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Beneficiary advocates urge CMS to correct inaccuracies in Medicare & You Handbook for 2019

Insurance Forums Staff

The Center for Medicare Advocacy, Justice in Aging and the Medicare Rights Center sent a joint letter to Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), last week, objecting to serious inaccuracies in the draft Medicare & You Handbook for 2019, and urging CMS to rectify the errors prior to disseminating the Medicare & You Handbook.

Medicare & You is the official government publication designed to provide beneficiaries with factual information about the Medicare program, their choices for obtaining coverage, and the benefits they can expect. Unfortunately, the beneficiary advocacy groups say, the draft 2019 Handbook includes inaccurate descriptions of the differences between original Medicare and private Medicare Advantage plans. “Without fair and accurate information, older adults, people with disabilities and their families cannot make informed choices about their health care coverage,” the groups said in a May 18 statement on the topic.

The letter to Ms. Verma voiced the three organizations’ concerns that the draft 2019 Handbook distorts and mischaracterizes essential facts on which beneficiaries rely to make decisions about their coverage.

  • First, it does not adequately inform beneficiaries of the significant limitations on choices of health care providers if they choose a Medicare Advantage plan rather than original Medicare.
  • In addition, it presents prior authorization in Medicare Advantage plans as a “right” that is not available in original Medicare, rather than acknowledging that it is a requirement, an extra step mandated for Medicare Advantage members before they are permitted to access care.
  • Further, the draft 2019 Handbook inaccurately implies that Medicare Advantage is the less expensive option for all beneficiaries. This sweeping generalization ignores the many variables that people with Medicare must consider in evaluating and selecting coverage that is most affordable and best suited for their needs.

“These can literally be life and death decisions. CMS has a duty to provide complete, unbiased information to help beneficiaries make the best choice for their Medicare coverage,” said Judith Stein, executive director of the Center for Medicare Advocacy. “Regrettably, the current version of Medicare & You does not fully and fairly inform people of the pros and cons of Original Medicare vs. Medicare Advantage. The draft Handbook needs to be corrected before it is published and sent to beneficiaries.”

Kevin Prindiville, Executive Director of Justice in Aging, stated: “Several proposed changes in the Handbook distort basic facts about how Medicare Advantage and original Medicare work. People with Medicare rely on Medicare & You for accurate and objective information. If these changes were adopted, beneficiaries would not have the information they need to make fully informed decisions about their Medicare coverage.”

Joe Baker, President of the Medicare Rights Center, added: “From the Medicare Rights Center’s experience assisting people with Medicare and their families, we know how challenging it can be for beneficiaries to make the best coverage decision for their unique circumstances. The Medicare & You Handbook must support this decision-making process by accurately describing the rules, restrictions, and benefits of both original Medicare and Medicare Advantage. Regardless of the coverage they ultimately select, all people with Medicare deserve the opportunity to make an informed choice. We commend CMS for incorporating many of the language changes we suggested in prior years, and urge the agency to address our concerns with the draft 2019 Handbook prior to its publication.”

Read the letter here.

The Center for Medicare Advocacy (http://www.medicareadvocacy.org) is a national, nonprofit, non-partisan law organization that works to advance access to comprehensive Medicare coverage and quality health care for older people and people with disabilities through legal analysis, education, and advocacy.

Justice in Aging (www.justiceinaging.org) is a national non-profit legal advocacy organization that fights senior poverty through law. Formerly the National Senior Citizens Law Center, since 1972 we’ve worked for access to affordable health care and economic security for older adults with limited resources, focusing especially on populations that have traditionally lacked legal protection such as women, people of color, LGBT individuals, and people with limited English proficiency.

The Medicare Rights Center (www.medicarerights.org) is a national, nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities through counseling and advocacy, educational programs, and public policy initiatives.



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