Medicare Enrollees Should Double-Check Drug Plan Prices
Advocates say official website is providing wrong information
En español | As millions of Medicare beneficiaries review their coverage and make decisions for 2020, advocates say some of the information on the Medicare website is wrong and could lead to consumers picking a plan that doesn't best meet their medical and financial needs.
Among the problems advocates have identified are inconsistent drug prices for the same plan and different versions of the lists of drugs covered by that plan. The Centers for Medicare and Medicaid Services (CMS) says the issues that have come to the agency's attention so far “are not inaccuracies but rather user error or confusion.”
"The drug prices just don't seem to have anything to do with reality,” said Julie Carter, a senior federal policy associate at the Medicare Rights Center. For example, Carter said, one web page will show that a particular drug on a specific plan costs one thing but then another page for the same plan will show a different price. “We're seeing big swings between the different pages of the same plan."
The Medicare Rights Center is one of many organizations that help Medicare enrollees walk through the open enrollment process. This year's open enrollment period ends Dec. 7. Center staffers work with consumers on the phone to help them. And Carter said she has also been hearing from State Health Insurance Program (SHIP) officials across the country who are also encountering problems as they help Medicare recipients. Each state has SHIP counselors, neutral experts who help Medicare beneficiaries with their enrollment and other issues.
Asked why different computer pages show different prices for the same drug, a CMS official said that the agency will look into the issue and that it would be helpful if users could provide screen shots of the different pages so CMS can understand what consumers are seeing.
"The problem is we don't know exactly how widespread the problem is,” Carter said. “We have some significant concerns that people will be making decisions based on numbers that are not right.” While you can tell something is wrong when you see two different prices for the same drug on the same plan, consumers might have a hard time seeing other mistakes in pricing, she said.
Advocates suggest that Medicare beneficiaries double-check the information they get on Medicare.gov by calling the plan they're considering to ask for its prices and to confirm what drugs are covered. And for people who have already picked a plan and thought they were finished with open enrollment, advocates say they too should go back, call the plan they have selected and make sure the prices and other information on the website were correct. As long as enrollees act before Dec. 7, they can change their mind and select another plan.
If you can, they say, take a screen shot or photograph of the information the Medicare plan finder has displayed, in case you need to present evidence to Medicare that you were misled and want to switch to another plan.
"We have not heard about any proposed solutions or relief so far,” said David Lipschutz, associate director at the Center for Medicare Advocacy, adding that he hopes CMS will set up special enrollment periods so people who received bad information can switch to a plan that better meets their medical needs and budget. “If you set up a system that relies on people doing their homework and comparing plans,” Lipschutz said, “it's your obligation to make sure the information is accurate."
On Wednesday, CMS officials advised beneficiaries to call 1-800-MEDICARE (633-4227) at any time during the coming year and ask for a Special Enrollment Period so they can change plans if they “believe they made the wrong plan choice because of inaccurate or misleading information. This process isn’t new,” the agency said in a blog post, “but this year we’re doubling down on ensuring that it’s a simple and painless experience for beneficiaries.”
This year CMS overhauled its Medicare Plan Finder for the first time in a decade. A CMS official said the agency is talking to stakeholders such as Medicare advocates and counselors on a regular basis and did extensive consumer testing throughout the development of the new website.
Editor's note: This story has been updated with new information from CMS.