People who have Medicare coverage have a deadline until Saturday to sign up for private drug and medical plans for next year. However, health care advocates, members of Congress and insurance agents fear that unsolicited surprises will result from enrollment decisions based on poor information on the government's revamped, error-prone Plan Finder website.
Beneficiaries could face difficulties in making plans that are too expensive and do not meet their medical needs - without a way out until 2021.
The Centers for Medicare and Medicaid Services told Kaiser Health News that beneficiaries could change their plans next year due to incorrect Plan Finder information, though officials provided few details.
The Medicare.gov website did not provide information about this option. Representatives who arrived at the Medicare call center on Thursday and helped with the last-minute enrollments, were unaware of this. CMS announced that these representatives will be retrained and after the current enrollment season has ended, they will update the website.
The revised Plan Finder was unveiled in late August, and plan information for 2020 was added in October. Over the past three months, the National Association of Insurance Commissioners, the National Association of Health Underwriters, and state and national consumer lawyers have reported issues with Plan Finder to CMS such as inaccurate pricing, drugs and dosages that are covered, and difficulties in sorting and saving search results, among others.
CMS fixed and made corrections to the website almost daily. This is the only way to compare dozens of private drug and medical plans - each with a different pharmacy network, drug prices and covered drugs. More than 60 million people with Medicare and their families have access to information from the website, and also state Medicare consultants and representatives who answer the 800 MEDICARE helpline.
In an unsigned blog article posted on a Medicare website last week, officials said they’re “not finished with improving the Plan Finder”. And they promised, "in the coming months, we will explore further improvements that can be implemented based on the lessons we are learning this year."
Although CMS has been praised for responding to mistakes found by Plan Finder users, some people may have signed up for plans before the errors were caught - errors that they may not notice until their coverage begins next year.
Seniors should choose the plan that works best for them
"Seniors should be in a position where they could choose the plans that work best for them," said Senator Susan Collins (R-Maine), chair of the Senate Special Committee on Aging. "However, problems with Medicare's new Plan Finder website have confused the beneficiaries and those who help them." She added that she was worried that "this problem had even occurred."
The response from Medicare, Collins said, "must be vigorous and comprehensive to inform seniors about special periods of enrollment."
Senator Bob Casey of Pennsylvania, senior Democrat on that committee, also said that Medicare needs to get in touch so that people know that they can apply for a "special enrollment deadline" next year if they feel they’ve made a wrong choice due to inaccurate Plan Finder information.
"People with Medicare need to be aware of the fact that this delay exists and they should not have to jump through the hoops to qualify," he said. The administration should do “everything in its power" to inform the beneficiaries about their options for a specific enrollment period.
Fifteen Senate Democrats, led by Casey, sent a letter to Medicare Administrator Seema Verma on Thursday calling on the agency to "publicize the existing SEP for people misled by information" in the Medicare Plan Finder and to simplify the process of switching plans.
In its statement to KHN, CMS said there are special registration deadlines for a number of reasons. It was added that beneficiaries can receive a special enrollment deadline for Plan Finder issues at any time next year.
They can call 1-800-MEDICARE and tell our call center representatives that they have a problem with their plan selection. It is not CMS's expectation that beneficiaries will be able to provide documentation or screenshots, "the statement says. The beneficiaries will be able to start the process of plan change during this call, CMS said.
CMS officials refused to be identified but gave no reason why.
Is it difficult to apply for a special enrollment period?
It can be difficult to apply for a special enrollment deadline. In a November 27 blog post, Medicare officials stated that the information on the Plan Finder is "the most up-to-date and precise information on deductibles, premiums and cost sharing that Medicare Advantage and Prescription Drug Plans provide." "Information often changes because the plans regularly update the drug forms and renegotiate drug prices.”
Spokeswoman Cathryn Donaldson said that, the Health Insurance Plans of America, the section of health insurers, "is not aware of any systematic problems with the Plan Finder, which is operated by CMS,"
Individuals who have completed a private Medicare Advantage policy, which is an alternative to the traditional Medicare run by the government, covers both medication and medical care, have an alternative already. They have until 31 March to change plans or enroll in traditional Medicare.
Collins and Casey are not the only members of Congress who address the subject. Senator Sherrod Brown (D-Ohio) wants CMS in these cases to set a specific enrollment deadline and clearly disclose the details, a spokesperson said.
Representative Richard Neal (D-Mass.), chairman of the House Ways and Means Committee, believes that the deadline for Saturday should be extended, said a committee aide. The committee has heard about the problems of the Plan Finder from a number of advocates and advisers to public health insurance programs and also insurance companies selling coverage.
Since enrollment Oct.1, 2020, the National Association of Health Underwriters, which represents 100,000 insurance agents, has sent CMS officials 54 problems related to the Plan Finder and continues to receive reports from agents, said John Greene who is the vice president of congressional affairs.
Nebraska's Senior Health Insurance Information Program's Medicare counselors reported more than 100 issues in mid-November, said Alicia Jones, the program's administrator.
Delaware insurance commissioner decided to issue a consumer alert last week, due to receiving complaints about the Plan Finder.
Tatiana Fassieux, a California Health Advocates education and training specialist, said her organization wanted CMS to offer a blanket, nationwide special enrollment deadline, rather than granting it on a case-by-case basis. The group supports the training of Medicare consultants for the California Health Insurance Counseling and Advocacy Program (HICAP).
Leslie Fried has been a lawyer in Washington, DC since 1985. She was very surprised when she was stumped last weekend helping her mother find a policy through the Plan Finder.
Fried, who is also senior director of the National Council on Aging Center for Benefits Access, has searched three times for the most favorable plans for her mother's medication, and each time achieving a different result.
"Beneficiaries should be able to trust the Plan Finder after a single search," she said.
We can Help! Our local advisors can help your family make a confident decision about senior living.