What is the Medicare Plan Finder? - dummies

What is the Medicare Plan Finder?

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Everybody who wants impartial information about Part D plans, free of sales pressure, uses the online plan finder. Not only people enrolled in Medicare but also doctors, pharmacists, counselors, social workers, advocates, help groups — anyone who assists a Medicare beneficiary in finding a plan. Clearly everybody depends on the plan finder, so asking “How reliable is it?” is a reasonable question.

The plan finder is a complex and sophisticated computer program. And in offering consumers a way to compare plans head to head to find their best deal, it’s long been a pioneer in the health insurance world. But of course such comparisons are only as reliable as the pricing information fed into them — in this case, by the Part D plans themselves.

Medicare officials say they rigorously monitor the accuracy of plan prices and, when errors are detected, remove all information about that plan from the website until corrections are made. Medicare also includes pricing accuracy as one of the measures of its quality assessment system, which rates individual plans from one star (poor) to five stars (excellent).

Officials say the ratings, displayed on the plan finder, are based on Medicare’s own regular reviews and the feedback (including complaints) it receives from consumers.

Nonetheless, the plan finder isn’t free from glitches and errors. Here are some guidelines for eliminating or minimizing your chances of choosing a plan based on misleading information:

  • Know that late September/early October is when Medicare posts online the new plan information for the following year. The first two weeks of this period are when pricing errors are most likely because huge amounts of information are being uploaded onto the system. If you do a plan search at this time, recheck the information after open enrollment starts on October 15.

  • Do your due diligence before signing up. After you’ve used the plan finder to choose the plan you like best but before you enroll in it, take the following sensible measures:

    • Double-check the accuracy of the drug information that you entered into the plan finder — especially dosages and frequencies.

    • Print out the plan’s complete details for your set of drugs and keep this hard copy with your records.

    • Call the plan to verify what you’ll pay for each of your drugs. Make sure you correctly specify the dosages and frequencies. Keep notes of this conversation; the plan likely won’t confirm the details in writing.

  • Bear in mind that the prices quoted for drugs on the plan finder are estimates. The exact prices may vary according to the pharmacy you get them from and may fluctuate during the year. However, the plan’s fixed charges — premiums, deductibles, and co-pay tiers — are invariably accurate on the plan finder; they change from year to year but can’t change during the year.

  • If you discover errors, report them to Medicare. Your information will be investigated and fed into Medicare’s quality rating system.

What do you do if you’ve already made a decision based on faulty info? If you discover you were misled into enrolling in a plan due to erroneous pricing information on the plan finder, you have the right to ask Medicare for a special enrollment period to switch to another plan.

This scenario is when keeping a printout of the details you got from the plan finder comes in handy; you can use the documentation as evidence.