Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

Medicare Current Beneficiary Survey (MCBS) (CMS-P-0015A)

Medicare Current Beneficiary Survey (MCBS):(CMS Number CMS-P-0015A)

OMB: 0938-0568

Document [pdf]
Download: pdf | pdf
2026 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

KNQ - BENEFICIARY KNOWLEDGE

Question Text/Description

Code List

Routing

(01) CONTINUE
(-7) Empty

KN1 - KNOWMC

(01) VERY EASY
(02) SOMEWHAT EASY
(03) SOMEWHAT DIFFICULT
(04) VERY DIFFICULT
(-8) Don't Know
(-9) Refused

KN2 - KCARKNOW

(01) JUST ABOUT EVERYTHING YOU NEED TO
KNOW
(02) MOST OF WHAT YOU NEED TO KNOW
(03) SOME OF WHAT YOU NEED TO KNOW
(04) A LITTLE OF WHAT YOU NEED TO KNOW
(05) ALMOST NONE OF WHAT YOU NEED TO KNOW
(-8) Don't Know
(-9) Refused

KN25B1 - KNINFMCR

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN25C - KNINTMCR KNCOVOPT

(01) VERY INTERESTED
(02) SOMEWHAT INTERESTED
(03) NOT VERY INTERESTED
(04) NOT AT ALL INTERESTED
(-8) Don't Know
(-9) Refused

KN25D-KNCOVOPT

(01) Very easy
(02) Somewhat easy
(03) Somewhat difficult
(04) Very difficult
(05) DOES NOT MAKE DECISIONS ON HEALTH
INSURANCE
(-8) Don't Know
(-9) Refused

KN25E-KNCOVREV

BENEFICIARY KNOWLEDGE AND INFORMATION NEEDS QUESTIONNAIRE SPECIFICATIONS
CRITERIA
INTTYPE=C001, C002, C004, C005, C006, C007
SPALIVE=1
SEASON=WINTER
SPPROXY=SP or PROXY
Other: N/A
PLACEMENT
Administer after CVQ.

KNINTR

KNINTRO

no entry

Now I have some questions that ask how you get information about the Medicare program [for (SP)]. Your answers
will help Medicare provide the information that people need.
Keep in mind that, generally, there are no right or wrong answers to these questions. Your opinions and
experiences are important to us.
SHOW CARD KN1

KNOWMC

KN1

code 1

Overall, how easy or difficult do you think the Medicare program is to understand?
[PROBE IF NECESSARY: Would you say it is very easy to understand, somewhat easy to understand, somewhat
difficult to understand, or very difficult to understand?]

SHOW CARD KN2
KCARKNOW

KN2

code 1

How much do you think you know about the Medicare program?
Do you know just about everything you need to know, most of what you need to know, some of what you need to
know, a little of what you need to know or almost none of what you need to know about the Medicare program?

KNINFMCR

KNINTMCR

KN25B1

KN25C

yes/no

code 1

In the past year, have you tried to find any information [for (SP)] about Medicare?

SHOW CARD KN3
How interested are you in getting (more) information [for (SP)] about Medicare?

SHOW CARD KN4 KN3
KNCOVOPT

KN25D

code 1

How easy or difficult would you say it is for [you/(SP)] to review and compare [your/(SP)'s] Medicare coverage
options? Would you say it is …

Page 1 of 6

2026 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

KNQ - BENEFICIARY KNOWLEDGE

Question Text/Description

SHOW CARD KN5 KN4
KNCOVREV

KN25E

code 1

How often [do you/does (SP)] review or compare [your/(SP)'s] Medicare coverage options? Would that be at least
once every year, once every few years, rarely, or never?

SHOW CARD KN6 KN5
KNCOVINF

KN25F

code 1

To what extent do you agree or disagree with the following statement:
[I have/(SP) has] the information [I need/(SP) needs] to make an informed comparison among different health
insurance choices.
Would you say you …

SHOW CARD KN7 KN6
KNFOSATI

KN26

code 1

KN27IN

KN27INT

no entry

KBOKRECD

KN27

yes/no

How satisfied are you in general with the availability of information about the Medicare program when you need it
[for (SP)]?

Now I would like to ask you about publications that are available to you [and (SP)] about the Medicare program.

Code List

Routing

(01) AT LEAST ONCE EVERY YEAR
(02) ONCE EVERY FEW YEARS
(03) RARELY
(04) NEVER
(05) ONLY ONCE WHEN FIRST SIGNED UP FOR
DRUG PLAN
(06) ONLY ONCE WHEN FIRST SIGNED UP FOR
MEDICARE
(07) JUST SIGNED UP FOR MEDICARE
(-8) DON'T KNOW
(-9) REFUSED

KN35F-KNCOVINF

(01) Completely agree
(02) Somewhat agree
(03) Somewhat disagree
(04) Completely disagree
(05) DOES NOT MAKE DECISIONS ON HEALTH
INSURANCE
(-8) Don't Know
(-9) Refused

KN26 - KNFOSATI

(01) VERY SATISFIED
(02) SATISFIED
(03) DISSATISFIED
(04) VERY DISSATISFIED
(05) NOT APPLICABLE
(-8) Don't Know
(-9) Refused

KN27INT - KN27IN

(01) CONTINUE
(-7) Empty

KN27 - KBOKRECD

SHOW CARD KN8 KN7

KBOKREAD

KN28

code 1

(01) YES
(02) NO
Did [you/(SP)] receive in the mail or view on the Medicare website a book called "Medicare and You [CURRENT
(-8) Don't Know
YEAR]?” This book gives an overview of the Medicare program and is sent to Medicare beneficiaries every fall. The
(-9) Refused
cover looks like this.

Would you say you have read this book thoroughly, that you have read parts of it, or that you haven't read it at all?

SHOW CARD KN9
KBOKUNDR

KN29

code 1

How easy or difficult did you find (the parts you read/this book) to understand?
[PROBE IF NECESSARY: Would you say (they were/it was) very easy to understand, somewhat easy to
understand, somewhat difficult to understand, or very difficult to understand?]
Next, I'd like to ask about [your/(SP's)] use of computers.

COMPDESK

KN50A

grid

[Do you/Does (SP)] own or use any of the following types of computers? Please tell me yes or no for each item I
list.
Desktop or laptop

(01) KN28 - KBOKREAD
(02) KN50A- COMPDESK
(-8) KN50A- COMPDESK
(-9) KN50A- COMPDESK

(01) READ IT THOROUGHLY
(02) READ PARTS OF IT
(03) HAVEN'T READ IT AT ALL
(-8) Don't Know
(-9) Refused

(01) KN29 - KBOKUNDR
(02) KN29 - KBOKUNDR
(03) KN50A-COMPDESK
(-8) KN50A- COMPDESK
(-9) KN50A- COMPDESK
KN50A- COMPDESK

(01) VERY EASY
(02) SOMEWHAT EASY
(03) SOMEWHAT DIFFICULT
(04) VERY DIFFICULT
(-8) Don't Know
(-9) Refused

KN50A- COMPDESK

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN50A- COMPPHON

Page 2 of 6

2026 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

KNQ - BENEFICIARY KNOWLEDGE

Question Text/Description
Next, I'd like to ask about [your/(SP's)] use of computers.

COMPPHON

KN50A

grid

[Do you/Does (SP)] own or use any of the following types of computers? Please tell me yes or no for each item I
list.
Smartphone
Next, I'd like to ask about [your/(SP's)] use of computers.

COMPTAB

KN50A

grid

[Do you/Does (SP)] own or use any of the following types of computers? Please tell me yes or no for each item I
list.
Tablet or other portable wireless computer
Some people use the Internet to get different kinds of information. The next questions ask about the Internet.

Code List

Routing

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN50A- COMPTAB

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN51INT - KN51IN

(01) CONTINUE
(-7) Empty

INTERNET-INTERNET

KN51IN

KN51INT

no entry

INTERNET

INTERNET

yes/no

[Do you/ Does (SP)] have access to the internet?

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) KN51A-USENET KN51C - OFTNNET
(02) KN51B- SOMELNET
(-8) KN51B- SOMELNET
(-9) KN51B- SOMELNET

USENET

KN51A

code 1

[Do you/Does (SP)] personally ever use the Internet to get information of any kind?

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) KN51C - OFTNNET
(02) KN51B - SOMELNET
(-8) AUDIOVID
(-9) AUDIOVID

SOMELNET

KN51B

yes/no

[Do you/Does(SP)] have someone else, such as a friend, relative, or anyone else, get information for [you/(SP)] on
the Internet?

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) KN51C - OFTNNET
(02) AUDIOVID BOX KN7
(-8) AUDIOVID BOX KN7
(-9) AUDIOVID BOX KN7

(01) EVERY DAY
(02) A FEW TIMES A WEEK
(03) A FEW TIMES PER MONTH
(04) A FEW TIMES PER YEAR OR LESS
(-8) Don't Know
(-9) Refused

AUDIOVID

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

BOX KN7

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN53A-KCOMINTE

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN53A -KCOMPRES

OFTNNET

KN51C

code 1

[EXPLAIN IF NECESSARY: The Internet includes web sites, e-mail, newsgroups, and other forums.]

How often [do you/does (SP)] access the Internet to seek information, either on [your/(SP)'s] own or with someone
else's help?
Please do not include any time spent reading or sending e-mail.

AUDIOVID

KVSTSITE

AUDIOVID

yes/no

Since (REFERENCE DATE), [have you/has (SP)] participated in video or voice calls or conferencing over the
internet, such as with Zoom, Skype or FaceTime?

BOX KN7

routing

IF SP DID NOT REPORT VISITING OR ACCESSING THE OFFICAL WEBSITE FOR MEDICARE INFORMATION
IN ANY PREVIOUS ROUND (SAMPLE_PERSON.P_KVSTSITE^=1) GO TO KN53 - KVSTSITE.
ELSE GO TO KN53A-KCOMINTE

KN53

yes/no

(Has anyone/[Have you/Has (SP)]) ever visited or ever accessed the official website for Medicare information www.medicare.gov [for (SP)]?

Now I have some questions that ask about how Medicare beneficiaries use the Internet to access health care
related information.
KCOMINTE

KN53A

Grid

During the past 12 months, [has anyone/have you/has (SP)] used the Internet to
Look up health information [for (SP)]?

Page 3 of 6

2026 MCBS Community Questionnaire

Variable Name

MR Screen Name

Question Type

KNQ - BENEFICIARY KNOWLEDGE

Question Text/Description
Now I have some questions that ask about how Medicare beneficiaries use the Internet to access health care
related information.

KCOMPRES

KN53A

Grid

During the past 12 months, [has anyone/have you/has (SP)] used the Internet to
Fill a prescription [for (SP)]?

Now I have some questions that ask about how Medicare beneficiaries use the Internet to access health care
related information.
KCOMAPPO

KN53A

Grid

During the past 12 months, [has anyone/have you/has (SP)] used the Internet to
Schedule an appointment with a health care provider [for (SP)]?

Now I have some questions that ask about how Medicare beneficiaries use the Internet to access health care
related information.
KCOMCOMM

KN53A

Grid

During the past 12 months, [has anyone/have you/has (SP)] used the Internet to
Communicate with a health care provider [for (SP)]?

KCHIHELP

KREELINE

KCPHINFO

BOX KN8

routing

IF PROXY IS RESPONDENT, GO TO BOX KN9.
ELSE GO TO KN54 - KCHIHELP.

KN54

code 1

Most of the time, do you make decisions about Medicare health insurance on your own, do you get help from
someone in making these decisions, or do you rely on someone else to make decisions about health insurance for
you?

BOX KN9

routing

IF SP HAS NOT BEEN ASKED KREELINE IN A PREVIOUS ROUND (SAMPLE_PERSON.P_KREELINE=.), GO
TO KREELINE.
ELSE GO TO BOX KN10.

KN56

yes/no

Before today, were you aware of the 1-800-MEDICARE toll-free line?

BOX KN10

routing

IF SP DID NOT REPORT CALLING 1-800-MEDICARE TO GET INFORMATION ABOUT MEDICARE IN ANY
PREVIOUS ROUND (SAMPLE_PERSON.P_KCHPINFO ^= 1) GO TO KN57 - KCPHINFO.
ELSE GO TO RGHTAPL

KN57

yes/no

Have you ever called 1-800-MEDICARE to get information about Medicare?

Code List

Routing

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN53A -KCOMAPPO

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN53A -KCOMCOMM

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

BOX KN8

(01) MAKES DECISIONS ON OWN
(02) GETS HELP ON DECISIONS
(03) SOMEONE ELSE MAKES DECISIONS
(-8) Don't Know
(-9) Refused

BOX KN9

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) KN57 - KCPHINFO
(02) RGHTAPL
(-8) RGHTAPL
(-9) RGHTAPL

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

RGHTAPL

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

KN58-OEINTRO1

Everyone covered by Medicare has certain rights and protections under their Medicare coverage.
These rights include the right to file a complaint or appeal any decision or action made by a medical provider if you
think you are being unfairly denied coverage, or denied adequate and complete treatment of your condition.
RGHTAPL

RGHTAPL

yes/no

If [you/(SP)] had concerns about the quality of care [you were/(SP) was] receiving from a healthcare provider or
facility, would [you/(SP)] know how to file a complaint or an appeal with Medicare?
[PLEASE INCLUDE SCENARIOS WHERE A PROXY HELPS THE RESPONDENT MAKE DECISIONS ABOUT
THEIR MEDICARE COVERAGE.]

Page 4 of 6

2026 MCBS Community Questionnaire

KNQ - BENEFICIARY KNOWLEDGE

Variable Name

MR Screen Name

Question Type

Question Text/Description

OEINTRO1

KN58

no entry

Now I would like to ask you about comparisons [you/(SP)] may have made during the last Medicare Open
Enrollment Period, which is sometimes called the Annual Election Period or Annual Coordinated Enrollment Period. (01) CONTINUE
The Open Enrollment Period runs each year from mid-October to early-December.

KN58A - RVWCOST

code 1

During the last open enrollment period, did [you/(SP)] review [your/(SP)'s] Medicare insurance coverage to see if
there were going to be changes in [your/(SP)'s] monthly premium, deductibles, co-payments, or other out of pocket
(01) YES
expenses?
(02) NO
(03) NOT APPLICABLE, JUST SIGNED UP FOR
[EXPLAIN IF NECESSARY: The Open Enrollment Period – sometimes called the Annual Election Period or Annual
MEDICARE
Coordinated Enrollment Period – runs each year from mid-October to early-December.]
(-8) DON'T KNOW
(-9) REFUSED
[PLEASE INCLUDE SITUATIONS WHERE A PROXY OR SOMEONE ELSE REVIEWS THE RESONDENT’S
MEDICARE INSURANCE COVERAGE FOR OR WITH THEM.]

KN58B - RVWSRVC

RVWCOST

KN58A

Code List

Routing

During the last open enrollment period, did [you/(SP)] review [your/(SP)'s] Medicare insurance coverage to see if
the kinds of treatment, drugs, and services covered will meet [your/(SP)'s] health care needs?
RVWSRVC

KN58B

code 1

(01) YES
(02) NO
[EXPLAIN IF NECESSARY: The Open Enrollment Period – sometimes called the Annual Election Period or Annual (03) NOT APPLICABLE, JUST SIGNED UP FOR
Coordinated Enrollment Period – runs each year from mid-October to early-December.]
MEDICARE
(-8) DON'T KNOW
(-9) REFUSED
[PLEASE INCLUDE SITUATIONS WHERE A PROXY OR SOMEONE ELSE REVIEWS THE RESONDENT’S
MEDICARE INSURANCE COVERAGE FOR OR WITH THEM.]

As you know, Medicare beneficiaries can choose different types of Medicare insurance plans. During the last open
enrollment period, did [you/(SP)] compare [your/(SP)'s] Medicare insurance plan with other Medicare plans that
were available?
CMPRPLN

KN58C

code 1

(01) YES
(02) NO
(03) NOT APPLICABLE, JUST SIGNED UP FOR
[EXPLAIN IF NECESSARY: The Open Enrollment Period – sometimes called the Annual Election Period or Annual
MEDICARE
Coordinated Enrollment Period – runs each year from mid-October to early-December.]
(-8) DON'T KNOW
(-9) REFUSED
[PLEASE INCLUDE SITUATIONS WHERE A PROXY OR SOMEONE ELSE REVIEWS THE RESONDENT’S
MEDICARE INSURANCE COVERAGE FOR OR WITH THEM.]

KN58C - CMPRPLN

(01) KN58D - CPLNTYPE
(02) KN59 - IRAKNOW1
(03) KN59 - IRAKNOW1
(-8) KN59 - IRAKNOW1
(-9) KN59 - IRAKNOW1
KN59 - KCSUGGST

SHOW CARD KN10
What types of Medicare plans did [you/(SP)] compare with [your/(SP)'s] Medicare insurance plan?

CPLNTYPE

KN58D

select all

[EXPLAIN IF NECESSARY:
-Medicare Parts A and B, commonly referred to as “Original Medicare,” provide hospital and medical insurance.
-Medicare Part C includes Medicare Advantage plans. These are plans offered to Medicare beneficiaries by private
companies (approved by Medicare) and provide beneficiaries with their Part A and B benefits. Medical Advantage
is an alternative to Original Medicare.
-Part D covers prescription drugs -- this type of plan is also known as an MPDP. Prescription drug plans are offered
by private companies (approved by Medicare).
- Medigap is a supplemental insurance plan sold by private companies for use with Original Medicare. It cannot be
used with Medicare Advantage. Medigap plans help pay some of the health care costs that Original Medicare
doesn't cover, like copayments, coinsurance and deductibles.]

(01) Medicare Parts A and B (Original Medicare)
(02) Medicare Part C, Medicare Advantage (MA) Plans
(03) Medicare Part D, Medicare Prescription Drug Plans
(MPDPs)
(04) Medigap Plans
(-8) DON'T KNOW
(-9) REFUSED

IRAKNOW1

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) IRAKNOW1 - IRALIMIT
(02) IRAKNOW1 - IRALIMIT
(-8) IRAKNOW1 - IRALIMIT
(-9) IRAKNOW1 - IRALIMIT

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) IRAKNOW1 - IRACAPRX
(02) IRAKNOW1 - IRACAPRX
(-8) IRAKNOW1 - IRACAPRX
(-9) IRAKNOW1 - IRACAPRX

[PLEASE INCLUDE SITUATIONS WHERE A PROXY OR SOMEONE ELSE REVIEWS THE RESONDENT’S
MEDICARE INSURANCE COVERAGE FOR OR WITH THEM.]

IRANEGOT

IRAKNOW1

grid

IRALIMIT

IRAKNOW1

grid

As far as you know, is there a federal law in place that …
Requires the federal government to negotiate the price of some prescription drugs for people with Medicare

Places an annual limit on out-of-pocket prescription drug costs for people with Medicare

Page 5 of 6

2026 MCBS Community Questionnaire

KNQ - BENEFICIARY KNOWLEDGE

Variable Name

MR Screen Name

Question Type

Question Text/Description

Code List

Routing

IRACAPRX

IRAKNOW1

grid

Caps the cost of each insulin product for people with Medicare at $35 per month

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) IRAKNOW1 - IRACAPVC
(02) IRAKNOW1 - IRACAPVC
(-8) IRAKNOW1 - IRACAPVC
(-9) IRAKNOW1 - IRACAPVC

IRACAPVC

IRAKNOW1

grid

Removes out-of-pocket costs for recommended vaccines covered under Medicare Part D
[IF NEEDED: Vaccines covered under Medicare Part D protect against Shingles, Respiratory Syncytial Virus (RSV),
Hepatitis A, Hepatitis B, Measles, Mumps, and Rubella (MMR), and others, including vaccines recommended for
international travel.]

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) IRAKNOW1 - IRAPRTDRX
(02) IRAKNOW1 - IRAPRTDRX
(-8) IRAKNOW1 - IRAPRTDRX
(-9) IRAKNOW1 - IRAPRTDRX

IRAPRTDRX

IRAKNOW1

grid

Allows Medicare Part D enrollees to spread their out-of-pocket prescription drug costs out over the year
[IF NEEDED: Medicare beneficiaries can receive insurance coverage for prescription drugs through Medicare
Prescription Drug plans. These plans are also called "Medicare Part D" plans.]

(01) YES
(02) NO
(-8) Don't Know
(-9) Refused

(01) KCSUGGST
(02) KCSUGGST
(-8) KCSUGGST
(-9) KCSUGGST

(01) R DOES NOT HAVE SUGGESTIONS OR
CONCERNS
(02) RECORD ALL OTHER RESPONSES VERBATIM
(-8) Don't Know
(-9) Refused

(01) BOX KNEND
(02) KN58 - KCSUGGVB
(-8) BOX KNEND
(-9) BOX KNEND

(01) continuous answer

BOX KNEND

KCSUGGST

KN59

verbatim text

As you know, this survey is sponsored by the Centers for Medicare and Medicaid Services, which is the
government agency that runs Medicare. What are your suggestions or concerns about Medicare?
RECORD VERBATIM.

KCSUGGVB

KN59

verbatim text

BOX KNEND

routing

GO TO USQ.

Page 6 of 6


File Typeapplication/pdf
AuthorNORC
File Modified2025:07:01 12:33:26-05:00
File Created2025:07:01 12:29:00-05:00

© 2025 OMB.report | Privacy Policy