End Drug Plan “Lock-In” for
Americans enrolled in Medicare-approved drug plans that refuse to
cover needed medications, consumer group says
Americans locked into plans that
refuse assistance
New York, NY –
Older and disabled Americans must be allowed to switch out of
Medicare private drug plans because confusion, misinformation from
the government, and deceptive drug plan marketing practices have led
many people to enroll in plans that do not cover their medications,
reports the Medicare Rights Center.
“Secretary Leavitt
can and must lift the ‘lock in’ provision and allow people with
Medicare to change drug plans when they discover their plan doesn’t
cover the medicines their doctors’ prescribed,” said Robert M.
Hayes, president of the Medicare Rights Center, a national consumer
service organization.
“It’s time that the Administration recognizes the drug benefit
should be about meeting human need, not just pleasing the insurance
industry,” he said.
As of May 15,
people are “locked in” to their Medicare private drug plans through
the end of the year. People who have drug coverage through Medicare
Advantage HMO’s are locked into their drug and health plans
beginning July 1.
The Medicare Rights
Center, which has received a flurry of calls from consumers
discovering that they cannot get needed medications from the plans
they enrolled in, reports that up until May 15 changing drug plans
was the only solution for people to get prescriptions filled.
Marketing abuses,
the Medicare Rights Center found, led countless numbers of people
with Medicare to enroll in plans that cannot provide the coverage
they need. The new report found:
-
Plan representatives have told prospective enrollees
that their drugs were covered when they were not, and neglected
to tell them some drugs are subject to utilization management
restrictions;
-
The Centers for Medicare and Medicaid Services’ provided
inaccurate drug plan coverage information on its web-based plan
finder and via 1-800-MEDICARE operators;
-
The appeals process does not work in a timely or fair
manner for people whose drug plans limit and change formularies
and place restrictions on covered drugs; and
-
Systems failures have resulted in chronic enrollment and
disenrollment break-downs.
Secretary Michael
Leavitt has the authority to call a “Special Enrollment Period”
(SEP) and lift the lock in provision through the end of the year,
reports the Medicare Rights Center in
People Must Be Allowed to Change Their Drug Plan.
The
consumer group says that if the Secretary refuses to act, then
Congress should eliminate the lock in provision in conjunction with
extending the May 15 enrollment deadline.
The Bush
Administration does allow people with Medicaid and Medicare, as well
as those in Medicare Savings Programs or receiving Social Security
Income, to switch plans throughout 2006.