From Nov. 15 to the start of the year, the Medicare hot line is swamped as beneficiaries look to enroll into drug plans.
Here are some tips for when you do have questions:
¢ Along with 1-800-Medicare, beneficiaries can call 1-800-860-5260, the hot line for Senior Health Insurance Counseling for Kansas (SHICK).
Janet Ikenberry, program manager for Douglas County Senior Services, said many seniors choose the state hot line over 1-800-Medicare. This hot line uses volunteers to assist in answering questions and clients can meet with counselors in person.
¢ If you do call 1-800-Medicare, make sure you have your Medicare ID card, a pen or pencil and paper on hand. Giving a customer service representative your Medicare ID number will allow them to pull up important information about your plan, which can help them better answer your questions.
¢ Make sure you check out your Medicare handbook before calling. Sent to each beneficiary's home, the handbook gives tips for bypassing the voice response system at the beginning of the call. For example, if you want to talk to a person, just say agent.
¢ To avoid long waits, call during off-peak hours. Mondays and Tuesdays tend to be the busiest days and 10 a.m. to 2 p.m. is typically the time of day with the most calls. Customer service representatives are available 24 hours a day, seven days a week.
For the millions of seniors who rely on Medicare as a lifeline, getting through its phone hot line can be a bit of a hang-up.
At least that was the testimony of U.S. Sen. Gordon Smith, R-Ore., during a congressional hearing last month.
His office made 500 test calls to 1-800-Medicare and revealed "hourlong waits, disconnected calls, endless loops of referrals and call transfers, and erroneous information about benefits and services."
Those concerns will likely resonate in Lawrence, home to one of the nation's six Medicare call centers.
One of city's largest employers, Vangent, which is in the East Hills Business Park, has more than 600 customer service representatives answering questions coming into the Medicare hot line. It is the third largest Medicare call center in the country.
For $225 million a year, Vangent contracts with the Centers for Medicare and Medicaid Services to operate Medicare's hot line call centers.
On Sept. 11, senior advocates from across the country testified before the U.S. Senate Special Committee on Aging about the continual problems they have with the hot line's service.
"You don't know whether to laugh or cry. They give answers that are clearly wrong and if they don't know an answer they make it up," said Elaine Wong Eakin, a project manager with California Health Advocates.
At the hearing, the nonprofit organization said customer service representatives gave out information that unintentionally locked clients into or out of drug plans. Among the more alarming mistakes was an agent who told a transplant patient that Medicare beneficiaries were not entitled to lifetime coverage of anti-rejection medication.
It took several phone calls and conversations with supervisors before the patient received the life-saving medication.
"They really need to be trained on every question that comes up," Eakin said.
In Wisconsin, seniors were seeing wait times as long as 30 minutes, said John Hendrick, a project attorney with the Coalition of Wisconsin Aging Groups.
And, there was the repeated problem of customer service representatives calling back, but not leaving a return phone number if they got a voice message.
"You have to start all over again and call 1-800-Medicare," Hendrick said. "You are basically starting from scratch."
Those unhappy callers are a small percentage of the traffic, said Eileen Rivera, Vangent's vice president of communications and investors relations.
"Ninety-eight percent of the calls are going very well. CMS is pleased with our performance. If they weren't, we would know about it," Rivera said.
Test calls coming from Smith's office weren't typical in that the callers didn't have Medicare identification numbers and had a half dozen or more questions," Rivera said.
Changes on the way
The hot line is the main outlet of information for Medicare clients wanting to talk to a representative. 1-800-Medicare handles questions ranging from enrolling in drug plans to billing information.
After navigating through menu options and an interactive voice response system, callers reach an agent. Prompted by key words the callers use, representatives read off of scripts.
If the questions are complicated, callers can be transferred to a second tier of customer service representatives.
Before new customer service representatives start taking calls, they undergo 15 days of training, Rivera said. For those who advance from the front lines of calls to more complicated issues, seven and half weeks of training is given.
More training is already under way for customer service representatives, Rivera said. The extra training is to gear up for the annual spike in calls when beneficiaries can enroll in new drug plans. More customer service representatives are also hired during this time, including 132 in Lawrence.
"We are working with CMS to do a better job. Training and improvement is a hallmark for our program. We are constantly training," Rivera said.
Even without the hearings, CMS was working to make improvements, said Mary Laureno, director of CMS' office of beneficiary information services.
Wait times have already gone down, she said. Vangent is contracted with CMS to have average wait times of 8 minutes and 30 seconds. In August, average wait times were 3 minutes and 40 seconds.
CMS is also looking at the scripts used by customer service representatives. The scripts are provided by a different contractor than Vangent.
"We are always looking at ways to improve the program and provide better customer care whether the Senate's committee on aging was doing the investigation or not," Laureno said.