While Medicare’s Open Enrollment is Over, Consequences for the Medicare Plan Finder’s Inaccuracies Are Not

While Medicare’s Open Enrollment is Over, Consequences for the Medicare Plan Finder’s Inaccuracies Are Not

Even though Medicare’s Open Enrollment period is over, the consequences resulting from some of the inaccurate information on Medicare’s Plan Finder (MPF) are not. In fact, they will only start to be realized in the new year when some beneficiaries find out the drug prices, premium information and more that they gathered on the Plan Finder was inaccurate and hence, they’re currently in a plan that’s not their best choice.


California Health Advocates, along with advocates around the country, Medicare counselors, U.S. Senators, Part D plans, state insurance commissioners, insurance brokers and others, have all voiced and documented numerous concerns with the new MPF throughout Medicare’s Open Enrollment. While the Centers for Medicare and Medicaid Services (CMS) has worked with us and others to address the issues, we are concerned about the positive spin CMS leadership continues to give to the Plan Finder, including direct denial of any mistakes or inaccuracies, as seen in their blog published on November 27: We’re Heading into the Last Week of Medicare Open Enrollment – Don’t Miss Out on Your Chance to Find Better Coverage.


Instead of admitting to the inaccuracies and taking action to ensure all affected beneficiaries have blanket access to a Special Enrollment Period (SEP) to change plans or return to Original Medicare if their plan choice doesn’t work due to faulty information on the MPF, CMS only touts that there were “no outages” since it has been launched. In their blog, CMS also blatantly states that the new Plan Finder “displays the most current and accurate information on premiums, deductibles and cost sharing that Medicare Advantage and Prescription Drug Plans provide” when it has not done so, as documented in the extensive appendix at the end of the Center for Medicare Advocacy’s (CMA) full statement, CMS Not Acknowledging Medicare Plan Finder Problems Could Hurt Beneficiaries.


For example, CMA states that:

“In addition to structural issues with the Plan Finder, it became apparent that there was erroneous data and information on the site.  More than “glitches” often inherent when a new system is first debuted, those who counsel Medicare beneficiaries began to see significant problems across the country.  As referenced in the Appendix, media reports emerged that highlighted “errors” in the MPF “that do not match with the insurance company websites” (Record Searchlight (10/11/19)); “various changes — and glitches […that] caused incomplete or incorrect results to be generated” (CNBC (10/15/19));  the website can “produce drastically inflated costs for some drugs, incorrect premiums for low-income people, and other ‘worrisome’ results [ … and costs for low-income subsidy (LIS) enrollees] are not being accurately reflected in the plan finder” (North Carolina Health News (10/22/19)); “a number of errors with the premiums reported for various health plans […] including instances when all options were listed as charging no premium when that is true only for a subset of health plans” and “showing wrong information about drug formularies” and “information about premiums and out-of-pocket costs doesn’t match data the state agency receives directly from insurers” (Star Tribune (11/20/19)); the Plan Finder “‘continues to produce flawed results,’ including inaccurate premium estimates, incorrect prescription drug costs and inaccurate costs with extra help subsidies” (ProPublica (11/25/19)); and “inconsistent drug prices for the same plan and different versions of the lists of drugs covered by that plan” (AARP (11/27/19)).”


CMS’ denial of any erroneous or inaccurate information sends a message to their agency workers and their Medicare representatives who answer beneficiary calls at 1-800-Medicare that “nothing is wrong”, “there’s not a problem” and hence there’s no urgent need to grant Special Enrollment Periods to the beneficiaries who will be asking for them in the new year.


California Health Advocates, along with our consumer advocate partners nationwide, will be advocating for CMS to grant a “blanket” SEP to any beneficiary negatively affected by inaccurate information on the Plan Finder. And until then, we want beneficiaries and their family members to know that if you selected a plan based on inaccurate or complex information given by the Plan Finder, call your local Health Insurance Counseling and Advocacy Program (HICAP). HICAP will help you advocate for an SEP to change your coverage.


Also, for people who just want to switch Medicare Advantage (MA) plans (not return to Original Medicare or change Part D plans), they can do that during the Medicare Advantage Open Enrollment Period (MA-OEP) which runs January 1 – March 31 each year. See our MA Plan Enrollment section for more details.


For more information, see our partners at Center for Medicare Advocacy’s article, CMS Not Acknowledging Medicare Plan Finder Problems Could Hurt Beneficiaries.

Karen Fletcher
Our blogger Karen J. Fletcher is CHA's publications consultant. She provides technical expertise, writing and research on Medicare, health disparities and other health care issues. With a Masters in Public Health from UC Berkeley, she serves in health advocacy as a trainer and consultant. See her current articles.

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