December 6, 20193:56 PM ET SUSAN JAFFE
Saturday is the deadline for most people with Medicare coverage
to sign up for private drug and medical plans for next year. But members of
Congress, health care advocates and insurance agents worry that enrollment
decisions based on bad information from the government's revamped,
error-prone Plan Finder website
will bring unwelcome surprises.
Beneficiaries could be stuck in plans that cost too much and
don't meet their medical needs — with no way out until 2021.
On Wednesday, the Centers for Medicare & Medicaid Services
assured Kaiser Health News in a written statement that beneficiaries would be able to change plans in 2020 if they
needed to because of Plan Finder misinformation, though the statement provided
few details on what steps consumers would need to take or what that process
would entail.
And, as of Friday morning, the Medicare.gov website had no
information alerting consumers to that option. Representatives reached at
Medicare's call center Thursday, who were busy helping with last-minute
enrollments, were unaware of it. On Friday, CMS said those representatives will
be retrained and the website will be updated after the current enrollment
season wraps up.
Medicare's overhauled Plan Finder debuted at the end of August,
and 2020 plan information was added in October. But over the past three months,
problems with Plan Finder have been reported to CMS by the National Association of
Insurance Commissioners, the National Association of Health
Underwriters and state and national consumer advocates.
The problems cited included inaccurate details about prices,
covered drugs and dosages, and difficulty sorting and saving search results,
among other things.
Throughout the fall, CMS has made almost daily corrections and
fixes to the website, which is the only tool that can compare dozens of private
drug and medical plans ― each with different pharmacy networks, covered drugs
and drug prices. The website provides information for more than 60 million
people with Medicare and their families, as well as state Medicare counselors
and the representatives who answer the 800-MEDICARE help line.
In an unsigned blog article published
on a Medicare website last week, officials said they're "not done
improving the Plan Finder." And, they promised, "in the coming months
we'll be scoping out additional improvements that we can implement based on lessons
we learn this year."
Although CMS has earned praise for responding to errors
identified by Plan Finder users, some people may have signed up for plans
before the mistakes were caught ― mistakes they may not notice until their
coverage kicks in next year. Some lawmakers and advocates are concerned that
Medicare hasn't done enough to reach out to consumers who might be affected by
website problems.
"Seniors should be able to choose the plans that work best
for them," says Sen. Susan Collins, R-Maine, chairwoman of the Senate
Special Committee on Aging. "Issues with Medicare's new Plan Finder
website, however, have reportedly created confusion among beneficiaries as well
as those assisting them." Collins adds that she is concerned "this
problem even occurred."
Medicare's response, Collins says, "must be vigorous with
extensive outreach to inform seniors of special enrollment periods."
Sen. Bob Casey of Pennsylvania, the senior Democrat on that
committee, also says Medicare needs to reach out so people know they can
request a "special enrollment period" if they discover next year they
made a wrong choice because of inaccurate Plan Finder information.
"People with Medicare must be aware that this reprieve
exists and should not have to jump through hoops to qualify," he says. The
administration should "use all means necessary" to let beneficiaries
know about their options for a special enrollment period.
Fifteen Senate Democrats, led by Casey, sent a letter this week
to Medicare Administrator Seema Verma asking the agency to "widely
publicize the existing [special enrollment period] for people who were misled
by information" in the Medicare Plan Finder and to make switching plans
easy.
In a written statement to Kaiser Health News on Wednesday, a CMS
spokesman noted that Medicare has always provided extra time for certain people
to enroll, for a number of specific
reasons. In keeping with that policy, Medicare beneficiaries will be able to get a special enrollment period
related to Plan Finder issues anytime next year, according to the statement.
They can "call 1-800-MEDICARE and explain to our call
center representatives that they have an issue with their plan choice. It is
not CMS's expectation that beneficiaries will have documentation or
screenshots," according to the CMS statement. Beneficiaries will be able
to start the process of changing plans during that call, CMS said.
Yet some critics fear that applying for a special enrollment
period because of Plan Finder's mistakes could be tricky. Trump administration
officials have continued to defend the accuracy of the website tool.
In the CMS blog article posted Nov. 27, Medicare officials
described the information on Plan Finder as "the most current and accurate
information on premiums, deductibles and cost sharing that Medicare Advantage
and Prescription Drug Plans provide." They seemed to shrug off the widespread
complaints about Plan Finder, noting that the "information changes
frequently because plans regularly update drug formularies and renegotiate drug
prices."
America's Health Insurance Plans, the trade group representing
health insurers, "is not aware of any systematic problems with the Plan
Finder, which is operated by CMS," says spokeswoman Cathryn Donaldson.
People who enroll in a private Medicare Advantage policy, an
alternative to traditional government-run Medicare that covers both drugs and
medical care, already have extra time to switch. They have until March 31 to
change plans or enroll in traditional Medicare before being locked into their
plan.
Collins and Casey are not the only members of Congress raising
concerns about Medicare applicants who may have been tripped up by the faulty
website. Sen. Sherrod Brown, D-Ohio, wants CMS to provide a special enrollment
period in these cases and clearly communicate the details, a spokesman from his
office said.
Rep. Richard Neal, D-Mass., who chairs the House Ways and Means
Committee, believes Saturday's deadline should be extended, a committee aide
said. The committee has heard about the Plan Finder's problems from numerous
advocates for seniors and counselors from state health insurance assistance
programs, as well as from the insurance companies that sell coverage.
Since enrollment for 2020 coverage began on Oct. 1, the National
Association of Health Underwriters, which represents 100,000 insurance agents,
has sent CMS officials notice of 54 Plan Finder problems and is still receiving
reports from insurance agents, said John Greene, the vice president for
congressional affairs.
The Medicare counselors at Nebraska's Senior Health Insurance
Information Program had flagged more than 100 issues as of mid-November, said Alicia
Jones, the program's administrator.
After receiving complaints about the Plan Finder, Delaware's
insurance commissioner, Trinidad Navarro, issued a consumer alert last
week.
Tatiana Fassieux, education and training specialist at
California Health Advocates, said her organization wants CMS to offer a
blanket, nationwide special enrollment period instead of granting it case by
case. The group helps train Medicare counselors for California's Health
Insurance Counseling and Advocacy Program, known as HICAP.
Leslie Fried is an attorney in Washington, D.C., who has
specialized in elder law since 1985, so imagine her surprise when she was stumped
last weekend helping her own mother pick a policy through the Plan Finder.
Fried, who is also senior director of the Center for Benefits
Access at the National Council on Aging, did the same search three times for
the least expensive plans that cover her mother's drugs and came up with a
different result each time.
"Beneficiaries should be able to have confidence in the
Plan Finder after a single search," Fried said.
For assistance reviewing drug and medical plans, call your state's
Senior Health Insurance Information Program at 877-839-2675 or the Medicare
Rights Center at 800-333-4114.
Kaiser Health News is a nonprofit, editorially independent program of the
Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.
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