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's revamped, error-prone Plan Finder website will bring unwelcome surprises.
Beneficiaries could be stuck in plans that cost too much and don't meet their medical needs — 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 Medicare.gov website and representatives at Medicare's call center had no information about that option.
The overhauled Plan Finder 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 National Association of Insurance Commissioners, 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 - 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 unsigned blog article published on a Medicare website last week, officials said they're "not done improving the Plan Finder." And they promised "in the coming months we'll be scoping out additional improvements that we can implement based on lessons we learn this year."
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 - mistakes they may not notice until their coverage kicks in next year.
"Seniors should be able to choose the plans that work best for them," said Sen. Susan Collins (R-Maine), chairwoman of the Senate Special Committee on Aging. "Issues with Medicare's new Plan Finder website, however, have reportedly created confusion among beneficiaries as well as those assisting them." She added that she was concerned "this problem even occurred."
Medicare's response, Collins said, "must be vigorous with extensive outreach to inform seniors of special enrollment periods."
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 "special enrollment period" if they discover next year they made a wrong choice due to inaccurate Plan Finder information.
"People with Medicare must be aware that this reprieve exists and should not have to jump through hoops to qualify," he said. The administration should "use all means necessary" to let beneficiaries know about their options for a special enrollment period.
In the statement to KHN Wednesday, CMS said it provides special enrollment periods for a number of reasons. 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's expectation that beneficiaries will have documentation or screenshots,” the statement said. The call center representatives "are trained and ready to help the beneficiary through the rest of the process."
CMS officials refused to be identified but would not give a reason.
Information about Plan Finder special enrollment periods will be available on the Medicare.gov website and at the call center, a CMS spokesman said.
However, nothing was posted on the website Thursday, and when Kaiser Health News called Medicare twice Thursday, both representatives said it would not be possible to switch plans next year because of inaccurate information from the Plan Finder.
Applying for a special enrollment period could be tricky. In the blog post, Medicare officials said the information on the Plan Finder is "the most current and accurate information on premiums, deductibles and cost sharing that Medicare Advantage and Prescription Drug Plans provide." They noted that the "information changes frequently because plans regularly update drug formularies and renegotiate drug prices."
America's Health Insurance Plans, the trade group representing health insurers, "is not aware of any systematic problems with the Plan Finder, which is operated by CMS," 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's deadline should be extended, a committee aide said. The committee has heard about the Plan Finder's problems from numerous seniors' 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's Senior Health Insurance Information Program flagged more than 100 issues as of mid-November, said Alicia Jones, the program's administrator.
After receiving complaints about the Plan Finder, Delaware's insurance commissioner, Trinidad Navarro, issued a consumer alert 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 granting it case by case. The group helps train Medicare counselors for California's 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's drugs and came up with a different result each time.
"Beneficiaries should be able to have confidence in the Plan Finder after a single search," she said.
For assistance reviewing drug and medical plans, call your state's Senior Health Insurance Information Program at 877-839-2675 or the Medicare Rights Center at 800-333-4114.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.