to go for 
information,  fewer  Michigan  beneficiaries  actually  contact  their  carrier.  Twenty-four 
percent  of Michigan  beneficiaries  have  called  their  carrier  in the  past  compared  with 
29 percent  of national  beneficiaries.  In addition,  33 percent  fewer  Michigan 
beneficiaries  have  contacted  the  carrier  to obtain  the  name  of a participating  doctofi. 
3Medicare  participating  doctors  agree  to charge  no more  than  Medicares 
approved  amount.  Medicare  pays 80 percent  of the  approved  amount.  The 
beneficiary  pays the  20 percent  coinsurance  after  meeting  the  deductible. 
7  CONCLUSION
The  results  of this survey show that  Michigan  beneficiaries  are  less satisfied  with the 
telephone  service  they  receive  from  Blue  Cross  Blue  Shield  of Michigan. 
Furthermore,  our  review  of the  Michigan  carriers  CPEP  scores  revealed  that  in the 
last few years  the  Michigan  carrier  has  consistently  scored  low in the  criterion  of 
beneficiary  and  provider  services.  The  primary  cause  has been  their  inability  to 
answer  incoming  beneficiary  telephone  calls timely.  We  hope  that  HCFA  will use  this 
information  along  with its CPEP  review  to improve  the  service  that  beneficiaries 
receive  in Michigan  from  the  carrier. 
8
 APPENDIX  A
Bibliography 
Office  of Inspector  General,  United  States  Department  of Health  and  Human 
Services. A  Survey of Medicare  Beneficiary  Satisfaction.  0EI-04-89-89040.  October 
1989. 
Ibid. Benejcia~  Satkfaction  with Geoyas Medicare  Camer. OEI-O4-9O-O1O5O. 
February  1990. 
Ibid. New Jersey Medicare  Beneficia~  Satzkfachon.  0EI-02-90-02040.  October  1990. 
Ibid. Medicare  Benejcia~  Satisfaction:  1991.  0EI-04-90-89030.  October  1991. 
Ibid. Medicare  Beneficia~  Satisfaction:  1993.  0EI-04-92-O0480.  Draft  report. 
A-1
 APPENDIX  B
Methodology 
The  purpose  of the  survey was to assess beneficiary  experience  and  satisfaction  with

the  Medicare  program  in Michigan.  The  sample  universe  was comprised  of

beneficiaries  who received  Part  B Medicare  Benefits  in Calendar  Year  1991.

From  approximately  1.1 million  individuals  who received  such benefits,  a non-stratified

simple  random  sample  was selected.

The  sample  size was calculated  to produce  an estimate  within  3.5 percent  of the  true

value  at the  95 percent  confidence  inte~al.  To  arrive  at the  sample  size, standard

equations  were  used  for estimating  sample  size with  a binary  response  variable.

We  drew  a sample  of 1,450 Health  Insurance  Claim  Numbers  (HICNS)  using

systematic  random  sampling.  From  this list of 1,450 HICNS we excluded  all

beneficiaries  who had  a date  of death  on the  file and  those  who were  in an HMO  as

of January  1993.  This  left  a total  of 1,283 individuals  in Michigan  who  are  receiving

semices  under  the  Fee-for-service  mechanism  and  were  alive as of January  1993.

On February  4, 1993, questionnaires  were  mailed  to  1,283 beneficiaries  in the  State  of

Michigan.  A follow-up  letter  was

sent  on February  16, 1993 to 783

beneficiaries.  Another  survev and  _  . .  .

lable 1
letter  was mailed  on Februa&  23, 
1993 to 580 beneficiaries  who had 
Reasons  for Return 
not  responded. 
Returned  because  of death  15 
A total  of 1,057 beneficiaries 
Returned  as undeliverable  13 
responded,  for a response  rate  of 
82 percent.  Forty-seven  Returned  for other  reasons  19 
incomplete  surveys were  returned  (alzheimer,  incapacity) 
for various  reasons  (see  Table  I.) 
Total  47 
Com~arison  of National  Survev 
At  the  same  time  the  Michigan  questionnaire  was mailed,  the  same  questionnaire  was 
mailed  to a national  sample  of beneficiaries.  The  national  survey was used  to 
compare  the  responses  from  the  Michigan  survey.  Using  a Chi-square  test  of 
independence  along  with a statistical  test  comparing  binomial  proportions,  we 
determined  whether  the  geographic  location  (carrier)  of beneficiaries  influences  how 
beneficiaries  would  respond. 
B-1
 APPENDIX  C
ANALYSIS  OF  RESPONDENTS  VS.  NON-RESPONDENTS 
An important  consideration  in surveys of this type  is the  bias  that  maybe  introduced 
into  the  results  if the  non-respondents  are  different  from  those  responding  to the 
survey.  To  test  for the  presences  of any bias, we obtained  demographic  information 
for all individuals  to whom  questionnaires  were  sent.  For  the  1,283 individuals,  we 
determined  their  Medicare  status,  sex and  race.  These  categorical  data  were  tested 
using a Chi-square  with the  appropriate  degrees  of freedom. 
The  results  are  presented  in Table  A,  The  Chi-square  values  given in the  table 
provide  a test  of the  difference  in the  distribution  of the  respondent  versus  the  non-
respondents  for the variable.  The  table  also provides  the  response  rates  for the 
different  values  of the  variables. 
Examination  of the  table  show that  two variables  have  a statistically  significant 
difference  between  respondents  and  non-respondents;  Medicare  status  and  race.  An 
analysis  of the  effect  of non-responses  by Medicare  status  and  race  follows Table  A. 
However,  the  effect  of the  non-responses  is inconsequential  and  within  the  bounds  of 
our  confidence  level,  plus or minus  3.5 percent.  Given  the  results  of these  analyses, 
we believe  that  the  results  fairly represent  the  opinions  of the  sample  of beneficiaries 
to whom  questionnaires  were  sent. 
c-l  MEDICARE  STATUS 
Non  Percent 
Responders  Responders  Total  Responding 
Aged  964  91.2%  194  85.8%  1158  83.2% 
Disabled  93  8.8%  32  14.2%  125  74.4% 
Total  1057  226  1283  82.4% 
CHI-SQ=6.061* 
D.F.=1 
SEX 
Non  Percent 
Responders  Responders  Total  Responding 
Male  421  39.8%  84  37.2%  505  83.4% 
Female  636  60.2%  142  62.8%  778  81.7% 
Total  1057  226  1283  82.4% 
CHI-SQ=O.553 
D.F.=1 
RACE 
Non 
Responders  Responders 
White  939  88.8%  175  77.4% 
* 
Non-White  100  9.5%  44  19.5%  144 I  69.4% 
Unknown  18  1.7%  7  3,1%  25  I  72.0% 
Total  I  1057 I  226  I  1283 I  82.4% 
CHI-SQ=21.263+ 
D.F.=2 
* Significant  at P  <.05 
+  Significant  at P  <.05 
c-2  For  Medicare  status,  survey results  show that  72 percent  of the  aged  beneficiaries 
understood  the  Medicare  program  while only 65 percent  of the  disabled  beneficiaries 
understood  the  Medicare  program.  To  determine  the  effect  of this difference,  we 
undertook  an analysis  of non-responders.  We  assumed  that  a non-responder  would 
answer  the  same  as a responder  with the  same  status  would  answer  the  question.  (See 
Table  B for a complete  break  down of questions  la,  lb  and  lc.) 
Table  B - Medicare  Status 
Percent  Adjusted  Percent 
Question  Answering  Yes  Answering  Yes 
Q-la.  72.4%  72.3% 
Q-lb.  67.8%  67.7% 
Q-1.c.  64.2%  64.19Z0 
Similarly,  for race,  sumey  results  show 73 percent  of whites  understood  the  Medicare 
program.  The  survey results  for non-whites  was 66 percent,  while  the  results  for 
unknown  was 89 percent.  A more  important  observation  is that  approximately  69 
percent  of non-whites  responded  to the  sumey, while  over  84 percent  of whites 
responded.  (See  Table  C for a complete  break  down  of questions  la,  lb  and  lc.) 
Table  C - Race 
Percent  Adjusted  Percent 
Question  Answering  Yes  Answering  Yes 
Q-la.  72.4%  72.39Z0 
Q-lb.  67.8%  67.7% 
Q-1.c.  64.2T0  64.2% 
c-3  APPENDIX  D

COMPARISON  OF  NATIONAL  SAMPIE  WITH MICHIGAN  SAMPLE 
The  percentages  are  shown  in bold,  while  the  number  of  response  are  italicized  and  in 
pare~thesis.  fiotall  questions  till  addupto  100percent  due  to rounding.  Questions  with 
statistically  significant  (p  <  .05) differences  are marked  with  an asterisk. 
National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
PART  1:  MEDICARE  COVERAGE 
1.  In gene~  do you  think... 
a.  The  Medicare  program  is

understandable?

YEs
 75V0  72% 
(753)  (721) 
NO
 25%  28% 
(256)  (275) 
*b.  You  can  get information  about

Medicare  when  you need  it?

YEs
 72$Z0  68% 
(730)  (g) 
NO
 7% 
(76)  (61) 
DONT  KNOW
 21%  26% 
(215)  (268) 
* 
c.  Medicare  pays your  claims

quickly enough?

71%  64% 
(727)  (653) 
NO
 15%  14% 
(153)  (145) 
DONT  KNOW
 14%  21% 
(144)  (219) 
D-1
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
2  What  types  of  medical  insurance  do  you  or  your  spouse  have  in  addition  to 
Medicare? 
(Check  all that  apply) 
DO  NOT  HAVE  ADDITIONAL 
INSURANCE  COVERAGE  20%  17% 
(199)  (170) 
MEDICAID  11%  9% 
(111)  (94) 
*HEALTH  INSURANCE  THROUGH  YOUR 
OR  YOUR  SPOUSES  CURRENT  OR 
FORMER  EMPLOYER  33V0  52% 
(329)  (537) 
*PRIVATE  MEDICARE  SUPPLEMENT	 27%  18% 
(273)  (181) 
CHAMPUS	 .5%  .5% 
(5)  (5) 
*OTHER	 24V0  20% 
(238)  (200) 
3.  Do  you  feel  at this you  are in good  health? 
YEs  67%  64% 
(664)  (644) 
NO  33%  36% 
(331)  (370) 
D-2  National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
4.  Thinking  about  the most  recent  time you were  a patient  in at hospital  for a least  one 
nigh~  was  it clear  to you  what  Medieare  paid  for? 
(Check  w  answer.) 
I HAVE  NOT  BEEN  IN THE  HOSPITAL 
FOR  AT LEAST  ONE  NIGHT  SINCE 
I HAVE  HAD  MEDICARE  COVERAGE  34%  34% 
(352)  (350) 
YES,  IT WAS CLEAR  WHAT  MEDICARE 
PAID  FOR  40%  37% 
(416)  (384) 
NO,  IT WAS NOT  CLEAR  WHAT  MEDICARE 
PAID  FOR  15%  16% 
(151)  (169) 
I DO  NOT  REMEMBER  IF IT WAS CLEAR 
WHAT  MEDICARE  PAID  FOR  10%  1270 
(100)  (122) 
MEDICARE  HAS  NOT  YET  PAID  THE 
HOSPITAL  1%  170 
(13)  (14) 
D-3
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
5.	 Thinking  about  the  last  time  you  received  medical  services  in  vour  home  from  a 
home  health  a~encv , was  it clear  to you  what  Medicare  paid  for? 
(Check  w  answer) 
I HAVE  NOT  RECEIVED  MEDICAL  SERVICES 
FROM  A HOME  HEALTH  AGENCY  SINCE  I 
HAVE  HAD  MEDICARE  789Z0  74% 
(783)  (765) 
YES,  IT WAS  CLEAR  WHAT  MEDICARE 
PAID  FOR  15%  15% 
(154)  (157) 
*NO,  IT WAS NOT  CLEAR  WHAT  MEDICARE 
PAID  FOR  370  5% 
(30)  (49) 
I DO  NOT  REMEMBER  IF IT WAS CLEAR 
WHAT  MEDICARE  PAID  FOR  3%  4% 
(30)  (37) 
MEDICARE  HAS  NOT  YET  PAID  FOR  THE 
HOME  HEALTH  SERVICES  1%  270 
(12)  (21) 
6.	 Thinking  about  the  last  time  you  went  to the  doctor,  was  it clear  to you  before  vou 
went  what  Medicare  would  pay  for? 
(Check  ~  answer) 
*I HAVE  NOT  BEEN  TO  THE  DOCTOR  SINCE 
I HAVE  HAD  MEDICARE  4%  2940 
(36)  (17) 
YES,  IT WAS  CLEAR  WHAT  MEDICARE  WOULD 
PAY  FOR  55%  57% 
(563)  (586) 
NO,  lT  WAS NOT  CLEAR  WHAT  MEDICARE 
WOULD  PAY  FOR  34%  36% 
(348)  (367) 
I DO  NOT  RECALL	 7%  6% 
(74)  (57) 
D-4
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
7.	 Did  you  know  before  today  that  Medicare  limits  how  much  doctors  can  charge  you 
for specific  seMces? 
64%  65% 
(653)  (664) 
NO  36%  35% 
(373)  (354) 
*8.  If you  should  ever  need  nursing  home  care,  do you  have  a way  to  cover  the  cost? 
YEs  37%  26% 
(362)  (229) 
NO  (skip  to Q-10)  60%  70% 
(587)  (622) 
I AM  CURRENTLY  IN A NURSING  HOME 
(Skip  to Q-n)  3%  3% 
(32)  (39) 
9.	 Listed  below  are some  ways people  might pay for nursing  home  care.  Which  of these 
would  you  rely on  if you  ever  needed  nursing  home  care  for more  than  5 months? 
(Check  all that  apply.) 
PERSONAL  SAVINGS  56%  63% 
(160)  (137) 
RETIREMENT  INCOME  44%  44$?0 
(126)  (96) 
PRIVATE  INSURANCE  3170  28% 
(88)  (61) 
*MEDICAID  30%  1970 
(87)  (42) 
EQUITY  IN YOUR  HOME  32%  26% 
(91)  (57) 
OTHER  9%  6% 
(25)  (14) 
D-5
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
* 
10.	 Many  people  think  Medicare  will pay for long-term  nursing  home  care.  It currently 
does  not.  Before  today,  did you  think  that  Medicare  WOULD  PAY  for long-term 
nursing  home  care  for more  than  5 months? 
YEs  24%  32% 
(222)  (244) 
NO  76%  68% 
(702)  (527) 
PART  2  GETTING  INFORMATION  ABOUT  MEDICARE 
11.	 The  following  are some  places  people  might  go to get  answers  if they  have  question 
about  what  Medicare  pays  for. 
*YOUR  DOCTORS  OFFICE  4870  53% 
$322)  (:s4) 
A FRIEND  OR  RELATIVE 
(103)  (86) 
AARP  OR  OTHER  MEMBERSHIP 
ORGANIZATION  20%  19% 
(200)  (199) 
*INSURANCE  COMPANY  THAT  PROCESSES 
YOUR  MEDICARE  CLAIMS  32%  40% 
(324)  (415) 
THE  SOCIAL  SECURITY  OFFICE  45%  47% 
(465)  (489) 
*A LOCAL  SENIOR  CITIZENS  GROUP  870  12% 
(83)  (120) 
AN  INSURANCE  SALESPERSON  2%  1% 
(17)  (13) 
THE  MEDICARE  HANDBOOK  54%  55% 
(552)  (s4!;) 
OTHER  4% 
(40)  (30) 
D-6
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
12.	 When  you have  needed  speeific  information  about  what Medicare  pays for, how often 
were  you  able  to get  the  information  you  needed? 
(Check  ~.) 
MOST  OF  THE  TIME  39%  36% 
(3!&)  (368) 
SOME  OF THE  TIME  16% 
(182)  (167) 
SELDOM  OR  NEVER  8%  7% 
(82)  (73) 
I HAVE  NEVER  NEEDED 
INFORMATION  35ZO  40% 
(360)  (411) 
D-7
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
13.	 Listed  below  are ways the Government  could  use  to tell people  about  changes  in the 
Medieare  program. 
Which  way  is best  for notifying  you  of Medieare  changes? 
(Please  check  ONLY  ONE.) 
ANNOUNCEMENTS  ON  TELEVISION 
AND  RADIO  7940  670 
(70)  (60) 
PAMPHLETS  DESCRIBING  THE  CHANGES 
MAILED  TO  ME  34%  34% 
(357)  (357) 
NOTICES  INCLUDED  WITH  MY  SOCIAL 
SECURITY  CHECK  17%  19% 
(179)  (193) 
A NEW  MEDICARE  HANDBOOK 
MAILED  TO  ME  THAT  INCLUDES  THE 
CHANGES  38$Z0  39% 
(394)  (403) 
ANNOUNCEMENTS  IN THE 
NEWSPAPER  1%  1% 
(12)  (lo) 
SPEECHES  OR  PRESENTATIONS  BY 
MEDICARE  REPRESENTATIVES  1%  .9% 
(11)  (9) 
OTHER  .8$Z0  .970 
(9)  (9) 
D-8
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
14.  How  many  times  in the  past  year  have  you  used  your  Medicare  Handbook? 
(Check  ~.) 
1 TO  3 TIMES  36%  34% 
(368)  (338) 
MORE  THAN  3 TIMES  6%  5% 
(57)  (50) 
*I HAVE  NEVER  USED  THE  MEDICARE 
HANDBOOK  (Skip to Q-17)  34%  42% 
(345)  (419) 
I DO  NOT  KNOW  WHAT  THE  MEDICARE 
HANDBOOK  IS  (Skip  to Q-17)  3%  470 
(27)  (39) 
*I DO  NOT  RECALL  RECEIVING  A 
MEDICARE  HANDBOOK  (Skip  to Q-17)  21%  16% 
(213)  (158) 
15.  Do  you  think  the  Medicare  Handbook  is: 
(Check  ~.) 
VERY  HELPFUL  27%  24% 
(113)  (91) 
GENERALLY  HELPFUL  66%  69% 
(:2&)  (2SJ) 
GENERALLY  NOT  HELPFUL 
(19)  (22) 
NOT  HELPFUL  AT ALL  2%  1% 
(7)  (2) 
D-9
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
16.  Thinking  about  the  Medicare  Handbook  you  have  receive~  would  you  say that... 
a.	 The wording  is easy to understand? 
YEs  80%  84% 
(313)  (294) 
NO  20%  16% 
(78)  (.55) 
b.  The  lettering  is large  enough  to read? 
YEs  94%  92% 
(344)  (300) 
NO  670  8% 
(23)  (27) 
c.	 It covers  enough  information? 
YEs  8s%  8s% 
(283)  g;) 
NO  15% 
(51)  (45) 
PART  3:  MEDICARE  CLAIMS 
17.	 Did  you  know  before  today  that  your  doctors  are  supposed  to  file  your  Medicare 
claims  for you? 
YEs  90%  89% 
(92;)  ~1) 
NO 
(loo)  (111) 
D-10
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
18.  Over~  how  satisfied  are you  with  the  way Medicare  has  processed  your  claims? 
VERY  SATISFIED  37%  33% 
(378)  (339) 
GENERALLY  SATISFIED  46%  49% 
(472)  (494) 
NEITHER  SATISFIED  NOR 
DISSATISFIED  9%  11% 
(91)  (110) 
GENERALLY  DISSATISFIED  370  3% 
(26)  (35) 
VERY  DISSATISFIED  l%  270 
(12)  (16) 
*MEDICARE  HAS  NOT  YET  PAID  CLAIM  4%  2% 
(39)  (20) 
D-II
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
19.  Did  you  have  any of the  following  problems  the  last time  you  had  a Medicare  claim 
for  a doctors  visit? 
(Check  as manv  as apdy.) 
I HAD  DIFFICULTY  GETTING  INFORMATION 
FROM  MEDICARE  ON  THE  STATUS  OF 
MY  CLAIM  3%  2% 
(27)  (25) 
I DID  NOT  UNDERSTAND  WHAT  PART  OF  MY  CLAIM 
MEDICARE  PAID  AND  WHY  15%  1470 
(144)  (136) 
I DID  NOT  UNDERSTAND  WHY  MEDICARE 
DENIED  THE  CLAIM  8%  6% 
(79)  (60) 
MEDICARE  TOOK  TOO  LONG  TO  PAY 
MY  CLAIM  9%  8% 
(85)  (76) 
I DID  NOT  UNDERSTAND  THE  NOTICE 
MEDICARE  SENT  AFTER  PROCESSING 
MY  CLAIM.  (THE  NOTICE  IS CALLED 
EXPLANATION  OF  MEDICARE 
BENEFITS.  )  13%  15% 
(128)  (151) 
I DID  NOT  HAVE  A  PROBLEM  WITH  MY 
MEDICARE  CLAIM  65%  66% 
(643)  (668) 
*OTHER  3%  5% 
(34)  (54) 
PART  4.  CALLING  MEDICARE 
* 
20.	 Have  you  ever  tried  to  call  the  insurance  company  the  processes  your  Medicare 
claims? 
YES  - Month  and  Year  of Last  Call:  29%  24% 
(288)  (228) 
NO  (Skip  to @26)  71%  769Z0 
(708)  (725) 
D-12
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
21.  Thinking  about  the last time you tried to cdl,  how  many tries did it take you to reach 
them? 
(Check  ~.) 
FIRST  TRY  35%  3090 
(95)  (65) 
SECOND  TRY  25%  20% 
(71)  (44) 
*THREE  OR  MORE  TRIES  32%  41% 
(86)  (89) 
NEVER  GOT  THROUGH  890  9% 
(22)  (19) 
22.	 How  satisfied  were  you  with  the  semice  you  received  the  last  time  you  called? 
(Check  ~.) 
*VERY  SATISFIED  31%  20% 
(87)  (43) 
GENERALLY  SATISFIED  43%  40% 
(119)  (85) 
*NEITHER  SATISFIED  NOR 
DISSATISFIED  12%  19% 
(32)  (41) 
GENERALLY  DISSATISFIED  9%  13% 
(25)  (27) 
VERY  DISSATISFIED  5%  9% 
(13)  (19) 
D-13
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
23.	 IJsted  below  are possible  problems  someone  might  have  when  calling  the Medicare 
insurance  campany. 
Did  you  have  any problems  the  last  time  you  called? 
(Check  as manv  as auuly.) 
I WAS  NOT  ABLE  TO  GET  MY  QUESTION 
ANSWERED  9%  14% 
(20)  (31) 
THE  LINE  WAS  BUSY  43%  43% 
(100)  (95) 
I GOT  DIFFERENT  ANSWERS  FROM 
DIFFERENT  PEOPLE  17%  2070 
(39)  (43) 
I WAS  PUT  ON  HOLD  TOO  LONG  27%  33% 
(63)  (73) 
I COULD  NOT  UNDERSTAND  THE 
ANSWER  THEY  GAVE  ME  10%  11% 
(23)  (24) 
THE  PERSON  ANSWERING  THE  CALL 
WAS  NOT  VERY  COURTEOUS  109IO  970 
(23)  (19) 
*I DID  NOT  HAVE  A PROBLEM  WITH  THE 
SERVICE  I RECEIVED  50%  39% 
(116)  (85) 
*OTHER  3%  10% 
(7)  (23) 
24.	 Some  Medicare  insurance  companies  use  an  automated  voice  system  to  handle 
telephone  calls. 
Thinking  about  the  last  time  you  called  the  Medicare  insurance  company  that 
processes  your  cl- how  was your  call  answered? 
BY  AN  AUTOMATED  VOICE  31%  33% 
(80)  (62) 
BY  A  MEDICARE  EMPLOYEE  69%  67% 
(Skip  to Q-26)  (177)  (128) 
D-14
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
25.	 IAsted below  are possible  reasons  that someone  would  be dissatisfied  with calling  the 
Medicare  insurance  company  and  getting  an automated  voice. 
Did  you  have  any of these  problems  the  last  time  you  called? 
(Check  as manv  as am@.) 
*I DID  NOT  HAVE  A TOUCH-TONE 
TELEPHONE  TO  RESPOND  TO  THE 
AUTOMATED  VOICE  SYSTEM  73%  35% 
(35)  (22) 
I COULD  NOT  UNDERSTAND  THE 
DIRECITONS  GIVEN  BY THE 
AUTOMATED  VOICE  SYSTEM  38%  29% 
(18)  (18) 
OTHER  14%  2170 
(7)  (13) 
PART  5:  APPEALING  CLAIMS 
* 
26.	 Sometimes  people  disagree  with the decisions  made  on their Medicare  claims.  When 
this  happens,  you  may  appeal  or request  a review  of those  decisions. 
Did  you  know  ~  that you  could  appeal  or request  a review? 
YEs  75%  71% 
(749)  (712) 
NO  25%  29% 
(254)  (296) 
27.  Have  you  ever  appealed  a decision  made  by Medicare  on  a claim  you  submitted? 
YEs  6%  5% 
(60)  (46) 
NO  (Skip  to @30)  94%  95% 
(904)  (930) 
D-15
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
28.  Did  you  understand  the  final  decision  made  on your  claim? 
YEs  65%  73?40 
(35)  (24) 
NO  35%  27% 
(19)  (9) 
29.  Do  you  think  your  appeal  was  handled  fairly? 
YEs  59%  62% 
(28)  (18) 
NO  4170  389Z0 
(20)  (11) 
PART  6  GETTING  SECOND  OPINIONS 
30.	 If your doctor  recommends  that you have  surgexy,  Medicare  will help  you  pay to get 
the  opinion  of another  doctor  to make  sure  the  surgery  is really  necessary. 
Were  you  aware  before  today  that  Medicare  would  help  to  pay  for  you  to  get  a 
second  opinion  before  having  surge~? 
YEs  39%  38% 
(397)  (392) 
NO  61%  62% 
(624)  (630) 
31.	 Do  you think people  should  be required  to get a second  opinion  form  another  doctor 
to make  sure  non-emergeney  surgery  is really  necessary? 
YEs  51%  55% 
(~;)  (54J 
NO 
(49)  (39) 
DEPENDS  ON  THE  TYPE  OF  SURGERY  4470  4170 
(447)  (409) 
D-16
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
32.	 Thinking  about  the  last  time  you  had  non-emergency  surgery,  did you  get  a second 
doctors  opinion  before  having  the  surgery? 
YEs  19%  18% 
(185)  (184) 
NO  43%  45% 
(425)  (446) 
I HAVE  NEVER  HAD 
NON-EMERGENCY  SURGERY  39%  37% 
(382)  (369) 
PART  7:  PARTICIPATING  DO~ORS  PROGRAM 
33.	 Medicare  has  participating  doctors  who  agree  to charge  no  more  than  Medicares 
approved  amount.  Medicare  pays  80%  of  the  approved  amount.  You  are  only 
responsl%le  for paying  the  deductible  and  the  2070  coinsurance. 
Before  today,  had  you  ever  heard  about  Medicare  participating  doctors? 
YEs  83%  82% 
(853)  (848) 
NO  17%  18% 
(172)  (189) 
* 
34.  Are  any of your  doctors  participating  doctors? 
YEs  65%  71% 
(677)  (735) 
NO  970  7% 
(94)  (68) 
DONT  KNOW  2s%  22% 
(262)  (209) 
D-17
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
* 
35.	 Have  you  ever  contacted  the insurance  company  that processes  you Medicare  claims 
to get  the  names  of doctors  who  are participating  doctors? 
YEs  6%  4% 
(65)  (43) 
NO  69%  74% 
(703)  (734) 
I DID  NOT  KNOW  I COULD  GET  THIS  INFORMATION 
FORM  THE  INSURANCE  COMPANY  THAT  PROCESSES  MY 
CLAIMS  24%  21% 
(246)  (209) 
36.	 Thinking  about  the  future,  how  likely  are you  to  select  a participating  doctor  for 
health  care  semices? 
(Check  ~.) 
*LIKELY  TO  SELECT  PARTICIPATING 
DOCTOR  65%  70% 
(634)  (698) 
NOT  LIKELY  TO  SELECI 
PARTICIPATING  DOCTOR  8%  7% 
(78)  (70) 
WILL  NOT  MATTER  ID  DOCTOR  IS 
PARTICIPATING  27%  23% 
(262)  (209) 
PART  8  HEALTH  CARE  FACILITIES 
37.	 For  people  who  are interested  the  Medicare  program  has information  by individual 
hospital  on  mortality  (death)  rates  of  Medicare  patients.  Were  you  aware  before 
My  that  the  Federal  Government  publishes  !Medicare  Hospital  Mortality 
Information? 
YEs  9%  7% 
(87)  (73) 
NO  91%  9370 
(916)  (949) 
D-18
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
38.	 Have  you  ever  used  the  Medicare  Hospital  Mortality  Information  to  choose  a 
hospital? 
.4%  Ivo 
(4)  (10) 
NO  44%  46fzo 
(449)  (460) 
I DID  NOT  KNOW  ABOUT  THE 
MORTALITY  INFORMATION  55%  53% 
(565)  (520) 
39.	 If in the  future  you  need  to be  hospitalize  how  likely  are you  to use  the  mortality 
(death  rate)  information  to select  a hospital? 
[Assume  you  have  a choice  of  going  to  one  of  two  hospitals  and  both  are  equally 
convenient  and seemingly  of equal  quality.  Would  you use  the mortality  information 
to select  which  hospital  to go  to?] 
LIKELY  TO  USE  THE  INFORMATION  56%  59% 
(525)  (551) 
NOT  LIKELY  TO  USE  THE 
INFORMATION  44%  41% 
(413)  (385) 
40.  Who  selected  your  hospital  the  last  time  you  were  hospitalized? 
(Check  ~.) 
*YOU  35%  31% 
(363)  (306) 
*YOUR  DOCTOR  48%  54% 
(488)  (:54) 
YOUR  RELATIVES  OR  FRIENDS  5% 
(47)  (37) 
AMBULANCE  DRIVER  270  2% 
(20)  (17) 
OTHER  2%  2940 
(22)  (19) 
I HAVE  NEVER  BEEN  IN HOSPITAL  9%  7% 
(88)  (75) 
D-19
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
41.	 The Medicare  Program  also publishes  information  of the results  on inspections  done 
on nursing  homes.  Before  todav,  were  you  aware  that  the Federal  Government  had 
this type  of information  on  nursing  homes? 
YEs  22%  20% 
(218)  (205) 
NO  78%  80% 
(794)  (817) 
42.  Have  you  ever  used  this  information  to  choose  a nursing  home? 
YEs  2%  2% 
(16)  (24) 
NO  6070  56% 
(592)  (552) 
I DID  NOT  KNOW  ABOUT  THE  NURSING 
HOME  INFORMATION  38%  41% 
(375)  (405) 
43.	 Now that  you  know  about  the  nursing  home  informatio~  are  you  likely  to use  the 
information  if you  should  need  to select  a nursing  home? 
YES,  LIKELY  TO  USE  THE 
INFORMATION  85%  88% 
(843)  (865) 
NO,  NOT  LIKELY  TO  USE  THE 
INFORMATION  15%  12% 
(145)  (120) 
44.	 Medicare  also  publishes  a booklet  entitled  Guide  to Choosihg a Nuning Home.  It 
discusses  things  to look  for in selecting  a nursing  home,  and is available  from several 
offitxx+ including  your  Social  Security  office. 
Before  today,  were  you  aware  Medicare  had  information  on  choosing  a  nursing 
home? 
YEs  10%  9% 
(97)  (94) 
NO  90?Z0  91940 
(909)  (932) 
D-20
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
45.  Have you  ever  used  the  booklet  to help  you  select  a nursing  home? 
YEs  1%  1% 
(9)  (11) 
NO  51%  50% 
(499)  (490) 
I DID  NOT  KNOW  MEDICARE  HAD  A 
BOOKLET  ABOUT  CHOOSING  A 
NURSING  HOME  48%  49% 
(476)  (488) 
46.  Was  the  booklet  helpful? 
YEs  2%  4% 
(19)  (36) 
NO  2%  2% 
(17)  (20) 
I HAVE  NOT  USED  THE  BOOKLET  %%  94% 
(786)  (806) 
47.	 Now that you  know  about  the bookle~  are you  likely  to use  it if you  should  need  to 
select  a nursing  home? 
YES,  LIKELY  TO  USE  BOOKLET  84%  87% 
(806)  (850) 
NO,  NOT  LIKELY  TO  USE  BOOKLET  16%  14% 
(150)  (133) 
48.	 Medicare  also  has  a  booklet  entitled  Gui&  to Health  Ihsurance for  People  with 
Me&we.  It discusses  things  you  should  look  for in choosing  Medigap  insurance  to 
supplement  your  Medicare  coverage.  Ig  too,  is  available  at  your  Social  Security 
office. 
Before  today,  were  you  aware  Medicare  had  a booklet  to  help  you  choose  other 
health  insurance? 
YEs 
13%  12% 
(132)  (118) 
NO  87%  88% 
(865)  (902) 
D-21
 National  Michigan 
Percentage  Percentage 
Question  (Responses)  (Responses) 
49.	 Have  you  ever  used  the  booklet  to help  you  seleet  health  insurance  to supplement 
your  Medicare? 
YEs 
2%  2% 
(16)  (23) 
NO  40%  39% 
(394)  (393) 
I DID  NOT  KNOW  MEDICARE  HAD  A 
BOOKLET  ABOUT  CHOOSING  OTHER 
HEALTH  INSURANCE  58%  58% 
(571)  (585) 
50.  Was  the  booklet  helpful? 
YEs 
7%  6% 
(61)  (5s) 
NO  1% 2% 
(9)  (17) 
I HAVE  NOT  USED  THE  BOOKLET  92%  92% 
(810)  (832) 
51.	 Now  that you know  Medicare  has a booklet  to help  you  choose  health  insura.nee,  are 
you  likely  to use  it should  you wish  to purchase  health  insurance  to supplement  your 
Medicare  or to  change  your  current  supplemental  policy? 
YES,  LIKELY  TO  USE  BOOKLET  65%  a% 
(619)  (608) 
NO,  NOT  LIKELY  TO  USE  BOOKLET  35%  36% 
(339)  (342) 
Is there  anything  else  you  want  to tell  us  about  Medicare? 
POSITIVE  5%  20% 
(6)  (64) 
NEGATIVE  60%  34% 
(70)  (108) 
MIXED  4%  5% 
(5)  (17) 
OTHER  30%  41% 
(35)  (130) 
D-22