Medicare & You is the government’s seminal guide to all things Medicare, and is a primary resource used by consumers in each year’s annual enrollment season beginning Oct. 15. As such, it is or should be the gold standard of reliable information for more than 65 million people already enrolled in Medicare and the millions of people who newly enroll each year.
According to three leading senior advocacy groups, however, the 2019 draft version of Medicare & You has unfairly tilted the playing field. After reviewing the draft, the three groups – the Center for Medicare Advocacy, Justice in Aging, and the Medicare Rights Center – said it contained false statements that appear designed to convince people that private Medicare Advantage (MA) insurance plans are superior to original Medicare.
“Medicare & You is the core Medicare communication to beneficiaries,” the groups said in a joint letter to Seema Verma, head of the Centers for Medicare & Medicaid Services (CMS). “It is critical that the information in the Handbook be fairly and accurately presented. Beneficiaries making important choices about their coverage need to be able to rely on the Handbook for unbiased information that they can trust. However, when comparing Original Medicare and Medicare Advantage, the 2019 draft Handbook does not meet this standard, distorting and mischaracterizing the facts in serious ways.”
The Medicare Rights Center released a copy of the draft 2019 Medicare & You handbook along with detailed examples of what it saw as improper comparisons between MA plans and original Medicare.
In several comparative discussions of the two approaches to Medicare, CMS downplays the possible shortcomings of getting care from a limited network of health providers in an MA plan, which involve not only a limited number of providers but also geographic limitations of where a plan provides coverage. At the same time, the draft handbook fails to emphasize that users of original Medicare can use any Medicare-licensed providers anywhere in the nation.
The bottom line
The handbook also creates the impression that MA plans are less costly to seniors than original Medicare. This may or may not be true; it depends on the types of coverage selected and a beneficiary’s individual medical needs.