Flaws in the Revamped Medicare Part D Plan Finder Could Result in Higher Than Expected Costs for Seniors

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The Centers for Medicare & Medicaid Services (CMS) recently made changes to the Medicare Part D plan finder tool, which is designed to assist enrollees select their Medicare plan during the open enrollment period. These changes altered how the available plans are displayed to prospective enrollees, and it now sorts plans by how expensive their premiums are with the cheapest plans displayed first. This is a departure from how the plan finder previously functioned, which sorted plans based on their total costs, not just premiums. Displaying plans in this way could persuade prospective enrollees to enroll in a plan that has higher-than-expected out-of-pocket costs, which are charged in addition to the plan’s premium when enrollees fill a prescription. Consumers are required to take additional steps to see the plan’s total expected costs, including out-of-pocket costs, which reduces the availability of this information. Additionally, the plan finder is displaying plans to prospective enrollees that do not cover all of the medications that they take. Consumers could assume that these plans will cover what they need and could be surprised when the plan’s coverage falls short.

Senator Bob Casey, who is the ranking member of the Senate’s Special Committee on Aging, has indicated that he will ask CMS to grant seniors a special enrollment period if they have had trouble signing up for a Part D plan.

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