Access for Blind and Visually Impaired People Blocked By Single Largest US Healthcare Payer

In brief: DREDF is conducting an investigation into the manner in which blind and visually impaired persons covered by Medicare experience problems accessing Medicare notices in alternate formats. Beneficiaries have already reported “solutions” that include relying on third parties to read their private medical information to them. These and other barriers are resulting in poor health outcomes and loss of critical benefits. Please contact Namita Gupta at DREDF,, or 510-644-2555 if you have experienced difficulty receiving Medicare notices in alternative formats.

Read on for details about the issue. Get informed and help us get the word out!

The Centers for Medicare and Medicaid (CMS), an agency of the US Department of Health and Human Services, is the largest single payer for health care in the United States, providing healthcare coverage to nearly 90 million Americans through Medicare, Medicaid, and the State Children’s Health Insurance Program. According to CMS data, there are approximately 49 million Medicare beneficiaries in the United States. Approximately 4.3 million individuals over the age of 65 report some form of visual impairment. There are also approximately 700,000 Medicare beneficiaries between the ages of 21 and 64 who have some form of visual impairment.

In a 2011 report, the Equal Rights Center found that blind and visually impaired individuals were generally unable to obtain information regarding their health care and benefits because the information was not provided in accessible formats. This information can include, among other things, medical exam, test, and lab results, appointment reminders, information explaining benefit eligibility or termination, prescription medication with dosage information, as well as security and privacy rights, and billing and other medical records.

CMS itself regularly communicates complex information to Medicare beneficiaries through Medical Summary Notices. CMS regularly sends blind and visually impaired persons standard print correspondence about their individual benefits. Similarly, many large private managed care organizations that contract with Medicare to serve Medicare beneficiaries as Medicare Advantage and Part D plans regularly provide patients with documents such as Explanation of Benefits (EOBs) and other important benefits and billing information in standard print formats.

But these standard print formats are inaccessible to blind and visually impaired persons. CMS itself refuses to provide individual statements in formats that are accessible, such as readers, Brailled materials, audio recordings, large print formats, accessible online statements, and data CDs, regardless of individualized requests. Other Medicare managed care contractors fail to provide alternate formats beyond slightly larger print or Braille which, depending on an individual’s disability, may be useless.

In the absence of alternative formats, blind and visually impaired persons are not effectively informed of and do not have an equal opportunity to participate in and enjoy the benefits of Medicare programs.

Instead of providing alternate formats for these critical notices and information, CMS has suggested that individuals seek the assistance of third parties to read their private medical information to them, thus requiring blind and visually impaired Medicare recipients to compromise their privacy regarding sensitive medical information.

Blind and visually impaired persons are additionally at risk of significant financial and personal hardship because they are unable to read notices regarding critical benefit eligibility or termination issues that arrive in standard print formats.

DREDF is conducting an investigation into the manner in which blind and visually impaired persons who receive Medicare are experiencing problems receiving Medicare notices in alternate formats. We want to hear your story. If you have experienced any of the above issues, please contact Namita Gupta at DREDF,, or 510-644-2555.

We anticipate this investigation will be ongoing for a minimum of the next several months. All communications will be kept confidential.

Thank you for sharing your experiences with us. Together, we will achieve healthcare justice for people with disabilities!