MHNMTD2180 : Medicare Mobile Research Study

Question Title

* 1. Murray Hill National is conducting a study on Medicare and would like you to participate. If you qualify for this study, we are offering an incentive. Please be assured that we are not selling anything and the information we gather will remain confidential and be used for research purposes only. We have a few questions to ask before providing more details and determining if you qualify to participate.

Name

Company

Address

Address 2

City/Town

State/Province

Zip/Postal Code

Country

Email address

Phone number

Question Title

* 2. Do you identify as...

Male

Female

Other (Please specify)

Rather not say

Question Title

* 3. In which state do you live?

Question Title

* 4. What was your annual household income (before taxes) in the past year?

Under $20,000

$20,000 to $49,999

$50,000 to $79,999

$80,000 to $109,999

$110,000 to $139,999

$140,000 or more

Question Title

* 5. Do you own a mobile phone?

Yes

Question Title

* 6. Which of the following statements best describes your level of comfort with using a mobile phone?

I find it easy to use my mobile phone and navigate the various features

I sometimes find it challenging to use certain features on my mobile phone

I find it challenging to use my mobile phone and often need assistance

Question Title

* 7. Are you aware of Medicare health insurance?

Yes

Question Title

* 8. Which of the following statements reflects your current enrolment status with regard to Medicare health insurance?

I am currently enrolled in Medicare health insurance

I am not currently enrolled in Medicare health insurance, but I am planning to enroll soon

I am not enrolled in Medicare health insurance, and I have no plans to enroll in the near future

Question Title

* 9. Which of the following Medicare Health insurance providers are you considering enrolling with?

Aetna Medicare

UnitedHealthcare

Cigna

Humana

Other (please specify)

Question Title

* 10. And which of the following types of Health Insurance Plans are you considering enrolling in?

Medicare Advantage

Medicare Advantage that includes a Prescription Drug Benefit

Medicaid

Original Medicare

Dual Special Needs Plan

Dual Special Needs Plan that includes a Prescription Drug Benefit

Medicare Supplement Plan

Other (please specify)

Question Title

* 11. Did you switch your Medicare Plan last year?

Yes

Question Title

* 12. Do you have plans to switch your Medicare health plan in the coming months?

Yes

Question Title

* 13. Which Medicare Health insurance provider are you currently enrolled with as a member?

Aetna Medicare

UnitedHealthcare

Cigna

Humana

Other (please specify)

Question Title

* 14. And which of the following types of Health Insurance Plans do you currently have?

Medicare Advantage

Medicaid

Original Medicare

Dual Special Needs Plan

Medicare Supplement Plan

Other (please specify)

Question Title

* 15. Which of the following best describes how you typically shop for Plans on the Medicare website?

I use a mobile phone

I use a desktop computer

I use both a mobile phone and desktop computer

None of the above

Question Title

* 16. Which of the following do you identify as…

White

South Asian (e.g., East Indian, Pakistani, Sri Lankan, etc.)

Chinese

Black

Filipino

Latin American

Arab

Southeast Asian (e.g., Vietnamese, Cambodian, Laotian, Thai, etc.)

West Asian (e.g., Iranian, Afghan, etc.)

Korean

Japanese

Other (please specify)

Question Title

* 17. What is your marital status?

Married/Common-Law

Single

Widowed

Separated

Divorced

Rather not say

Question Title

* 18. Which of the following best describes your current employment status?

Work full-time

Work part-time

Student

Homemaker

Maternity leave

Retired

Unemployed

Rather not say

MHNMTD2180 : Medicare Mobile Research Study

Question Title

Question Title

* 2. Do you identify as...

Question Title

* 3. In which state do you live?

Question Title

* 4. What was your annual household income (before taxes) in the past year?

Question Title

* 5. Do you own a mobile phone?

Question Title

* 6. Which of the following statements best describes your level of comfort with using a mobile phone?

Question Title

* 7. Are you aware of Medicare health insurance?

Question Title

* 8. Which of the following statements reflects your current enrolment status with regard to Medicare health insurance?

Question Title

* 9. Which of the following Medicare Health insurance providers are you considering enrolling with?

Question Title

* 10. And which of the following types of Health Insurance Plans are you considering enrolling in?

Question Title

* 11. Did you switch your Medicare Plan last year?

Question Title

* 12. Do you have plans to switch your Medicare health plan in the coming months?

Question Title

* 13. Which Medicare Health insurance provider are you currently enrolled with as a member?

Question Title

* 14. And which of the following types of Health Insurance Plans do you currently have?

Question Title

* 15. Which of the following best describes how you typically shop for Plans on the Medicare website?

Question Title

* 16. Which of the following do you identify as…

Question Title

* 17. What is your marital status?

Question Title

* 18. Which of the following best describes your current employment status?

Question Title

* 19. Can you tell me your age?