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The current Medicare enrollment period ends on December 7, 2019. As reported yesterday in the Minneapolis Star Tribune, while some Medicare Plan Finder (MFP) problems previously identified have been fixed, there are still significant outstanding issues.  As noted in the article, “[i]n some cases, the federal website has been showing wrong information about drug formularies, […] In other cases, the information about premiums and out-of-pocket costs doesn’t match data the state agency receives directly from insurers.” According to a senior policy analyst at the Minnesota Board on Aging, “‘Our concern is that even though CMS is working on changes, all the changes haven’t been done yet and we’re concerned that people are making decisions and enrolling in plans that aren’t going to be the best for them in 2020.’”

CMS has reported that the 1-800-MEDICARE call center is no longer referring individuals to their State Health Insurance Assistance Programs (SHIPs) during the current enrollment period. Although 16 state SHIP programs to date have apparently informed CMS that they can no longer take such referrals due to their caseloads, referrals to all SHIP programs have stopped until the end of the current Medicare enrollment period. Concerns about SHIP caseloads are warranted, particularly given the challenges associated with counselors learning the new MPF and the functional problems it has presented, however SHIPs remain the best source of neutral, unbiased counseling on Medicare options, and limiting referrals to such programs that are still able to serve their state’s residents limits Medicare beneficiaries’ access to quality information.

Medicare messaging continues to be all about “plans” but not traditional Medicare. As discussed in a CMA Alert earlier this month, email messages from Medicare during the current enrollment period continue to focus only on “plans.” As noted, 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. Further, references to “health” coverage and prescription drug coverage are lumped together in a manner that does not account for individuals who are happy in traditional Medicare but benefit from help selecting a stand-alone Part D plan, not just an MA plan that includes Part D (MA-PD).

An email sent by the Medicare program dated 11/15, entitled “Find a plan that works for you”, makes no distinctions between traditional Medicare and MA plans, and states:

“Cost, coverage, and benefits are all important when choosing a Medicare health or drug plan, but there are even more things to consider:

  • Is the pharmacy you use included in your drug plan’s network?
  • Have your prescription drug needs changed?
  • Do your preferred doctors accept Medicare?
  • Do you travel a lot, or spend part of the year in a different state?”

While the first two questions are relevant to Part D prescription drug coverage, regardless of whether someone has a stand-alone Part D plan or is in an MA-PD, the last two question are relevant only to MA plans (and the third question should ask whether preferred doctors are in the Medicare Advantage network rather than just accepting Medicare).

Similarly, in an email from CMS dated 11/21 entitled “Review your health & drug coverage today” there is no mention of traditional Medicare, and “health” coverage is lumped together with prescription drug coverage:

“Now is your chance to review your Medicare health and drug coverage and make sure it meets your needs. Even if your plan hasn’t changed, there could be another plan that works better for you. You may be able to save money on prescriptions or get new extra benefits.”

As noted in earlier CMA Alerts, in an attempt to provide more balanced information about the choices between traditional Medicare and MA, the Center for Medicare Advocacy, along with the National Committee to Preserve Social Security and Medicare, relaunched our Fully Informed Project to provide an array of objective materials about all Medicare options.

November 21, 2019 – D, Lipschutz

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