CMS Revises Medicare Pamphlet To Include Information About Extra Costs Associated With Private Medicare Advantage Plans

Main Category: Medicare / Medicaid / SCHIP
Article Date: 19 Nov 2007 - 10:00 PDT

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CMS has revised a Medicare handbook to include more information about the differences in out-of-pocket costs between private Medicare Advantage plans and traditional Medicare coverage, The Hill reports. The "Medicare & You" handbook, which is provided annually to beneficiaries, also has been amended to include additional information about benefits and options for coverage under the traditional Medicare plan, private MA plans, Medicare prescription drug plans and other types of private health plans.

Critics had accused the Bush administration of using the handbook as a political tool to promote MA plans because earlier versions included less information about the differences between deductibles and out-of-pocket costs for MA plans and traditional Medicare. The administration denies the charge. Lawmakers also had complained that CMS did not allow them to make recommendations or review the handbook in advance of its release.

Acting CMS Administrator Kerry Weems noted that this year's handbook includes the input of congressional aides who received advance copies in April. "There was a more conscious effort ... to take those comments into account," Weems said. According to The Hill, the new text included in the handbook "is more conditional." It states that beneficiaries' "costs may be lower than in the Original Medicare Plan, and you may get extra benefits." The new version also states, "These plans must cover medically necessary services. However, plans can charge different copayments, coinsurance or deductibles for these services."

An aide to Senate Finance Committee Chair Max Baucus (D-Mont.), who criticized earlier versions of the handbook, said, "I think this year they have made substantive changes to it," adding, "They've neutralized it." Vicki Gottlich, a senior policy attorney for the Center for Medicare Advocacy, in an e-mail said that the handbook "says in several places that Medicare Advantage plans have different cost sharing from traditional Medicare. They even admit that the cost sharing can be higher or lower than traditional Medicare." However, she added that the handbook still is not sufficiently balanced (Young, The Hill, 11/16).

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