Handbook ‘does not fully address the challenges’ Medicare Advantage can create for seniors, senator says

A pair of senators have introduced a bill to improve the “Medicare & You” handbook after hearing complaints about seniors inadvertently selecting plans that do not best meet their healthcare needs. 

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The handbook is mailed to every Medicare household each fall and includes a summary of Medicare, benefits and patient protections, a list of available plans and frequently asked questions, according to a Nov. 22 news release from Sen. Roger Marshall. 

Mr. Marshall said he has grown increasingly concerned about mass marketing campaigns during open enrollment. Fellow bill sponsor Sen. Maggie Hassan said the handbook “does not fully address the challenges Medicare Advantage can create for seniors.”  

Their proposed bill would add to the handbook a description of what utilization management techniques are — including prior authorization and step therapy — and how beneficiaries can find which techniques apply under a specific Medicare Advantage or prescription drug plan.

The bill would also add a description of the network sizes of Medicare Advantage plans relative to the number of healthcare providers who accept traditional Medicare. Additionally, it would include a description explaining that when seniors switch to a Medicare Advantage plan and later switch back to a traditional Medicare plan, they may be prohibited from purchasing supplemental coverage or may have to pay significantly higher premiums. 

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