The Medicare Advantage and Prescription Drug Plan Disenrollment Reasons Survey
Overview: The Medicare Advantage and Prescription Drug Plan Disenrollment Reasons Survey captures the reasons Medicare beneficiaries voluntarily disenroll from their Medicare Advantage (MA) health and prescription drug plan (PDP) contracts. The Disenrollment Reasons Survey provides additional insight about reasons people leave their MA and PDP contracts beyond what disenrollment rates tell us. The survey excludes beneficiaries who involuntarily disenrolled from contracts for eligibility reasons, moved out of their contract’s service area, died, are Low Income Subsidy (LIS) beneficiaries reassigned by CMS, and those who switch from one plan benefit package to another under the same contract. Since 2013, CMS has surveyed beneficiaries who have voluntarily disenrolled from PDP and MA contracts.
About the survey: The PDP and MA Plan Disenrollment Reasons Survey is administered using three survey versions tailored to the type of contract the beneficiary left: 1) a stand-alone prescription drug plan (PDP) version; 2) a Medicare Advantage Prescription Drug (MA-PD) plan version; and 3) a Medicare Advantage (MA)-only version. A random sample of voluntary disenrollees from each contract is drawn monthly and surveyed as soon as possible following the beneficiary’s actual date of disenrollment. The sampled participants receive a pre-notification letter and up to two mailed survey packages (original and follow-up) within a 1-2 month window from time of disenrollment. The survey asks participants what reasons prompted them to disenroll from their contract including financial, drug or health benefits, customer service, and the coverage of doctors and hospitals by the contract.
Public reporting and policy relevance: Survey results are grouped into composite measures, so that the reasons given by disenrollees can be compared across contracts. Five composite measures are available: “Financial Reasons for Disenrollment,” “Problems with Prescription Drug Benefits and Coverage,” “Problems Getting Information and Help from the Plan,” “Problems Getting the Plan to Provide and Pay for Needed Care” and “Problems with Coverage of Doctors and Hospitals.” Data on these composite measures can be found at, http://go.cms.gov/partcanddstarratings in the annual Star Ratings Data Table and in the Display Measures .zip folder.
The survey results are used by contracts to identify areas in need of quality improvement and by Medicare administrators and policymakers to monitor the performance of Medicare plans.
For more information, please contact: DisenrollSurvey@cms.hhs.gov