Kanjorski Warns of Costly Error in "Medicare and You" Handbook

Wilkes-Barre, Pa. - Congressman Paul E. Kanjorski (PA-11) today advised Medicare participants to be aware that the "Medicare and You" handbook sent by the Centers for Medicare and Medicaid Services to 40 million households contains an error that could end up costing low-income Medicare beneficiaries hundreds of dollars next year. Specifically, the federal government will NOT pay the full premiums for low-income Medicare beneficiaries who qualify for extra help for any prescription drug plan that they choose. The "Medicare and You" book erroneously states that the government will cover that full monthly premium. CMS is not planning to send a corrected version of the handbook, but a notice sent to Members of Congress is attached.

The FACT is that low-income Medicare beneficiaries who qualify for extra help must enroll in a prescription drug plan with monthly premiums at or below their region's benchmark to receive the full subsidy. If low-income Medicare participants follow the guidelines in the "Medicare and You" handbook, and they choose a prescription plan with monthly premiums greater than the monthly benchmark, they will have to pay the difference. The benchmark for the Commonwealth of Pennsylvania is $32.59.

"Many of the monthly premiums for the prescription drug benefit are much higher than the benchmark for Pennsylvania, with some nearly doubling it. If Medicare participants who qualify for extra help choose a plan that costs $58, they would owe $25.41 each month to make up the difference. This is an extra cost that these individuals will not expect because the government's handbook told them they would not owe it. With the large volume of information that Medicare participants are receiving and will receive about the new Medicare prescription drug plan, it is essential for individuals to have the correct information to make well-informed decisions about their health care plans," Congressman Kanjorski said. "At this point, CMS has posted the correct information on its Web site, but the fact is that many individuals, and particularly low-income seniors, do not have access to the Internet. Additionally, the CMS Web site adds more confusion because it does not differentiate that this is, in fact, a different version of the handbook than they received in the mail."

The corrected version of the handbook is now on the CMS Web site, http://www.medicare.gov/spotlights.asp#medicare2006.

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Following is the text of the notification sent to Members of Congress by CMS:

NOTICE OF ERRATA

"MEDICARE & YOU 2006" HANDBOOK

Where Does the Error Occur?

This notice affects the printed area-specific versions of the "Medicare & You 2006" handbooks, which were mailed in October to people with Medicare. The error occurs in the comparison charts listing the Medicare Prescription Drug Plans, beginning with page

97-A. Note: The electronic versions of the handbook that will be posted on www.medicare.gov by October 7, 2005 are accurate.

What is the Error?

The last column of the charts is headed "If I Qualify for Extra Help, will My Full Premium be Covered?" For each plan listed, this column should show "Yes" if the plan's premium is at or below the regional benchmark, and a beneficiary who qualifies for the low-income subsidy would pay no premium for this plan. The column should show "No" if the plan's premium is above the regional benchmark and a beneficiary who qualifies for the low-income subsidy would pay some cost toward the premium for this plan. Due to an error, this column lists "Yes" for every plan.

What is the Scope of the Error?

Approximately 60% of the Prescription Drug Plans listed in the handbook should have a "No" in this column. This error does not impact the charts listing Medicare Advantage plans.

Does this Affect Auto-Enrollment?

No. People with Medicare who qualify for the low-income subsidy will still be auto-enrolled ONLY into plans where they will incur no premium. The information in the printed handbook would be used only by people who qualify for the subsidy and are considering changing to a plan other than their auto-enrolled plan.

How Can a Person with Medicare Get the Correct Information?

The handbook is just one piece of a very large effort to educate people with Medicare about the new Prescription Drug Coverage. Individuals who qualify for the low-income subsidy and use the Medicare Prescription Drug Plan Finder on www.medicare.gov will be able to see the exact dollar amount of the premium they will pay for any plan. People with Medicare who call 1-800- MEDICARE for assistance will be accessing correct premium information to make accurate comparisons and decisions. Beneficiaries will have many opportunities for personalized counseling in the local community, including outreach targeted to people who qualify for the low-income subsidy. In addition, each organization offering Medicare Prescription Drug Plans will be aware of this issue. Plans must provide correct premium information to individuals who qualify for the low-income subsidy, prior to enrollment. Medicare also has corrected the information in the affected column in the handbooks before posting electronic copies at www.medicare.gov on the web. Copies that will be posted on the web by October 7, 2005 are accurate. In addition, CMS has provided information about the error to all of our outreach and education partners and we have equipped them with information to assist people who ask about plans available to people who qualify for extra help.

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