2025 Annual Medicare Survey

We encourage you to complete this survey so that Medicare can best serve your healthcare needs. As a reminder, you remain eligible to receive the same Medicare benefits and you still have the right to use any doctor, other health care professional, or hospital that accepts Medicare, at any time.

Please complete the following 10 questions.

Please provide the survey Id found on your letter.

Do you want to continue taking the survey?*

YesNo

Within the past 12 months, did you worry that your food would run out before you got money to buy more?

YesNo

Within the past 12 months, did the food you bought just not last and you didn’t have money to get more?

YesNo

Do you have housing?

YesNo

Are you worried about losing your housing?

YesNo

Within the past 12 months, have you or your family members you live with been unable to get utilities (heat, electricity) when it was really needed?

YesNo

Within the past 12 months, has lack of transportation kept you from medical appointments, getting your medicines, non-medical meetings or appointments, work, or from getting things that you need?

YesNo

Do you feel physically and emotionally safe where you currently live?

YesNo

Within the past 12 months, have you been hit, slapped, kicked or otherwise physically hurt by someone?

YesNo

Within the past 12 months, have you been humiliated or emotionally abused in other ways by your partner or ex-partner?

YesNo

Can Vytalize Health Contact you regarding your responses?*

YesNo

Please provide your name*

First NameLast Name

Please provide a phone number where you can be contacted.*

Please enter a valid phone number.

Thank you. Please click "Submit" to exit the survey.

If you have questions, feel free to ask your doctor or other health care professional, call Vytalize Health at 1-844-570-1010, or call Medicare at 1-800-MEDICARE (1-800-633-4227) to ask about ACOs. TTY users should call 1-877-486-2048.

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