Medicare beneficiaries have a distinctive combination of needs and circumstances that make providing appropriate health care services for them a greater challenge than for the working age population. Medicare beneficiaries generally have poorer health status, lower literacy levels, and suffer from more chronic conditions than the general population. More than half have arthritis and high blood pressure. Many Medicare beneficiaries are not totally independent, with forty-five percent needing help with at least one of the key activities of every day living, such as eating, bathing, shopping, using the telephone, or balancing a checkbook. Medicare beneficiaries also have an increased likelihood of financial insecurity; nearly sixty percent have annual incomes below $20,000, compared to only fourteen percent of the working-age population. Given the complex needs and circumstances of many Medicare beneficiaries, managing their health and navigating the health care system can be challenging. Choosing physicians, understanding doctors' orders, deciding among complex treatment options, or choosing a drug discount card are more difficult for them than for the general population. Decreased mobility hampers their ability to travel to health care facilities. Others do not use the telephone easily because they cannot hear or see well. Many do not have computers or know how to use the internet to find valuable information. For all these reasons, many beneficiaries need appropriate services and supports to ensure that Medicare is meeting their needs.