Health Assistance Partnership - Helping SHIPS Help Medicare Beneficiaries
Building Your SHIP
Collaborative State Projects
SHIPTools
Volunteer Program Development
Best Practices
SHIP Funding

Charting Your Course
Original Medicare
Medicare Advantage
Medicare Drug Coverage
Medicaid & Low-Income Benefits
Reference Library

Propelling Your SHIP
Consultative Services

Join the HAP Community

Medicare Part D Manual:
Evaluation Form

To ensure that the Part D Manual is meeting your needs, we ask that you take 10 minutes to complete this evaluation form. You may also contact Lee Thompson directly at 202-737-6340 or at lthompson@hapnetwork.org. Thank you for your time.

1. How will you use the Part D Manual? Please select all that apply. (If you choose other, please specify below.)

Other (please specify)

2. Which section(s) of the manual did you read and/or use?


3. Please rate each section of the Part D Manual on a scale of 1 to 5, with 1 as the lowest and 5 as the highest rating. Rate each section according to how clear and useful the section was for you. (If you did not use a a section, please put N/A.)

Section  Rating 

I. Overview of Medicare Part D

II. Types of Drug Plans

III. Eligibility and Enrollment

IV. Relationship to Medicare Advantage

V. Costs and Prices

VI. Help for Low-Income Beneficiaries

VII. Access to Drugs and Formularies

VIII. Coverage Determinations
and Appeals

IX. Marketing Rules

X. Resources

4. If you rated any section below 3, please indicate the section and briefly explain why.

5. Please explain your thoughts on the Counseling Tips in the manual.
6. Please explain your thoughts on the Counseling Questions in the manual.
7. Please explain your thoughts on the For Examples in the manual.

8. Please describe any difficulties you encountered with the manual.

9. What additional materials would you like to have included in the manual?

10. Would you be interested in any training to accompany the manual? If yes, please describe what type of training would be most helpful.

11. Would you like to have reviews or “tests” available for each section of the manual as a way to certify your counselors?

12. Would you like this manual to be updated and available in future years?

13. Would you like this manual to be available online for your counselors?

14. Would you be interested in manuals on topics other than Medicare Part D? If yes, please indicate which topics.

15. If you have any additional comments and/or you would like to be contacted by HAP about manuals on topics other than Medicare Part D, please include your email address here:

 

     
Update Your Profile | Web Features | Privacy Policy | Contact Us | Printer-Friendly Version | Copyright and Terms of Use

Health Assistance Partnership
1201 New York Avenue NW, Suite 1100
Washington, DC, 20005
Phone: 202-737-6340
Fax: 202-737-8583
shiphelp@hapnetwork.org