Medicare Advantage (MA) Survey

Medicare Advantage, Medicare Part D, and Medicare Fee-For-Service Consumer Assessment of Healthcare Providers and Systems (CAHPS) Survey (CMS-R-246)

OMB: 0938-0732

IC ID: 8404

Documents and Forms

Document Name Document Type
Form CMS-R-246 Medicare Advantage (MA) Survey Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey 2025-MA-Only-Survey.docx Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey - Chinese 2025-MA-Only-Survey-Chinese.pdf Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey - Korean 2025-MA-Only-Survey-Korean.pdf Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey - Spanish 2025-MA-Only-Survey-Spanish.pdf Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey - Tagalog 2025-MA-Only-Survey-Tagalog.pdf Form and Instruction
CMS-R-246 Medicare Advantage Plan Survey - Vietnamese 2025-MA-Only-Survey-Vietnamese.pdf Form and Instruction
2025-MA-Only-Survey-REDLINE.pdf Track Change version IC Document