Medicare Customer Support Services
Centers for Medicare and Medicaid Services, Department of Health and Human Services
Medicare provides health care coverage to more than 63 million people and offers services to help customers understand this coverage and empower future customers to make informed decisions about which Medicare plan is right for them.
Medicare enrollees and those looking to enroll report high satisfaction with the service they receive when calling Medicare, and new online tools are helping make the agency’s website clearer and easier to navigate. Despite these successes, customers who are new to Medicare can struggle to navigate the service options available. To address the needs of these new customers, the agency redesigned the section of its website that offers information specifically for new customers and piloted a free “concierge service” to offer more in-depth support when these customers call Medicare.
point increase in customer satisfaction with Medicare.gov among customers who are new to Medicare (from January to August 2021).
of callers who participated in a pilot of Medicare’s free “concierge service” were satisfied with the service.
Customer Experience Insights
Improvement from last year
Room for improvement
In late 2020, the agency launched a new Care Compare tool on Medicare.gov that is optimized for mobile devices. It enables customers to easily search for the type of care they are seeking and narrow down results to find the provider best match. This new feature combines several previous search tools that had been confusing to customers: before that, they would have to know exactly what type of care they were looking for and the specific technical term Medicare uses to describe it. The new tool enables customers to search by location, key words or phrases and includes improved filters and maps of provider locations, making it easier for customers to find the provider that is right for them. The tool also includes additional resources to help customers make decisions; for example, customers searching for a nursing home can see a checklist with common questions and considerations to help them evaluate their options.
The process of enrolling in Medicare for the first time can be complicated for customers who must make several important decisions about the type and timing of coverage they want. Medicare’s customer research shows that these “new to Medicare” customers do not have as smooth an experience with Medicare services as existing customers and may need extra support. To address this gap, the agency recently redesigned the “Get Started with Medicare” section of Medicare.gov to help new customers more easily find the information they need to make decisions about their coverage. Medicare also improved its Initial Enrollment Period package to lay out more clearly the actions new customers must take when enrolling and partnered 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. With these changes, customer satisfaction with Medicare.gov increased by 24 points for “new to Medicare” customers between January and August 2021.
This year the agency also piloted free “concierge service” to offer more in-depth assistance to new customers calling 1-800-Medicare. For customers who accepted, call center representatives scheduled a follow-up call and noted any questions or topics the customer would like to discuss. Specialized call center representatives then returned the customer’s call at the scheduled time to talk through their specific questions. To ensure customers had the information they needed, representatives also offered to follow up after the call with a letter detailing the topics discussed and the next actions the customer needed to take. In survey data Medicare collected, 97% of callers who participated in the pilot were satisfied with the concierge service.
Some people get help from caregivers in managing their Medicare benefits—whether family members or aides, nurses or other professionals. It can be hard for caregivers to access claims information and health care records on Medicare.gov, since only a Medicare beneficiary can set up an account on the site. In the future, CMS plans to add an option for caregivers to create their own accounts that link to the information for those they assist—potentially enabling them to manage benefits for multiple people (e.g., both their parents) with one login.
Leading Customer Experience Practices
The Partnership and Accenture developed the following list of practices to understand how agencies prioritize the customer experience, and steps they can take to improve. The list is based on research about effective customer experience practices in both government and the private sector, and aligns with practices in a customer experience maturity self-assessment for agencies developed by the Office of Management and Budget.
A strong commitment and plan from agency leaders to prioritize customer experience is essential for sustained progress.
1. Includes high-quality customer experience in its strategic goals.
Customer experience improvements are included in several of Medicare’s 16 strategic initiatives.
2. Specifies customer feedback as a key measure of the organization’s performance.
CMS uses customer feedback when measuring the performance of Medicare customer service programs, although it does not have a specific performance measure based on customer feedback.
3. Has a senior executive with the responsibility and authority to lead efforts to improve the customer experience across the organization.
CMS coordinates its customer experience efforts across the agency through its Office of Communications, and the head of this office has customer experience as one responsibility.
Ease of Customer Interactions
Interactions with the federal government should be easy, transparent and designed around user needs.
For the most common services provided, customers can:
1. Complete common transactions using the service delivery channel of their choice.
Most common transactions can be completed online or over the phone. Customers can also use webchat to speak with the Medicare contact center. Medicare does not have field offices.
2. Obtain status updates through online self-service.
Customers with MyMedicare accounts can log in to get information on the status of their Medicare enrollment and claims.
3. Receive a response to feedback or answers to questions over social media.
Medicare occasionally responds to basic customer comments on the agency’s social media by sharing links to the agency’s website.
4. Access online information and support in languages other than English.
Medicare.gov is available in both English and Spanish, and some service information is available in 22 additional languages.
Listening to Customers and Acting on Feedback
To understand and prioritize customer needs, agencies should collect, publish, analyze and act on feedback.
1. Collects meaningful customer experience data across interactions and service delivery channels and shares it with the public.
While Medicare collects customer experience data across service delivery channels, it does not currently share this data with the public.
2. Collects and analyzes first-hand customer feedback to understand customers’ experiences, based on their own words.
CMS regularly collects and analyzes first-hand customer feedback.
3. Aggregates and analyzes customer feedback across channels and programs, and shares feedback with relevant staff members so they can act on it.