New Medicare Handbook Contains Error About Prescription Drug Benefit
The "Medicare and You" handbook that CMS is mailing out to beneficiaries this week mistakenly says low-income beneficiaries will be able to enroll in any prescription drug plan available in their area without paying premiums, the Cleveland Plain Dealer reports (Jaffe, Cleveland Plain Dealer, 10/5). According to the AP/Las Vegas Sun, CMS is mailing out the handbook to 35 million beneficiaries "in waves," and some beneficiaries are expected to receive them this weekend (AP/Las Vegas Sun, 10/5).
In describing the financial subsidies available to low-income individuals, the handbook says that beneficiaries with annual incomes at or below $14,355 for an individual or $19,245 for a couple who have few assets can receive financial assistance with monthly premiums and deductibles. About 14 million beneficiaries are thought to be eligible for the subsidies, and 3.1 million people have applied for the extra benefits.
However, the handbook "incorrectly" indicates that all plans available to low-income beneficiaries will charge no premium, the Plain Dealer reports. According to CMS spokesperson Gary Karr, beneficiaries who qualify for the premium exemption only can take advantage of the additional financial assistance if they sign up for a plan with a premium at or below the regional average (Cleveland Plain Dealer, 10/5). About 40% of plans qualify to offer no premium, according to the AP/Sun (AP/Las Vegas Sun, 10/5).
Medicare staff members caught the mistake, the Plain Dealer reports (Cleveland Plain Dealer, 10/5).
CMS on Tuesday circulated a memo to members of Congress explaining the error and describing how health plans can ensure beneficiaries do not select the wrong prescription drug plan. The memo said CMS will rely on insurers to explain how the zero-premium coverage works. The agency also is giving out the correct information on its Medicare hotline and posting it on its Web site, Karr said (Young, The Hill, 10/6).
He added that CMS has told insurers selling plan to low-income beneficiaries that they must make clear whether the financial subsidy they receive will cover the premium. Medicare officials also are informing state health insurance programs and senior advocacy groups about the mistake (Cleveland Plain Dealer, 10/5). Karr attributed the error to "inadequate proofreading," the AP/Sun reports (AP/Las Vegas Sun, 10/5).
CMS also said most low-income beneficiaries will not be affected by the mistake because they will be enrolled automatically in a drug plan (CQ HealthBeat , 10/5).
According to The Hill, the error "has given Democrats new ammunition to charge" that the new Medicare drug benefit "is too confusing for older Americans to understand."
Senate Minority Leader Harry Reid (D-Nev.) said, "The administration has created a drug benefit that is so confusing, even the people running Medicare can't get it right." He added, "This mistake underscores the need for legislation to delay the application of the late-enrollment penalty. ... If the folks at Medicare can't get it right on the first try, seniors deserve extra time to make the right choices" (The Hill, 10/6).
Rep. Sherrod Brown (D-Ohio) said he hopes CMS "isn't serious that seniors can 'go online' to get the correct information," adding, "How will they know it's incorrect in the first place? Misinformation will turn a frustrating decision-making process into a complete waste of time."
Semanthie Brooks, director of community advocacy at the Cleveland-based Benjamin Rose Institute, said, "It is disappointing that along with the complicated task of having to find a plan that meets your needs, there now may be errors in the handbook" (Cleveland Plain Dealer, 10/5).
A spokesperson for AARP said CMS officials are "doing what they can" to correct the error, adding that AARP will help deliver the correct message (The Hill, 10/6).
In related news, CMS Administrator Mark McClellan on Tuesday discussed the new drug benefit with about 50 low-income seniors at the National Caucus and Center on Black Aged retirement home in Washington, D.C. McClellan said low-income beneficiaries will receive help covering most of their monthly premiums and annual deductible and urged seniors to apply for the low-income subsidy.
Del. Eleanor Holmes Norton (D-D.C.) urged seniors to enroll, adding, "Even if it costs you something, you can't afford to be penny-wise and pound foolish. You can't afford to be here without drugs today" (CQ HealthBeat , 10/5).
NPR's "Morning Edition" on Thursday reported on the error in the Medicare handbook. The segment includes comments from Robert Hayes, director of the Medicare Rights Center; Karr; and Judith Stein, executive director of the Center for Medicare Advocacy (Rovner, "Morning Edition," NPR, 10/6). The complete segment is available online in RealPlayer.This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.