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Bipartisan House Leaders Raise Medicare Plan Finder Concerns

Dec 10, 2019
Press Release
Committee Leaders Urge CMS to Open Special Enrollment Period for Beneficiaries Who Used Plan Finder to Make Enrollment Decisions

Bipartisan House health leaders sent a letter to Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma today expressing concerns over reports that the Medicare Plan Finder was confusing, generated incorrect results, and inadvertently led beneficiaries to select plans with lower premiums but higher overall costs.

The letter was signed by Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), Energy and Commerce Ranking Member Greg Walden (R-OR), Ways and Means Chairman Richard E. Neal (D-MA) and Ways and Means Ranking Member Kevin Brady (R-TX).

“It is critical that Medicare beneficiaries have the most accurate and up-to-date information and that Medicare provides them with reliable information on their health care costs and coverage information relevant to their needs,” the bipartisan members wrote to Administrator Verma.  “Understanding cost-sharing obligations when selecting plans is especially critical for seniors who take prescription medications that often can have costly coinsurance, tiering, and co-payment requirements.”

The Medicare Plan Finder is intended to help millions of beneficiaries compare Medicare coverage options, most notably for Part D prescription drug plans.  During the Open Enrollment Period, which closed on December 7th, the Plan Finder can be used by beneficiaries to review coverage options and switch plans as needed based on year-to-year changes, which may affect out-of-pocket costs.

The four Committee leaders raised concerns, based on reports from consumer advocates, volunteers and other Medicare counselors that help beneficiaries compare and select plans.  They have reported that, in some cases, Plan Finder is not providing beneficiaries with accurate and appropriate information necessary to choose a plan that covers needed prescription drugs or services.  

“We strongly urge you to immediately examine these concerns, and evaluate and correct, as necessary, errors with the Plan Finder tool identified by consumer advocates,” Pallone, Walden, Neal and Brady continued in their letter.  “Additionally, given that Medicare Open Enrollment has now closed, CMS must ensure that beneficiaries who may have relied on Plan Finder to make these decisions are held harmless.  These beneficiaries should be included in a Special Enrollment Period so they can make changes to their plan selection despite the close of the Medicare Open Enrollment Period at this point.”

The Committee leaders also requested answers to a series of questions included in their letter by December 30, 2019.

Read the letter HERE.  

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