"They should have gotten six right just by guessing," said Public Affairs Specialist Mike Fierberg of the Centers for Medicare & Medicaid Services Region VIII office. "They were just yes and no questions."

Fierberg, along with the new Regional Administrator Jeff Hinson, toured the state last week to dispel misinformation as well as listen to concerns from Medicare recipients. From radio call-in shows and other venues, they addressed the legislation while steering clear of the political minefields.

"It's our job to implement the law, not take a position," Fierberg said. "We just want beneficiaries to understand the changes and how to take advantage of them."

According to Hinson, the most far-reaching change is a switch in emphasis to quality outcomes for patients rather than paying for quantities of services. As an example, he said the law provides seniors with an annual physical and screenings such as mammograms without a deductible.

"We want to work on prevention," Hinson said.

He pointed out that 75 percent of Medicare costs go for medical services in the last few years of life for catastrophic diseases that screenings should catch at an earlier, more treatable stage. Fierberg said Medicare hopes to increase the number of people receiving services such as mammograms by eliminating or reducing their out-of-pocket costs.

"For mammograms, the number of women getting them is disturbingly low -- under 50 percent," he said. "That's just not acceptable."

Hinson and Fierberg have found some lingering misconceptions from the hotly debated Patient Protection and Affordable Care Act, usually called the health-care reform bill. Fierberg said the legislation does not have a public option for health insurance.

"A lot of people still think that's part of this package," he said. "A lot of people think physicians' payments were cut. They actually got an increase."

About four out of every 10 people think the act contains the infamous "death panels." According to Fierberg, that's another misconception that has gotten a life of its own.

Hinson said he wants the public to know that this legislation improved the financial viability of Medicare. He said that the date that Medicare would run out of money has been 2017 for 20 years but is now estimated at 2029.

"Your Medicare is going to be here for the long term and it's only going to get better," he said.

They also addressed changes in Part D prescription drug coverage plans and confusion about the $250 rebate check. Fierberg said that about 30 percent of people with Part D hit the $2,830 coverage limit each year that requires them to pay 100 percent of drug costs until expenses reach $6,444.

About half of the 30 percent who hit the gap receive the extra help feature for low-income beneficiaries that continues their coverage, reducing the number impacted. Those with extra help don't receive the $250.

In 2010, Medicare will mail the rebate check to Part D participants who lose their coverage due to the gap. In 2011, the act provides a 50 percent discount on prescription drugs purchased in the coverage gap with additional savings in each year until the gap is eliminated in 2020.

Hinson and Fierberg also addressed the recent media stories about Medicare changes to Part D requiring insurance companies to stream line their plan offerings. Fierberg said stories quoting numbers of people who may have to change their plans aren't based on fact because no data has been published.

"We're only cutting out plans that are the most duplicative and the ones lowest-subscribed," he said.

According to Fierberg, Medicare will have detailed information about Part D and Medicare Advantage changes around the last week of September. The website www.Medicare.gov should have the data available by the second week in October.

Companies that withdraw plans must notify participants by Sept. 30, well in advance of the start of open seasons when people may switch plans.

"We don't expect that to be very common," Fierberg said.

Along with the media visits, Hinson and Fierberg traveled to Libby to meet with new beneficiaries of Medicare as a result of the work by Sen. Max Baucus, D-Mont., to cover patients who developed asbestosis in this Public Health Emergency area.

Hinson said the people in Libby appreciated the coverage but had one major concern.

"It's the premiums," he said.

Billed quarterly, the premium for Part B coverage caught some by surprise. Hinson said they were able to help the majority who couldn't pay by moving them into Medicaid coverage.

He said their work with Libby coverage continues and will become the model for any future areas receiving Health Emergency designations.

With the adoption of health care reform, the Centers for Medicare & Medicaid Services received a new mandate to work with states on interim coverage for people with pre-existing conditions such as the Montana Affordable Care established here.

By 2014, those plans go away in favor of a network of insurance exchanges, also part of the Centers for Medicare & Medicaid Services' new responsibilities. Regulation writers now are producing the details of these programs that kick in at the same time as the requirement for universal coverage.

Fierberg speculates that picking plans from exchanges may work like booking trips on Expedia where you stipulate the coverage you desire and receive a laundry list of options.

"You pick out what you want and what you're willing to pay for," he said.

According to Hinson, the Centers for Medicare & Medicaid Services was tapped because of its low overhead, citing the 1.6 percent margin with just 4,300 people administering a huge budget.

"We're one of the most efficient agencies in the federal government," Hinson said. "We're small but we're mighty."

The two officials encouraged anyone with questions or problems with Medicare to contact local experts trained to help by calling 1-800-551-3191. For instant assistance, call 1-800-Medicare for information, to file complaints and report suspected fraud.