Is The New Medicare Plan Finder A Barrier Against Open Enrollment Plan Review?

The Centers for Medicare and Medicaid Services (CMS) is promoting the new Medicare Plan Finder. It will be the exclusive source of information for 2020 Part D drug plans and Medicare Advantage plans. According to a CMS promotional video, beneficiaries can create an “online account for a personalized experience.”

There will be some issues creating that experience and those likely will interfere with plan review during the Open Enrollment Period, October 15-December 7.

The first one: Records in the old system, the Legacy Plan Finder, will not migrate to the new one.

For those who do not have a “My”account, anything in that old system will stay there when it is retired. Beneficiaries may want to log in soon and print a copy of their drug lists.

Once an account is established, a “drug list” appears. In the CMS Medicare National Training Support national training program on August 16, the presenter said this is a list from the claims database, meaning drugs that have been billed to Medicare. It may or may not be the list of your current medications.

The second one: Beneficiaries must establish an account in the new Plan Finder.

This will involve entering specific information and creating a user name and password for the account.

The third one: Anyone reviewing plans during Open Enrollment must log into the new Plan Finder with the user name and password.

You might wonder what’s so horrible about these changes. We have to establish accounts and log into websites every day. There is no doubt that many Medicare beneficiaries can do this, as shown in the CMS promotional video. But there are many, with medical issues, living in a nursing home or memory care center, or who just never got into computers, who will not be able deal with an online account. Those who help them – their kids or grandchildren, SHIP (State Health Insurance Assistance Program) counselors, pharmacists, insurance agents, friends, volunteers – will face challenges. Consider this example.

Bill, a retired pharmacist, helps his former customers, members of his church, friends and relatives with their Open Enrollment drug plan reviews. After setting up a record in the Legacy Plan Finder, he writes down the Drug List ID and Password Date. Then, in October every year, he meets with them to update their files and study plans.

Bill has to be able to access the individual accounts in the new Plan Finder, but the Legacy information will be gone. So how will he do that? During the training program on August 16, the presenter addressed two scenarios. If meeting in person, Bill would give the beneficiary the keyboard and have him or her enter the user name and password. If talking on the phone, Bill asks for that information, enters it in the Plan Finder but does not write it down.

Those answers assume that beneficiaries will establish an account in the new system. Bill knows that many of those he helps do not have smart phones, tablets, or computers. And if they did, that most could not set up an account. How is Bill going to deal with this? He recognizes that the information necessary to set up the account – Medicare number, full name, date of birth, and email address – can be considered protected health information (PHI) under HIPAA. Even though, as a volunteer, he is not subject to HIPAA, Bill is not sure he wants to go there. If he doesn’t, these beneficiaries likely will not get help during Open Enrollment.

It is not clear why CMS made this big change of putting plan reviews behind a wall. Perhaps once beneficiaries have an account, they can access all kinds of Medicare information. However, requiring an account creates a big barrier to plan review, both for current beneficiaries and those enrolling in Medicare. Given the importance of reviewing a drug or Medicare Advantage plan, the powers-that-be should look for ways to simplify the process.

Author: Diane Omdahl. Link to original posting: