By now, most who work with the Medicare Plan
Finder have had a chance to familiarize themselves with the new version. The
most onerous change is that beneficiaries must log into
their MyMedicare.gov account to access saved information. If they don’t have an
account and they want the system to save their information, they will need to
set up an account, which requires entry of their Medicare number and other
pieces of protected health information.
This requirement should concern anyone who
helps beneficiaries with Medicare Advantage and Part D drug plan reviews. How
should they deal with this secure access? The presenter for the Centers for
Medicare and Medicaid Services’ (CMS) NTP New Plan Finder Webinar
on August 16 suggested that, if meeting in person, the helper should pass the
keyboard to the beneficiary to type in his or her user name and password. If
talking on the phone, the helper should ask for that information, enter it in
the Plan Finder and not write it down.
However, that suggestion does not align with
the MyMedicare.gov help
page. “MyMedicare.gov is a secure site. Your MyMedicare.gov account may only be
accessed by signing in with your own username and personalized password. You
or your appointed Authorized Representative are the only people who should have
this information.”
According to Medicare, anyone who helps a
beneficiary with plan review must be an authorized representative. This
involves more than sharing a keyboard.
“ -
Choosing a plan to participate in;
“ - Gathering more information about your
insurance plan/policies for research and decision making purposes….”
There is a procedure for becoming a personal
representative. The beneficiary can add authorized representatives to their
MyMedicare.gov account by completing an online version of the “Medicare Authorization to Disclose
Personal Health Information” form available via the link on the “My
Account tab.” Or, the beneficiary can complete and mail in the form.
Beneficiaries are able to add and remove personal representatives through their
accounts or by contacting Medicare.
Hopefully, you’re beginning to see the issues
involved with this change. According to Medicare, only those who are authorized
representatives can access the account to help with Medicare plan review. The
beneficiary must go through a process to designate that representative. How
will beneficiaries feel about designating SHIP (State Health Insurance
Assistance Program) counselors, pharmacists, insurance agents or plan
representatives, and others? In many cases, the beneficiary has never met the
person on the other end of the phone. Then, the new Plan Finder raises
concerns about the security of the individual’s information. Once logged in to
help with plan review, the reviewer has access to current coverage, favorite
providers, and claims information. What if this information falls into the
wrong hands? For example:
Sam, a very congenial guy, got to know several
individuals at the senior center. In conversations, he mentioned that he knows
Medicare and offered help during the Open Enrollment Period. Several accepted
the offer and provided the information to set up a MyMedicare.gov account because
they didn’t know where to start. Unknown to these seniors, he accessed more
than just medications. In the following months, several of these seniors
received calls about money they owed for past medical procedures with a demand
for immediate payment.
Farfetched, you say? Hopefully, but with
reports of a new scam a day, I believe something like this could happen.
CMS did provide the ability in the new Plan
Finder to check plan information without logging into an account. But how
helpful will that be? For example:
During a phone call, Catherine shared her 11
medications and pharmacies with a volunteer, who entered the information.
Together, they discussed her options and selected a plan. The next day,
Catherine realized she had forgotten a medication and called the volunteer.
Once again, he had to enter medications (now 12) and three pharmacies. Then,
two weeks later, a new pharmacy opened in Catherine’s village. She wanted to
find out whether this would be a good choice for her so she called her volunteer
yet again.
The new system is not only inefficient and
frustrating for both beneficiaries and reviewers but it also greatly increases
the chance for mistakes. By the third time a reviewer enters the same
medications, the likelihood of errors increases dramatically.
Why and
what’s next?
This change no doubt befuddles those who have
experience with plan review while raising many questions.
Why was it necessary to connect plan review to a MyMedicare.gov account?
The Legacy Plan Finder requires only zip code,
medications and pharmacies. It saves the information and generates a drug list
ID and password date (no protected health information) for login. Logging back
in to the system does not provide access to all kinds of protected
information.
Maybe the fact that the system pulls in
medications billed to Medicare is a benefit. However, that list may not be
current so the reviewer will need to check it carefully.
Will those who have helped with Open
Enrollment in the past want to do so again this year?
Doing reviews without logging in will be
time-consuming and frustrating because information cannot be saved. Even if
there are no changes in medications during the review period, it’s very
possible the beneficiary may have follow-up questions about the plan,
pharmacies, or benefits. To get the answers, the reviewer will need to start over.
Do reviewers want to be personal
representatives?
Being designated a personal representative
brings its own set of issues. Personally, I am very concerned about having
access to information I don’t need. What if a beneficiary I help has his
identity stolen? As his representative, would I be in trouble? Maybe that’s an
overreaction but in today’s world, I would rather be safe than sorry.
Where does that leave beneficiaries who need
help?
CMS must figure out how to allow those who
assist with plan reviews to save information in a way that doesn’t involve
logging into an account. Otherwise, too many beneficiaries will not get the
help they need and will likely pay more. That’s not how a new tool should
work.
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