Medicare Plan Finder Woes Get National Coverage

State insurance regulators and nonprofit health advocates have started to get large-scale, national media coverage for a problem that Medicare plan agents and brokers have been talking about for weeks: The government's recently updated Medicare Plan Finder is not working very well.

The system is supposed to help consumers shop for Medicare plans based on factors such as quality, provider networks, covered drug lists and projected out-of-pocket costs as well as premium costs.

The Centers for Medicare and Medicaid Services (CMS) had been using the same Medicare Plan Finder system since 2005. Many consumer groups and government watchdog agencies argued that the system was too hard for consumers to use.

CMS released an updated version for the Medicare Advantage plan and Medicare Part D prescription drug plan annual enrollment period for 2020 coverage, which started Oct. 15 and is set to end Dec. 7.

Agents, brokers, and advocates at State Health Insurance Assistance Programs all complained about the same thing: That the system no longer makes it easy to shop based on a consumer's total projected out-of-pocket costs; that it makes determining how plans will cover specific drugs a consumer takes difficult; and that it provides information that's wrong.

One problem for agents and brokers is that, for privacy reasons, agents and brokers are not supposed to have independent access to Medicare plan shoppers' prescription lists. Producers have to persuade consumers to enter prescription lists and help with the searches, or they must enter drug lists manually, each time they perform a plan search.

Ricardo Alonso-Zaldivar of the Associated Press published a widely used article on the Medicare Plan Finder problems Nov. 21.

Akilah Johnson, a reporter at ProPublica, a nonprofit news organization, wrote, in an article published Tuesday, that consumer advocates say the Medicare Plan Finder is "malfunctioning with alarming frequency." Johnson includes the example of one woman who received an incorrect assurance that the plan she was choosing would cover her blood pressure medicine. The plan did not actually cover the medicine. If the woman bought the drug on her own, the full cost would have been $2,700 per month.

Allyson Schwartz, president of the Better Medicare Alliance, a group that represents issuers, advocacy groups and other organizations with an interest in Medicare Advantage plans, said in a statement about the news reports that the alliance would like to see CMS fix the problems and prioritize putting a total out-of-pocket cost sorting tool back in.

"While CMS made many positive changes with their redesign of the Medicare Plan Finder site earlier this year, it is clear that more work remains to be done," Schwartz said.

Quick Fixes

A web broker with a private Medicare plan shopping site, eHealth Inc., says one way to get around the Medicare Plan Finder problems is to use eHealth's own eHealth.com system to enter prescription lists and see which plans will cover them with the lowest out-of-pocket cost.

The web broker says another good fix is to talk to a licensed agent.

"It's possible these days to do most of your Medicare research and shopping online without talking to anyone," eHealth says in a set of five tips for Medicare plan shoppers. "That's great for some, but there's no substitute for the personal touch. A licensed Medicare agent can answer your questions and offer insights specific to your situation, at no additional cost to you."

— Read Medicare Managers Update Their Plan Finder, on ThinkAdvisor.

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