Medicare Enrollment 2020

The Question

Why is the process of enrolling in Medicare so complicated and how can we make it easier for users?

The Story

The U.S. Department of Health and Human Services runs the largest health insurance program in the United States: Medicare. And despite the fact that millions of Americans register for Medicare coverage every year, it is a complicated process. Just to name a few challenging elements:

It involves choosing between the traditional fee-for-service Medicare or the private managed-care alternative, called Medicare Advantage.
Enrollees have to choose among different coverage and payment plans.
Lifelong financial penalties are a real possibility if an enrollee misses their enrollment window.
There isn’t a single federal agency responsible for the end-to-end enrollment process. Enrollees might interact with the Social Security Administration (SSA), the Centers for Medicare and Medicaid Services (CMS), or government-funded non-profits, depending on their circumstances and how they sign up.

Working with SSA and CMS together, we asked: how might we improve the Medicare enrollment process?

After conducting 51 interviews with recent or prospective Medicare enrollees, and 18 stakeholder interviews, we discovered that many enrollees struggled to understand and navigate the Medicare enrollment process. Based on challenges identified during our research, we developed prototypes of a web-based Medicare Enrollment Roadmap, an online Chatbot, and a Get Help Search Tool that could direct people to local resources. We decided to refine and test the Medicare Enrollment Roadmap after feedback indicated this would be the most helpful tool for Medicare enrollees.