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Problems with Medicare Plan Finder Persist

As reported by SHIPs across the country and some of our partner organizations, problems with the new Medicare Plan Finder (MPF) persist during the current Medicare Annual Election Period, which lasts through December 7, 2019. These problems include: inaccurate information about covered drugs and costs, non-formulary drugs, dosage options, copays for individuals with the Part D Low Income Subsidy (LIS) and problems creating a MyMedicare account.

We are aware that one Part D plan sponsor, EnvisionRx, in an email to agents and brokers dated October 31st instructed those agents and brokers to no longer use MPF until certain problems are fixed:

We want to make you aware of several issues with the new release of Medicare Plan Finder. The issues are affecting drug pricing for all plans. Drug pricing is not calculating correctly for carriers with plan designs that have a deductible that applies for specific tiers only. Also, mail order pricing is still only pricing for Standard and not Preferred mail order pharmacies. Until these matters are resolved, we encourage you and your clients to use [the plan’s website] to check drug pricing.

We are also aware that CMS is working to resolve these functional issues, and is providing regular updates to the SHIP network. But these fixes are ongoing, in the middle of an enrollment period, and people are making enrollment decisions based upon inaccurate information.

While those enrolled in MA plans have an additional opportunity to change plans between January and March through the Medicare Advantage Open Enrollment Period, those enrolled in stand-alone PDPs do not have such options. Further, problems might not arise or be identified until later in the year.

As stated in our August 2019 joint letter with Medicare Rights Center, Justice in Aging and National Council on Aging raising concerns about the MPF and marketing guideline changes, CMS must “provide any enrollment relief that may be needed to prevent beneficiaries from being negatively impacted.” It is becoming more evident that such action is required.

Medicare Messaging: All about “Plans,” Not Traditional Medicare

As outlined in previous Alerts, the Center remains concerned about CMS efforts to steer individuals toward Medicare Advantage (MA) plans rather than adhere to its role as a neutral source of information about coverage options. While promoting the Medicare Plan Finder – notwithstanding the problems discussed above – CMS should make clear that people with traditional Medicare can stay put if they wish, and people enrolled in MA can consider the option of returning to traditional Medicare. Instead, information coming from CMS focuses almost exclusively on “plans” and “plan choices” with little or no reference to traditional Medicare as an option.

For example, a recent email from CMS (dated Oct 24) focuses only on “plans.”  The email opens:

“Happy with your current 2019 Medicare coverage? Plans — and your health care needs — may change from year to year, so it’s still important to take a few minutes and shop around during Medicare Open Enrollment.”

After touting the new MPF, the email concludes:

“If you’re happy with the coverage you have now, and your plan is still being offered next year, you don’t need to do anything further. But if you find a plan that better meets your needs for 2020, you can easily enroll online until December 7.”

Similarly, a November 7th email from Medicare makes no mention of traditional Medicare as an option:

“Medicare Open Enrollment is your chance to compare 2020 plans and choose what’s best for you.”

The email links to a video about the new MPF that includes the narrator statement:

“It’s easier than ever to learn the key differences between Original Medicare and Medicare Advantage before shopping for health and drug plans.”

MPF Information Comparing Traditional Medicare and MA is Incomplete

On the new Plan Finder landing page, under the statement “New to Medicare?” there is a tab labelled “Learn more about options” that allows individuals to see some basic comparisons between the traditional Medicare and MA. This information, though, is incomplete. As noted by the National Association of Insurance Commissioners (NAIC) in an October 16, 2019 letter to CMS, concerns about the MPF include the fact that:

“The cost comparison between Medicare Advantage (MA) and Medicare with a Medigap plan does not capture out of pocket costs – only premiums. This gives the false sense that Medigap is much more expensive overall than an MA plan.”

This echoes concerns the Center for Medicare Advocacy has previously raised about other coverage compare tools on the Medicare website.

Need for Balanced Information

A prominent MA insurance industry-backed organization, which promotes itself as a beneficiary advocacy group, recently sent materials to Congressional members’ offices promoting enrollment in Medicare Advantage during the current enrollment period, calling their guidance “an educational tool to help legislative offices engage and inform Medicare beneficiaries on the choices they have in Medicare.” In the document, they provided charts and other information “adapted” from the 2020 Medicare & You handbook, but did so in a way that paints Medicare Advantage in a light most favorable, reworking such material so that any disadvantages of MA plans are downplayed.

Promotion of MA plans by the MA industry is to be expected (as long as actors are clearly identified as working on the industry’s behalf).

Promotion of MA plans by the Medicare program itself, however, is a breach of trust.

As noted in earlier Alerts, in an attempt to provide more balanced information about the choices between traditional Medicare and MA, the Center along with the National Committee to Preserve Social Security and Medicare relaunched our Fully Informed materials.

November 7, 2019 – D, Lipschutz

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