Medicare Plan Finder Upgrade: Will Brokers Need to Keep Hard Copy RX Lists?

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Source: Modern Healthcare

The CMS on Tuesday launched a redesigned Medicare Plan Finder to help Medicare beneficiaries and their caregivers shop for and compare Medicare Advantage and Part D plans, the first major update to the most popular tool in a decade.

The changes include an improved mobile-friendly design, as 25% of beneficiaries accessed the plan finder via mobile devices in 2018 and that number is growing quickly.

The new plan finder will also inform users if a generic version of their prescription drug is available, which is likely an effort to address the high out-of-pocket costs for prescription drugs. Beneficiaries and their caregivers can use the new tool to enroll in Medicare Advantage and Part D plans, as well as view and compare the supplemental benefits of Medicare Advantage plans.

The new plan finder is part of the CMS’ eMedicare initiative announced last year, which promises to deliver a streamlined user experience for Medicare beneficiaries.

“President Trump has made it clear that he wants to protect and strengthen Medicare,” CMS Administrator Seema Verma said in a statement. “The redesigned Medicare Plan Finder is another example of how CMS is empowering beneficiaries with price and quality information to take advantage of lower rates and new benefits in MA and Part D.”

The new tool will let users compare prices among original Medicare, Medicare prescription drug plans, Medicare Supplement Insurance (or Medigap) policies and Medicare Advantage plans. Users will have access to plan costs and benefits.

Users can also create a personalized drug list and view drug coverage across Medicare Part D plans. If someone is already a Medicare recipient, their recent claims data will be used to prefill a personalized drug list that they can modify based on recent changes in their medical care.

The old Medicare Plan Finder will be available through the end of September. The CMS will continue to gather feedback about the new tool as the Medicare open-enrollment period approaches. Open enrollment begins October 15.

The CMS also said that it would release by the end of the year real-time Medicare plan data in an application programming interface format. It hopes that the private sector will use this information to create new tools that Medicare recipients can adapt to make informed decisions about their health coverage.

During a Q&A session, Verma said the new tool largely addresses the concerns outlined in a July report from the Government Accountability Office that found the old plan finder was difficult to use for beneficiaries and provided incomplete information. She claimed that ongoing issues regarding incomplete information are due to a lack of data availability and cited the absence of some Medigap pricing information as an example.

The GAO report also found that the old tool did not include an integrated provider directory that beneficiaries could use to find out if their doctors are in-network. The new tool doesn’t fix that problem because the CMS doesn’t have the data required to build an integrated directory of providers. Verma said that’s one of the reasons the CMS has requested in a pending interoperability rule that health plans provide information about participating providers in an open API format.

Both the old and new tools include external links to health plan provider directories.

Last Updated 01/22/2020

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