New Medicare Plan Finder Doesn’t Fix The Woes GAO Found


The Centers for Medicare and Medicaid Services (CMS) redesigned the Medicare Plan Finder to address many concerns. Probably, the best summary of these concerns is in the July 2019 GAO report, “Medicare Plan Finder: Usability Problems and Incomplete Information Create Challenges for Beneficiaries Comparing Coverage Options.”

Let’s take a look at some of the GAO’s comments and see whether the new Plan Finder actually fixes anything. 

“One of these stakeholders also told us that MPF (Medicare Plan Finder) navigation is cumbersome because users cannot jump directly to certain pages or sections that address their needs, such as viewing the availability of preferred pharmacies.” 

GAO Report

In the current or Legacy Plan Finder, some users find it difficult to view preferred pharmacies, those that offer preferred retail cost sharing. That won’t be a problem with the new Plan Finder. It doesn’t include preferred pharmacies.

As for navigation, a header bar on each page of the Legacy Plan Finder allows you to click and go back. For instance, you want to change pharmacies. Click on the link and land on the pharmacy page. The only way I found to go to previous pages in the new Plan Finder is to hit the back button. More than once, I backed myself right out of the system. 

“… in our interviews two stakeholders also noted that navigation is difficult because beneficiaries are uncertain of the information needed to make different comparisons or identify specific plans. For example, the ability to filter and sort plan information does not appear until later in the plan search process, where users are refining plan results.”

GAO Report

In the Legacy Plan Finder, the ability to filter and sort plans appears after entering medications and pharmacies. There are three separate categories: Part D drug plans, Medicare Advantage plans with drug coverage, and Advantage plans without drug coverage.

In the new Plan Finder, you can choose Part D drug plans or Medicare Advantage plans at the beginning and there is a link on some pages to see all the drug or Advantage plans. However, the sort filter is problematic. There are four sort items for Medicare Advantage plans and three for Part D drug plans, compared to 10 and eight, respectively, in the Legacy Plan Finder.

The default in the new Plan Finder is lowest monthly premium. Change that to lowest estimated costs (which does not include the premium), look at plans, return to the first page and the search goes back to lowest monthly premium.

Another concern is the comingling of Medicare Advantage plans with and without drug coverage. Once you’ve selected Medicare Advantage, you see all the plans. Because the default sort is lowest monthly premium, many plans without drug coverage appear first. It’s possible a beneficiary could select one of those, without realizing the difference. And, if choosing one, there is no alert that she or he could face a late enrollment penalty for Part D. (The Legacy Plan Finder has separates these two types of plans.)

 “As part of the redesign, CMS is also taking steps to provide more complete cost information in MPF to help compare coverage options, according to agency officials.”

GAO Report

As for interpreting how much they will pay for drug coverage, the new Plan Finder does not include an estimate of total costs for the year. For whatever reason, it includes only the out-of-pocket costs, not the premiums. 

“Some stakeholders noted that beneficiaries do not always understand terminology, such as the differences between cost sharing, copayment, and out-of-pocket costs. Most stakeholders also noted that beneficiaries struggle to understand cost estimates and interpret how much they will have to pay.”

GAO Report

Unfortunately, terms such as out-of-pocket max, copayment, deductible, etc., identify the costs a beneficiary will face and are part of the landscape. The new Plan Finder does include these terms because there is simple substitute. 

 “According to CMS, in order to ensure user and stakeholder needs are met, the redesigned MPF tool will be rolled out in phases. During a public preview phase, scheduled for early August 2019, users can access the redesigned MPF, but can opt out at any time to use the legacy MPF. During this phase, CMS plans to route subsets of users to the redesigned MPF with the goal of routing 100 percent of users to the redesigned MPF by mid-August (actually late August). The full launch, scheduled for October 1, 2019, will route all users to the redesigned MPF, and they will no longer use the legacy MPF.”

GAO Report

This is one of the most troubling aspects of the new Medicare Plan Finder: the timeline for implementation. CMS is giving everyone who does plan reviews just one month to test the system. And, this isn’t just any month. It’s the month before the biggest plan review time of the year, Open Enrollment. No more practicing then.

“A 2017 CMS study noted that MPF navigation is difficult and is better suited for specialist users who assist beneficiaries in determining their coverage options.”

GAO Report

By its very nature, Medicare plan review is very complex and complicated. I don’t believe there’s much that can be done to change that. In its quest to make this a beneficiary “do-it-yourself” system, however, CMS is eliminating many of the tools that help to find the best plan, the ultimate end result. Consequently, beneficiaries will likely experience cost and coverage issues in 2020. That should scare the 45 million who are enrolled in a Part D drug plan and the 22 million who have Medicare Advantage plans. 

Articles You May Like

The Expense That’s Covertly Boosting Your Personal Inflation Rate
Americans are going into debt to buy groceries. Here’s why those balances can be difficult to pay down
Flying is cheaper in 2024. But not for some destinations
China consumption slows as retail sales and investment data disappoint
China’s economy reveals pockets of softness. Here’s what to watch ahead of Friday’s data

Leave a Reply

Your email address will not be published. Required fields are marked *