Journalist Philip Moeller answers your questions about health, aging, and retirement. Phil is the author of the book, “Get What’s Yours for Medicare,” and co-author of “Get What’s Yours: The Revised Secrets to Maxing Out Your Social Security.” Send your questions to Phil.
Medicare’s annual open enrollment period ends on Dec. 7, prompting me to make one last pitch for current Medicare beneficiaries to take a careful look at their 2020 coverage plans. Even if you’ve chosen one or more new Medicare plans, there is still time during the next few days to change those selections.
As noted in an earlier article, this year’s open enrollment process has been made more confusing than normal because Medicare redesigned its online Plan Finder – the only tool that offers detailed comparisons of the often dizzying array of private Medicare Advantage and Part D drug plans.
Patient advocates and Medicare experts have taken Medicare to task for the way Medicare plan information is presented in the new Plan Finder, and also have reported inaccuracies in the information it provides about 2020 plan choices.
The Centers for Medicare and Medicaid Services (CMS) has steadfastly maintained that the tool is working as planned and that it represents a marked improvement over the previous Plan Finder.
In a blog last week, the agency complained about negative media coverage of the redesigned Plan Finder. “CMS has been distressed to see media coverage talking about ‘glitches’ or ‘malfunctions’ in the Plan Finder,” the agency said in an 800-word rebuttal.
In response to one of the criticisms, CMS said the tool defaults to sorting plans by premium costs, rather than total estimated out-of-pocket costs because that is what most people use for initial comparisons of various plans. At the same time, it said estimated out-of-pocket cost is still displayed “prominently.”
CMS further emphasized that “the Plan Finder redesign is an iterative project, and in the coming months we’ll be scoping out additional improvements that we can implement based on lessons we learn this year.”
The nonprofit Center for Medicare Advocacy countered CMS’ defense of its system in an annotated response earlier this week that was over 3,100 words and provided details from 20 stories critical of the new tool.
“CMS’ inability to admit that there have been problems with the Plan Finder undermine and undercut the hard work of Medicare counselors and advocates across the country who have dutifully tried to adapt to the new platform, provide needed assistance, and report problems to CMS,” the response said. “Many Medicare beneficiaries have likely made choices about their Medicare Advantage and Part D plans based on inaccurate information, yet CMS is publicly saying that this enrollment period has been no different from any other. This is simply not true.”
Nevertheless, Medicare beneficiaries are stuck with using Plan Finder for this enrollment period, so here are some steps to follow to make sure your 2020 plan choices are based on accurate information:
- Don’t choose a plan simply because it has the lowest premium. This information is prominently displayed in the new Plan Finder, but it may not be as important as the Plan Finder’s projection of a plan’s total annual out-of-pocket costs, which is also listed.
- Make sure your Part D plan section covers all the drugs you take and includes price projections for the pharmacy you plan to use.
- Before enrolling for 2020, call insurers whose plans you are set to select and make sure the information in Plan Finder is accurate.
- Medicare Advantage enrollees in particular should call their insurers to make sure their preferred doctors and care facilities are included in a plan’s provider network.
- If you believe information from Plan Finder caused you to make an incorrect Medicare decision for 2020, CMS has emphasized that it will consider providing people a special enrollment period –- after open enrollment has closed –- in which they can elect different Medicare plans
Although choosing a new Medicare plan might be harder this year, the benefits of shopping around continue to be worth it. Plans often change a lot from one year to the next, including new charges for copays and drugs, adding and dropping coverages, and the like.
The possible benefits of taking the time to shop around–better coverage at a lower cost–are missed by most beneficiaries, according to regular assessments by the Kaiser Family Foundation. A recent Kaiser Family Foundation study found that only between 6 percent and 13 percent of Medicare enrollees switched their Medicare Part D plans in any single year during the decade ending in 2016.
Nearly half of all enrollees “rarely or never” review their plans and simply keep what they have, Kaiser said in its report, adding that this percentage rose to nearly 60 percent for enrollees aged 85 or older.
At the same time, Kaiser’s regular surveys of Medicare beneficiaries found that about 35 percent to 45 percent of respondents said it was hard to compare their Medicare options. People in poorer health with more complicated medical needs were more likely to have difficulty comparing plans.
“Low switching rates could also indicate that many beneficiaries find the process of comparing plans too challenging, are unaware of the open enrollment period, or have limited confidence in their ability to choose a better plan,” Kaiser said in the report.
“The finding that nearly half of all Medicare beneficiaries say they never or rarely compare plans suggests that many beneficiaries may be unaware of important differences across plans that could have a significant impact on their coverage, costs, and, in the case of Medicare Advantage plans, access to certain providers,” it said.