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Top Challenges for People with Medicare Identified by Nation’s Largest Medicare Consumer Organization

January 19, 2016  
•  Press Releases

Top Challenges for People with Medicare Identified by Nation’s Largest Medicare Consumer Organization
–Medicare Rights Center Report Highlights 2014 National Helpline Trends and Provides Policy Solutions –

New York, NY—Today, the Medicare Rights Center released its annual helpline trends report, which outlines the top concerns facing people with Medicare heard through thousands of calls to Medicare Rights’ national helpline.

“This analysis of our national helpline data makes clear that too many people with Medicare struggle to navigate the complexities of the Medicare program. But there are straight-forward solutions for alleviating these challenges and strengthening the Medicare program as a whole,” said Medicare Rights Center President Joe Baker. “In this election year, it’s important that candidates hear feedback from people with Medicare and translate their stories into concrete solutions to improve the Medicare program.”

The report, Medicare Trends and Recommendations: An Analysis of 2014 Call Data from the Medicare Rights Center’s National Helpline, includes an in-depth discussion of two important issues heard on Medicare Rights’ helpline. Each issue is accompanied by policy solutions, which the Centers for Medicare & Medicaid Services (CMS), state agencies, insurers, elected officials, and others can pursue to improve the Medicare program for the more than 52 million people it serves.

Out of more than 17,000 questions posed by older adults and people with disabilities, their family members, and the professionals serving them in 2014, two trends stood out among the questions from helpline callers:

  • Navigating Medicare Part B Enrollment: Many individuals who call Medicare Rights are confused by Medicare enrollment rules, and specifically by decision-making related to taking or declining Part B, which covers doctors’ and other services. Some have other coverage through an employer or the new state or federal Marketplace and need information about how that insurance may change because they are eligible for Medicare. While callers may be aware of the risk of late enrollment penalties, they may not realize that their former insurance may refuse to pay for care entirely once they are Medicare-eligible.
  • Navigating Part D Prescription Drug Appeals: Frequently, in addition to not knowing why their prescription drug was denied, callers are confused by the Part D appeals process, which they need to use to get access to their medications. They are often unsure as to whether their appeal has been filed, what level of appeal they are at, and what their doctors may have done on their behalf.

Drawing directly from Medicare Rights’ 25 years of experience serving people with Medicare and their families, the report includes a comprehensive set of policy recommendations intended to improve access to affordable health coverage for beneficiaries.

Among the recommendations regarding Part B enrollment and prescription drug appeals are:

  • Better education for newly eligible beneficiaries and for employers
  • Streamline and align enrollment periods
  • Include the reason for a drug denial in the pharmacy counter notice, and allow an immediate request for an appeal.

“While Medicare continues to serve older Americans and people with disabilities well, now is not the time to rest on our laurels,” said Baker. “Members of Congress and the Administration should view this report as a continuing call to action. Now is the time to seek solutions that make Medicare an even fairer, simpler, and more affordable benefit.”

Read the report.

To contact Medicare Rights’ national helpline, call 800-333-4114.
For more information about Medicare, visit


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About Medicare Rights
The Medicare Rights Center, a national nonprofit consumer service organization that works to ensure access to affordable health care for older adults and people with disabilities.

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