Sunday, November 10, 2019

IBM Medicare Via Benefits Extend Health Medicare's new plan finder is a mess

If you are using www.medicare.gov to find a better drug plan to use in 2020, do not rely on the results you get from the government application.  It is riddled with bugs, returns unpredictable results and by default presents an ordered list of plans with the lowest premiums.  Low premium results are only useful for people who take NO drugs.  Obviously, that's a low percentage of Medicare eligible users.

If you call Medicare to ask them to help you find a plan, know that they are using the same application so the results they give you might not be accurate. Via Benefits has its own plan analysis application, albeit for their subset of prescription drug insurance policies. That's what they are searching at to help you find a plan.  I don't know how accurate their application is but my guess is it is better than the new plan finder on medicare.gov.

Updated 11/25/19:  I just found this news report about the new plan finder....Oh, boy:
https://www.propublica.org/article/the-11-million-dollar-medicare-tool-that-gives-seniors-the-wrong-insurance-information

What do you do for 2020 if you need to find a better part D plan? You have no option but to run the application on medicare.gov to figure out who is selling plans. It appears that at least the formularies are accurate.  If you run the application here are some tips:


  1. Make sure you choose the sort option (on the left side of the screen) for results that orders plans by the annual cost of drugs + premium
  2. Enter your prescription amounts as 1 month supplies.
  3. When you look at the results for a specific plan, be sure to look at the details to find out if all your drugs are covered.  That means you have to scroll down to the BOTTOM of the plan details. Reminder, if a drug is not covered by a plan, then the cost is not used for the  calculation of when you get into the coverage gap nor catastrophic coverage.
  4. Pick a couple of plans that you are considering and ... gulp ... CALL THE INSURANCE COMPANIES to verify ALL the results you got.  You'll also need to call the insurance companies to find out their list of preferred in-network pharmacies.  That information is not in plan details and those pharmacies won't show up in the "pick your pharmacies" step if they are more than 10 miles away.  If you weren't able to run plan finder using a preferred pharmacy, ask the insurance company what the annual cost is at a preferred pharmacy.  Don't assume mail order will be cheaper as sometimes it isn't.
  5. Call your congressional representative and raise hell - this situation is terrible!