Saturday is the deadline for most people with Medicare coverage to sign up for private drug and medical plans for next year. But members of Congress, health care advocates and insurance agents worry that enrollment decisions based on bad information from the government鈥檚 revamped, error-prone Plan Finder website will bring unwelcome surprises.
Beneficiaries could be stuck in plans that cost too much and don鈥檛 meet their medical needs 鈥 with no way out until 2021.
On Wednesday, the Centers for Medicare & Medicaid Services told Kaiser Health News that beneficiaries would be able to change plans next year because of Plan Finder misinformation, although officials provided few details.
And the website had no information about that option. Representatives reached at Medicare's call center Thursday, who were busy helping with last-minute enrollments, were unaware of it. On Friday, CMS said those representatives will be retrained and the website will be updated after the current enrollment season wraps up.
The overhauled debuted at the end of August, and 2020 plan information was added in October. Over the past three months, Plan Finder problems reported to CMS by the , the National Association of Health Underwriters, and state and national consumer advocates included inaccurate details about prices, covered drugs and dosages, and difficulty sorting and saving search results, among other things.
CMS made almost daily corrections and fixes to the website, which is the only tool that can compare dozens of private drug and medical plans 鈥 each with different pharmacy networks, covered drugs and drug prices. The website provides information for more than 60 million people with Medicare and their families, as well as state Medicare counselors and the representatives who answer the 800-MEDICARE help line.
In an published on a Medicare website last week, officials said they鈥檙e 鈥渘ot done improving the Plan Finder.鈥 And they promised 鈥渋n the coming months we鈥檒l be scoping out additional improvements that we can implement based on lessons we learn this year.鈥
Although CMS has earned praise for responding to errors identified by Plan Finder users, some people may have signed up for plans before the mistakes were caught 鈥 mistakes they may not notice until their coverage kicks in next year.
鈥淪eniors should be able to choose the plans that work best for them,鈥 said Sen. Susan Collins (R-Maine), chairwoman of the Senate Special Committee on Aging. 鈥淚ssues with Medicare鈥檚 new Plan Finder website, however, have reportedly created confusion among beneficiaries as well as those assisting them.鈥 She added that she was concerned 鈥渢his problem even occurred.鈥
Medicare鈥檚 response, Collins said, 鈥渕ust be vigorous with extensive outreach to inform seniors of special enrollment periods.鈥
Sen. Bob Casey of Pennsylvania, the senior Democrat on that committee, also said Medicare needs to reach out so people know they can request a 鈥渟pecial enrollment period鈥 if they discover next year they made a wrong choice due to inaccurate Plan Finder information.
鈥淧eople with Medicare must be aware that this reprieve exists and should not have to jump through hoops to qualify,鈥 he said. The administration should 鈥渦se all means necessary鈥 to let beneficiaries know about their options for a special enrollment period.
Fifteen Senate Democrats, led by Casey, 聽 Thursday to Medicare Administrator Seema Verma asking the agency to 鈥渨idely publicize the existing SEP for people who were misled by information鈥 in the Medicare Plan Finder and to make switching plans easy.
In its statement to KHN Wednesday, CMS said it provides special enrollment periods for . It added that beneficiaries can get a special enrollment period related to Plan Finder issues anytime next year.
They can "call 1-800-MEDICARE and explain to our call center representatives that they have an issue with their plan choice. It is not CMS鈥檚 expectation that beneficiaries will have documentation or screenshots," the statement said. Beneficiaries will be able to start the process of changing plans during that call, CMS said.
CMS officials refused to be identified but would not give a reason.
Applying for a special enrollment period could be tricky. In the Nov. 27 blog post, Medicare officials said the information on the Plan Finder is 鈥渢he most current and accurate information on premiums, deductibles and cost sharing that Medicare Advantage and Prescription Drug Plans provide.鈥 They noted that the 鈥渋nformation changes frequently because plans regularly update drug formularies and renegotiate drug prices.鈥
America鈥檚 Health Insurance Plans, the trade group representing health insurers, 鈥渋s not aware of any systematic problems with the Plan Finder, which is operated by CMS,鈥 said spokeswoman Cathryn Donaldson.
People who enroll in a private Medicare Advantage policy, an alternative to traditional government-run Medicare that covers both drugs and medical care, already have an alternative. They have until March 31 to change plans or enroll in traditional Medicare.
Collins and Casey are not the only members of Congress raising the issue. Sen. Sherrod Brown (D-Ohio) wants CMS to provide a special enrollment period in these cases and clearly communicate the details, a spokesman said.
Rep. Richard Neal (D-Mass.), who chairs the House Ways and Means Committee, believes Saturday鈥檚 deadline should be extended, a committee aide said. The committee has heard about the Plan Finder鈥檚 problems from numerous seniors鈥 advocates and counselors from state health insurance assistance programs, as well as the insurance companies that sell coverage.
Since enrollment for 2020 coverage began Oct. 1, the National Association of Health Underwriters, which represents 100,000 insurance agents, has sent CMS officials 54 Plan Finder problems and is still receiving reports from agents, said John Greene, the vice president for congressional affairs.
The Medicare counselors at Nebraska鈥檚 Senior Health Insurance Information Program聽 flagged more than 100 issues as of mid-November, said Alicia Jones, the program鈥檚 administrator.
After receiving complaints about the Plan Finder, Delaware鈥檚 insurance commissioner, Trinidad Navarro, last week.
Tatiana Fassieux, education and training specialist at California Health Advocates, said her organization wants CMS to offer a blanket, nationwide special enrollment period instead of 聽granting it case by case. The group helps train Medicare counselors for California鈥檚 Health Insurance Counseling and Advocacy Program, known as HICAP.
Leslie Fried has been an elder law attorney in Washington, D.C., since 1985, so imagine her surprise when she was stumped last weekend helping her mother pick a policy through the Plan Finder.
Fried, who is also senior director of the Center for Benefits Access at the National Council on Aging, did the same search three times for the least expensive plans that cover her mother鈥檚 drugs and came up with a different result each time.
鈥淏eneficiaries should be able to have confidence in the Plan Finder after a single search,鈥 she said.
For assistance reviewing drug and medical plans, call your state鈥檚 Senior Health Insurance Information Program at 877-839-2675 or the Medicare Rights Center at 800-333-4114.
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