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Medicare Plan Finder Gave Inaccurate Information: Your Rights

Medicare.gov Website Gave Inaccurate Drug Prices for 2020 Drug Plans

The Centers for Medicaid and Medicare Services officials advise beneficiaries to call 800-633-4227 at any time during the coming year and ask for a Special Enrollment Period so they can change plans. This is verified on the Medicare.gov website

“If you believe you made the wrong plan choice because of inaccurate or misleading information, including using Plan Finder, call 1-800-MEDICARE and explain your situation. Call center representatives can help you throughout the year with options for making changes.”

As millions of Medicare beneficiaries reviewed their drug coverage and made decisions for 2020, some of the information on the Medicare website was wrong. Consumers picked plans that did not give accurate drug pricing information.  For example, Nuedexta, is a very expensive drug. Full drug price is about $1,500.  On the Medicare Plan Finder Website it showed that after meeting the $415 deductible, the drug would cost $41.60 a month. When calling the drug plan the prices were very different.  The first month of meeting the deductible and then paying the copay was $650.00.  Thereafter the drug would cost about $500 a month.

Among the problems that have been identified are inconsistent drug prices for the same plan and different versions of the lists of drugs covered by that plan.

“The drug prices just don’t seem to have anything to do with reality,” said Julie Carter, a senior federal policy associate at the Medicare Rights Center. For example, Carter said, one web page will show that a particular drug on a specific plan costs one thing but then another page for the same plan will show a different price. “We’re seeing big swings between the different pages of the same plan.”

There is no deadline for making a new enrollment request, and you should not be required to provide proof of the misinformation or confusion you experienced. If you have any issues using this Special Enrollment Period when you call Medicare, ask to speak with a supervisor. You can also contact your State Health Insurance Assistance Program (SHIP) by calling 877-839-2675.

Asked why different computer pages show different prices for the same drug, a CMS official said that the agency will look into the issue and that it would be helpful if users could provide screen shots of the different pages so CMS can understand what consumers are seeing.

“The problem is we don’t know exactly how widespread the problem is,” Carter said. “We have some significant concerns that people will be making decisions based on numbers that are not right.” While you can tell something is wrong when you see two different prices for the same drug on the same plan, consumers might have a hard time seeing other mistakes in pricing, she said.

The Institute of Food and Agricultural Sciences (IFAS) is an Equal Opportunity Institution authorized to provide research, educational information and other services only to individuals and institutions that function with non-discrimination with respect to race, creed, color, religion, age, disability, sex, sexual orientation, marital status, national origin, political opinions or affiliations