Bill Overview
Title: Medicare & You Handbook Improvement Act of 2022
Description: 2022 This bill specifically requires the Centers for Medicare & Medicaid Services to describe the types of prior authorization requirements and other utilization management requirements that may apply under Medicare in the Medicare & You handbook, including how to inquire about requirements under Medicare Advantage (MA) or prescription drug plans. It also requires the handbook to include a description of the network sizes of MA plans and an illustrative example showing the impact of switching from an MA plan to Medicare on the ability to purchase Medigap supplemental policies.
Sponsors: Sen. Marshall, Roger [R-KS]
Target Audience
Population: Medicare Participants
Estimated Size: 65000000
- All individuals enrolled in Medicare will receive the updated handbook as it pertains to their benefits.
- The handbook provides critical information relevant to seniors or those with disabilities who are eligible for Medicare.
- Individuals who are considering switching from a Medicare Advantage plan to traditional Medicare will benefit from the clarification provided in the handbook.
Reasoning
- The handbook improvement act influences those directly involved with Medicare, especially seniors and individuals with disabilities.
- The goal of the policy is to enhance clarity in the Medicare & You handbook, targeting about 65 million Medicare participants.
- Considering the expansive reach yet moderately low change impact on wellbeing, only a segment of Medicare users actively make decisions impacting their supplementary coverage or might be confused by prior authorization requirements, this policy will have a low to medium impact over a long duration.
Simulated Interviews
Retired teacher (Phoenix, AZ)
Age: 72 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 18/20
Statement of Opinion:
- Getting detailed information about my MA plan is helpful, but I have been satisfied with my plan as it is.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Retired (Miami, FL)
Age: 68 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- I was confused about how changing plans affects my ability to get Medigap. This new information in the Handbook makes it a bit clearer.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 7 | 5 |
Part-time consultant (San Francisco, CA)
Age: 58 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- More information is always good, but I mostly rely on my care coordinator for handling authorizations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Retired nurse (Boulder, CO)
Age: 82 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- Having clear information on which doctors and services are covered impacts my peace of mind.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Retired engineer (Boston, MA)
Age: 70 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 15/20
Statement of Opinion:
- The extra information about Medigap is helpful, but changing plans is still overwhelming.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired accountant (Houston, TX)
Age: 66 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 2.0 years
Commonness: 15/20
Statement of Opinion:
- I mainly rely on my family to help with understanding Medicare. The handbook updates are a good backup source.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Retired plumber (Columbus, OH)
Age: 75 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- The handbook shouldn't just tell what but also assist more directly in managing my Medicare Advantage authorizations.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired public servant (Seattle, WA)
Age: 64 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 3.0 years
Commonness: 15/20
Statement of Opinion:
- Unsure how useful the handbook updates will be once fully enrolled, but it's good to have clarification available.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired doctor (New York, NY)
Age: 85 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- I see the value in updating Medicare materials, though it's mostly for new enrollees.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Retired librarian (Chicago, IL)
Age: 74 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- Ensuring everyone understands their healthcare options is vital. This update is a small but important step.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $20000000 (Low: $15000000, High: $25000000)
Year 2: $18000000 (Low: $13000000, High: $23000000)
Year 3: $17000000 (Low: $12000000, High: $22000000)
Year 5: $16000000 (Low: $11000000, High: $21000000)
Year 10: $15000000 (Low: $10000000, High: $20000000)
Year 100: $14000000 (Low: $9000000, High: $19000000)
Key Considerations
- Updating the handbook is logistically straightforward, but will require precise and clear descriptions to be effective.
- The policy applies widely given the large number of Medicare enrollees, necessitating emphasis on accessibility and clarity of information.