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Radar On Market Access: Does New Medicare Plan Finder Make Part D Plans Tougher to Parse?

Posted by Leslie Small on Oct 1, 2019

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Some Medicare experts are expressing concern and frustration about changes to the Medicare Plan Finder that may make it more difficult for beneficiaries to find the best Part D plan for their unique circumstances, AIS Health reported.

For example, the version of the new plan finder that CMS debuted does not include the ability to sort Part D plans based on a beneficiary's total out-of-pocket drug costs (including plan premium) for the rest of the year, says Ann Kayrish, who is the National Council on Aging’s senior program manager for Medicare.
 
The good news, she says, is that CMS notified stakeholders that the total-cost calculator feature will be in place in time for the annual election period (AEP) that begins Oct. 15 — which CMS confirmed to AIS Health.

However, Kayrish says it's still problematic that the total-cost calculator isn't yet available to test before the hectic AEP begins. "We don't want open enrollment to be like a beta test for the new plan finder," she says.

Elizabeth Gavino, founder of insurance consulting firm Lewin & Gavino and an independent broker and a general agent for Medicare plans located in the New York City area, also has qualms with the way the new plan finder is designed.

The old plan finder allowed brokers to quickly scan multiple Part D plans and see whether all of the person's medications are on their formularies. Now, that information is only available by clicking on a "plan details" button for each individual Part D plan, she explains.

"I could do a review for a client in 10 minutes" with the old system, Gavino says. "The way it is now, this is going to be a nightmare."


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Topics: Industry Trends, Data & Analytics, Provider, Payer