Medicare Plan Finder Problems Emerge – At Least Three SHIP Programs Cautioning People to Delay Enrollment until Problems Resolved

The Medicare Annual Election Period (AEP), which lasts from October 15 until December 7, is a time during which Medicare beneficiaries can make changes to their Medicare Advantage and/or Part D prescription drug coverage for the following calendar year.  The primary tool used to compare coverage options is the Medicare Plan Finder (MPF), which is produced by the Centers for Medicare & Medicaid Services (CMS) and available at www.medicare.gov.

Regrettably, with the AEP now in full swing, people assisting Medicare beneficiaries who are trying to navigate the MPF are reporting many unwelcomed issues with the MPF tool. Due to these emerging problems, this year at least one State Health Insurance Assistance Program (SHIP), Connecticut’s CHOICES program, is recommending that beneficiaries wait until the MPF issues are resolved and the information is complete before enrolling in Part D plans.  It has been reported to the Center that New Hampshire and Massachusetts have also paused enrollments.

Current Plan Finder Problems

A message from the CHOICES program directed to Medicare beneficiaries receiving assistance from them states: “As of 10/19/20, we have been notified by the Centers for Medicare and Medicaid Services (CMS) and the Administration for Community Living (ACL) that there is incomplete information in the Medicare Plan Finder tool on Medicare.gov. We understand that CMS, as well as companies that offer these plans, are working to fix these issues.”

The message to beneficiaries continues: “Specifically:

• Not all plans are displaying full drug costs, including plans offered by Cigna-Healthspring and Express Scripts.
• Not all plans are displaying accurate pharmacy network information
• Beneficiaries entitled to Extra Help/LIS may not be able to view accurate cost-sharing.

Please understand that if you enroll in a plan at this time:

• We cannot guarantee that this plan is the lowest cost option for you.
• We cannot guarantee that you will be able to change plans due to incorrect cost information in the Medicare Plan Finder. However, in the past, beneficiaries who have enrolled in the wrong plan due to inaccurate information on the Plan Finder have been granted a Special Enrollment Period (SEP) to enroll in a new plan after Jan 1.”

In addition to the issues identified above, the MPF is showing “N/A” with respect to pricing for some plans. According to a message sent to SHIP programs by ACL, “If you see “N/A” on a plan card in the Medicare Plan Finder instead of pricing information it means that the plan has an error with their drug pricing data and Medicare has temporarily removed the information. This is not a problem with the Plan Finder but is an issue with the data that the plan sent over to CMS.”  ACL also stated that the data problems concerning Cigna-Healthspring and Express Scripts is expected on 10/26.

MPF Problems During Last Year’s AEP

As described in of the several Center’s previous CMA Alerts, there were numerous problems with the Plan Finder during the last Annual Enrollment Period.  A new, updated Plan Finder released in late August 2019 presented challenges prior to the AEP, and a number of functional problems arose during the enrollment period.  These problems included: inaccurate information about covered drugs and costs, non-formulary drugs, dosage options, copays for individuals with the Part D Low Income Subsidy (LIS), problems creating a MyMedicare account and the listing of plan choices by premium rather than total cost.  At the time, CMS leadership both downplayed the scope of problems identified, and did not adequately promote a Special Enrollment Period (SEP) available to beneficiaries who relied on inaccurate information in making their plan choices.

Conclusion

While CMS has made some improvements to the Plan Finder since last fall, it cannot repeat the failure to both adequately inform the public about the tool’s problems and promote avenues to address harm caused by Plan Finder errors. Further, given that the ongoing COVID-19 pandemic minimizes the availability of in-person counseling and assistance, and the fact that Plan Finder problems are preventing people from currently obtaining information they need in order to make informed choices, we urge CMS to extend the Annual Election Period past the December 7 end date.

While individuals enrolled in Medicare Advantage (MA) plans as of the first of the year have an additional opportunity to make plan changes from January to March during the Medicare Advantage Open Enrollment Period (MA-OEP), people with stand-alone Part D prescription drug plans do not have such an opportunity.  CMS has provided numerous flexibilities to plans and providers during the ongoing public health emergency.  It should employ the same approach to beneficiaries who are relying on information from the Medicare program that is flawed.