Department of Health and Human Services 

OFFICE OF 

INSPECTOR GENERAL 

Medicare Beneficiaries With Additional 

Medical Insurance in 1997 

JUNE GIBBS BROWN 

Inspector General 

JULY1998 

OEI-04-97-00031 
OFFICE OF INSPECTOR GENERAL 

The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, is to 

protect the integrity of the Department of Health and Human Services programs as well as the 

health and welfare of beneficiaries served by them. This statutory mission is carried out through 

a nationwide program of audits, investigations, inspections, sanctions, and fraud alerts. The 

Inspector General informs the Secretary of program and management problems and recommends 

legislative, regulatory, and operational approaches to correct them. 

Office of Evaluation and Inspections 

The Office of Evaluation and Inspections (OEI) is one of several components of the Office of 

Inspector General. It conducts short-term management and program evaluations (called 

inspections) that focus on issues of concern to the Department, the Congress, and the public. The 

inspection reports provide findings and recommendations on the efficiency, vulnerability, and 

effectiveness of departmental programs. 

OEI’s Atlanta Regional Office prepared this report under the direction of Jesse J. Flowers, 

Regional Inspector General, and Christopher Koehler, Deputy Regional Inspector General. 

Principal OEI staff included: 

ON 

Betty Apt, Project Leader 

Jason Stanfield, Contractor 

Joe Townsel, Program Analyst 

Paula Bowker, Program Analyst 

Greg Jones, Program Analyst 

Janet Miller, Program Analyst 

RTERS 

Wynethea Walker, Program Specialist 

Linda Moscoe, Technical Support 

Barbara Tedesco, Statistician 

To obtain copies of this report, please call the Atlanta Regional Office at 404-562-7743 

Reports are also available on the World Wide Web at our home page address: 

http:flwww.dhhs.govlprogorg/oei 
PAGE 

EXECUTIVE SUMMARY 

INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..l 

FINDINGS 

Most Beneficiaries Have Additional Insurance . . . . . . . . . . . . . . . . . . . . . . . . . 2 

Most Beneficiaries Are Satisfied with Insurance . . . . . . . . . . . . . . . . . . . . . . . . . 3 

APPENDICES 

Beneficiary Responses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A- 1 

Confidence Intervals . . , . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . B- 1 
PURPOSE 

To determine how many beneficiaries have medical insurance that supplements Medicare, and 

if they are satisfied with the insurance. 

BACKGROUND 

Medicare is a Federal health insurance program for individuals age 65 and older, and for 

certain categories of disabled people. In Calendar Year 1997, Medicare served over 38 million 

people, known as beneficiaries, and paid benefits of approximately $211 billion.’ 

During our 1997 survey of Medicare beneficiary satisfaction, we asked 977 beneficiaries about 

their satisfaction with insurance that supplements their Medicare coverage. Several people in 

the Health Care Financing Administration expressed an interest in this subject when we 

conducted our 1995 beneficiary satisfaction survey, and suggested questions for us to include. 

We kept those questions in our 1997 survey . 

In July 1997, we mailed a questionnaire to 1269 randomly-selected Medicare beneficiaries for 

whom Part B claims had been filed in Calendar Year 1996. We excluded from our sample 

beneficiaries who were enrolled in an HMO. A total of 977 beneficiaries returned completed 

questionnaires, for a response rate of 77 percent. 

We compared responses to our 1995 and 1997 surveys, and determined statistically significant 

differences through use of a t-test. 

We conducted this inspection in accordance with the Quality Standards for Inspections issued 

by the President’s Council on Integrity and Efficiency. 

‘Health Care Financing Administration, United States Department of Health and Human Services, HCEA 

Statistics, October 1997. 

1 
EIGHTY-SIX PERCENT OF BENEFICIARIES REPORT THEY HAVE MEDICAL 

INSURANCE IN ADDITION TO MEDICARE 

In 1997, 86 percent of the beneficiaries said they have medical insurance coverage in addition 

to Medicare. This is about the same as in 1995, when 84 percent said they had other 

insurance coverage. 

Table 1 shows the types of insurance Medicare beneficiaries said they have. The percentages 

in 1997 are about the same as in 1995 except for Medigap insurance, i.e., insurance obtained 

by Medicare beneficiaries directly from private sources. The increase in the percent of 

beneficiaries who had private Medigap policies from 1995 to 1997 was statistically significant. 

Table 1 

Types of Medical Insurance Medicare Beneficiaries Have 

Insurance Through Current or Former Employer 

Current Employer 

Former Employer 

Private Medicare Supplemental (Medigap) 

Medicaid 

Other 

‘Somebeneficiaries said they have more than one type of insurance. 

‘In 1995, we combined the question about insurance through current andformer employment. 

‘The increase in the number of beneficiaries with Medigap insurance is statistically significant. 

‘Although the number of beneficiaries with Medicaid decreased 3 percent, the decrease is not 

statistically significant. 

2 
EIGHTY-EIGHT PERCENT OF BENEFICIARIES ARE SATISFIED WITH THEIR 

ADDITIONAL INSURANCE 

As shown in Figure 1, 88 percent of beneficiaries who have insurance policies that supplement 

Medicare said they are satisfied with them. Only 6 percent are dissatisfied. 

Figure 1 

Beneficiary 

Supplemental 

q 35% 

Satisfaction with 

Health Insurance 

. Very Satisfied 53% 

q Generally Satisfied 35% 

. Neither Satisfied nor 

Dissatisfied 6% 

q Generally Dissatisfied 4% 

q Very Dissatisfied 2% 

Figure 1 represents the responses of beneficiaries who have either 

Medigap or insurance through former or current employers. 

Table 2 shows that satisfaction with insurance that supplements Medicare has not changed 

since 1995. 

Table 2 

Satisfaction with Insurance That Supplements Medicare 
APPENDIX A 

RESPONSES TO 1997 SURVEY OF BENEFICIARIES 

Question Number of Responses 

1. What types of medical insurance do you or your spouse have in addition to 

Medicare? 

(Check all that apply.) 

(N = 907 - Number Responding 

I do not have additional 

insurance coverage 

Medicaid (or other State or 

county medical assistance 

program) 

Health insurance through you or 

your spouse’s current employer 

Health insurance through you or 

your spouse’s former employer 

Private Medicare supplement 

(Medigap) 

Other 

Not Answering: 70 

to Question) 

127 

85 

58 

321 

347 

7 

A-l 
Question Number of Responses 

2. How satisfied are you with your private Medicare supplemental insurance? 

(Check one.) 

(N = 504 - Number Who Had Medigap or Insurance Through Current or Previous 

Employment and Responded to Question) 

Very Satisfied 

Generally Satisfied 

Neither Satisfied 

nor Dissatisfied 

Generally Dissatisfied 

Very Dissatisfied 

Not Answering: 72 

268 

178 

30 

20 

8 

A-2 
APPENDIX B 

CONFIDENCE INTERVALS 

FINDING #l Eighty-six percent of beneficiaries report they have medical coverage in 

addition to Medicare. 

Estimate Boundaries for the 95% Description 

1997 

Beneficiaries with Additional Coverage: 

Insurance through Current or Former 

Employer 

Current Employer 

Former Employer 

Private Supplemental (Medigap) 

Medicaid 

Other 

Beneficiaries with No Added Coverage 

Beneficiaries with Additional Coverage: 

Insurance through Current or Former 

Employer 

Private Supplemental (Medigap) 

Medicaid 

Other 

Beneficiaries with No Added Coverage 

Confidence Intervals 

86% +I- 2.3% 

41% +I- 3.2% 

6% +/- 1.5% 

35% +/- 3.1% 

38% +I- 3.2% 

9% +/- 1.9% 

1% +/- .6% 

16% +I- 2.3% 

84% +I- 2.5% 

42% +I- 3.4% 

32% +I- 3.2% 

12% +/- 2.3% 

1% +I- .7 

16% +/- 2.5% 

B-l 
FINDING #2 Eighty-eight percent of beneficiaries are satisfied with additional coverage. 

Description Estimate Boundaries for 95% 

Confidence Interval 

Beneficiaries satisfied with additional 

medical coverage. 88% +/- 2.8% 

B-2