The Centers for Medicare and Medicaid Services
(CMS) is promoting the new Medicare Plan Finder. It will be the exclusive
source of information for 2020 Part D drug plans and Medicare Advantage plans.
According to a CMS promotional video,
beneficiaries can create an “online account for a personalized
experience.”
There will be some issues creating that
experience and those likely will interfere with plan review during the Open
Enrollment Period, October 15-December 7.
The first one:Records in the old system,
the Legacy Plan Finder, will not migrate to the new
one.
For those who do not have a “My
Medicare.gov” account, anything in that old system will stay there
when it is retired. Beneficiaries may want to log in soon and print a copy of
their drug lists.
Once an account is established, a “drug list”
appears. In the CMS Medicare National Training Support national
training program on August 16, the presenter said this is a list from the
claims database, meaning drugs that have been billed to Medicare. It may or may
not be the list of your current medications.
The second one: Beneficiaries must establish
an account in the new Plan Finder.
This will involve entering specific
information and creating a user name and password for the account.
The third one: Anyone reviewing plans during
Open Enrollment must log into the new Plan Finder with the user name and
password.
You might wonder what’s so horrible about
these changes. We have to establish accounts and log into websites every day.
There is no doubt that many Medicare beneficiaries can do this, as shown in the
CMS promotional video. But there are many, with medical issues, living in a
nursing home or memory care center, or who just never got into computers, who
will not be able deal with an online account. Those who help them – their kids
or grandchildren, SHIP (State Health Insurance Assistance Program) counselors,
pharmacists, insurance agents, friends, volunteers – will face challenges.
Consider this example.
Bill, a retired pharmacist, helps his former
customers, members of his church, friends and relatives with their Open
Enrollment drug plan reviews. After setting up a record in the Legacy Plan
Finder, he writes down the Drug List ID and Password Date. Then, in October
every year, he meets with them to update their files and study plans.
Bill has to be able to access the individual
accounts in the new Plan Finder, but the Legacy information will be gone. So
how will he do that? During the training program on
August 16, the presenter addressed two scenarios. If meeting in person, Bill
would give the beneficiary the keyboard and have him or her enter the user name
and password. If talking on the phone, Bill asks for that information, enters
it in the Plan Finder but does not write it down.
Those answers assume that beneficiaries will
establish an account in the new system. Bill knows that many of those he helps
do not have smart phones, tablets, or computers. And if they did, that most
could not set up an account. How is Bill going to deal with this? He recognizes
that the information necessary to set up the account – Medicare number, full
name, date of birth, and email address – can be considered protected health information (PHI)
under HIPAA. Even though, as a
volunteer, he is not subject to HIPAA, Bill
is not sure he wants to go there. If he doesn’t, these beneficiaries likely
will not get help during Open Enrollment.
It is not clear why CMS made this big change
of putting plan reviews behind a wall. Perhaps once beneficiaries have an
account, they can access all kinds of Medicare information. However, requiring
an account creates a big barrier to plan review, both for current beneficiaries
and those enrolling in Medicare. Given the importance of reviewing a drug or
Medicare Advantage plan, the powers-that-be should look for ways to simplify
the process.
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