Millions of seniors can now begin enrolling in private policies that offer Medicare medical and drug coverage by 2020. But many could waste their money and even jeopardize their health care because of changes in Medicare’s plan finder, its most popular website.
For more than a decade, beneficiaries used the search engine to compare dozens of Medicare policies offered by different insurance companies and get a list of their options. However, after a website redesign, the search results lack crucial details: How much will you pay out of pocket? Or which plan offers the best value for money?
That’s because the search engine can no longer add and sort prescription costs, plus monthly premiums, and any deductibles for all those plans. The consumer may try it, but it’s a cumbersome process full of obstacles. A plan may have the lowest premium but not the lowest drug prices. Another might exclude the preferred pharmacy from a plan that offers lower prescription drug prices.
“We can no longer guarantee that you will be in the best or cheapest plan,” said Howard Houghton, former Fairfax County Coordinator for the Virginia Insurance Counseling and Assistance Program, who is still helping with volunteer enrollment.
The old plan finder provided great savings. Counselors at Passages, the Health Insurance Information Program for Older Adults (SHIP) serving five Northern California counties, said in August they used it to save a woman $8,400 for this year and more than $5,000 by helping another client.
Medicare officials say the total cost calculator is ready for the annual enrollment season, which begins Oct. 15 and runs through Dec. 7 nationwide. But many other issues raised by the Medicare Rights Center and industry groups have yet to be addressed.
“The new tool will provide better information on quality and pricing” to ensure informed health care decisions, said Seema Verma, administrator of the Centers for Medicare & Medicaid Services (CMS), when she unveiled the redesign in August.
During open enrollment, beneficiaries can enroll in Medicare Advantage plans, the alternative to traditional Medicare that offers drug coverage and often more benefits than the government program. Approximately one-third of the 64 million people on Medicare choose this option. Next year, Medicare Advantage’s average monthly premium is expected to drop 14% from 2019 to an estimated $23, according to CMS.
This is also the only time most people on traditional Medicare can enroll in a drug plan, known as Part D, to help cover prescription costs. It’s a good idea to review the plans each year because cost and drug coverage can change annually. The estimated average monthly premium for these policies will be $30 next year, 8% less than in 2019, according to CMS.
In 2020, Medicare Advantage may offer additional benefits for people with certain chronic illnesses, such as dementia, diabetes, or heart disease. This is in addition to non-medical benefits, which are not linked to a person’s health problems, added this year, such as meals delivered home after a hospitalization, transportation to medical appointments, and home improvements, such as grab bars to prevent falls in the bathroom.
The additional services that some Advantage plans will offer next year may not sound like insurance benefits: pest control, assistance dog food, home-delivered meals, and shopping cart discounts.
“We are moving from reactive care to preventive care,” said Martin Esquivel, vice president of Medicare product management in Anthem, who will offer these and other new advantages to some of his more than 1 million Medicare Advantage members.
The smaller Medicare Advantage plans have also expanded benefits. Alignment Healthcare’s 60,000 members in some California, Florida and North Carolina plans will have access to free transportation to medical appointments with Uber or Lyft.
To address social isolation, some members of California with certain chronic illnesses may receive visits from Grandkids On-Demand, college students who help with household chores and accompany for up to two hours a day. Humana and Aetna will also offer this service in some plans.
But most insurers are not taking advantage of the opportunity to add additional benefits.
“Of the Medicare Advantage plans affected by the new rules, 10 percent (about 500) offered new supplemental benefits in 2020 for people with serious chronic illnesses, such as in-home services, palliative care, respite care, or adult day care,” explained Robert Saunders, a director of Duke University’s Margolis Center for Health Policy. Saunders is still looking at the other categories of additional benefits.
UnitedHealthcare (UHC), which controls 26 percent of the Medicare Advantage market, focuses “on providing basic medical benefits, which is the main reason people buy insurance,” said Steve Warner, UHC vice president for Medicare Advantage, “Most consumers don’t want to buy a plan that has been loaded with ancillary benefits they don’t plan to use.
The insurer’s alternative is to offer more plans that don’t restrict members to a network of health care providers and introduce specialized plans for people with diabetes or dementia, among other changes.
Since the new additional benefits won’t be available in all counties, seniors may have to do some detective work to find out their options. With the search engine, Medicare Advantage options can be reduced only to those plans that offer coverage for hearing, vision, dental, fitness, and transportation.
Bonnie Burns, a consultant with California Health Advocates, recommends that customers call insurers to confirm details before enrolling.
Improvements in the new plan finder include the ability to compare estimated Medicare Advantage plan costs with traditional Medicare coverage with a separate drug plan and one of 11 types of Medigap supplemental plans, which cover all or some of the out-of-pocket costs Medicare does not pay.
But the monthly premiums on the list of Medigap policies – at least in some areas – do not correspond to reality. According to the plan finder, an older person in San Francisco can buy a Medigap plan for as little as $20.83 a month. However, the plan is not on the California Department of Insurance’s tariff list, where the cheapest policy for a 65-year-old costs four times as much.
With a more complicated and slower enrollment process, older adults are likely to need more help. And help may be scarce.
“It means fewer people we can see because we spend more time on each person,” said Alicia Jones, administrator of the state’s SHIP program at the Nebraska Department of Insurance.
[box type=”info” align=”” class=”” width=””]To find your local SHIP program, call 1-877-839-2675 or visit www.shiptacenter.org