Medicare Plan Finder Issues

Potentially Misleading Information on Medicare Plan Finders

As you may know the Centers for Medicare & Medicaid (CMS) released a new version of Medicare Plan Finder (MPF) this year. Unfortunately, there are issues with the information in MPF that could lead to confusion for agents and beneficiaries. With the Annual Enrollment (AEP) approaching, some consumers, agents and caregivers may use the MPF and there are concerns that the information is potentially misleading. This may cause seniors to make decisions on plans that don’t meet their medical needs and have negative financial implications.

As an agent you are the trusted advisor in aiding seniors in navigating their health care decision so we wanted to make you aware of the concerns which are also shared in this article from National Association of Health Underwriters.

Specifically, three concerning issues we’ve identified with the Medicare Plan Finder include:

The “Total Yearly Cost of Care” does not provide personalized or transparent information. For example, when a consumer inputs or changes personal data, such as drug information, his or her total estimated costs do not change. This is not mathematically possible based on the plan benefits. Additionally, the tool does not share what is included in the total cost. As a result consumers will likely see the total cost and assume they are receiving a personalized and tailored estimate which may not be accurate.
The estimated total yearly cost of care is flawed. On a plan that has reduced benefits year over year, the expectation would be that the “estimated total yearly costs” would increase. However the tool is inaccurately estimating the consumer’s costs will decrease. It doesn’t make mathematical sense. For consumers on a fixed income and cost conscious, this could be detrimental to their situation.
Most supplemental benefits are not included in the total yearly cost of care. Over the past several years supplemental benefits have expanded and provided members with options that not only treat, but prevent illness and increase quality of life. We know the high value of benefits such as vision, dental and hearing to our consumers, and they are a key way we are partners in care with our members. Some of the benefits that are not included are:
- Transportation lists copay but not number of rides.
- Eyeglasses list copay but does not share if benefit covers frames, lenses or contacts.
- Wellness Programs include a long list of possible items including fitness, nurse hotline, Personal Emergency Response and telehealth, that can’t be lumped into a single “covered” or “not covered” benefit.

What does this mean for you and your consumers:

For you: Please refer to the plan search tool directly with each carrier when reviewing specific plan benefits and costs.

For your consumers: If they have indicated they have searched for plans in MPF please share the concerns about MPF accordingly. That is why it is important for consumers to have you, their trusted health advisor, to navigate their decision.

We want to be sure beneficiaries have access to useful information about Medicare plans as they make decisions to find the best health care for their needs. We will keep you updated as we become aware of them.