A large national organization that serves older adults recently issued a report critiquing Medicare’s Plan Finder website, which is designed to help people choose among Medicare health plan options. The website, which should provide helpful and reliable information is called out for being misleading and confusing. While fixes could improve the site, the lack of helpful information available about commercial Medicare Advantage plans dooms the site from the get-go.
In its report, the National Council on Aging (NCOA) writes: “The site is overwhelming, information is poorly presented, and the user design is potentially misleading — all of which confuses beneficiaries and can contribute to many making poor plan selections.” As bad as the website is, even if it were improved, the Medicare Advantage health plan options cannot be compared in a meaningful way. For example, data about which plan delivers better value care for people with cancer, heart disease and stroke is unavailable.
The Medicare Advantage plans do not reveal how they meet the needs of people with costly and complex conditions or out-of-pocket costs for people with different chronic conditions. Reliable data on Medicare Advantage plan performance and costs is sorely lacking. How good is the care available to people with congestive heart failure or diabetes? Medicare ratings of Medicare Advantage plans are a farce.
Moreover, Medicare Advantage plans generally offer a limited choice of doctors, unreliable network directories, and no coverage outside of a person’s primary residence, except in emergencies. Choosing among Medicare Advantage plans is at best a poor gamble. Whichever plan you choose, you can save money if you need little or no health care. But, if your health needs are significant, you could be out of pocket thousands of dollars quickly or without needed health care.
Medicare’s Plan Finder implicitly suggests that, with good information, people could choose a health plan that’s “right for them.” In reality, none of us know what our future health care needs will be or where in the US we will need care. Unless a health plan covers care from top specialists anywhere in the US—which none of the commercial Medicare Advantage plans appear to do—we are gambling with our care needs. Only traditional Medicare provides people with this important protection.
With traditional Medicare, we are not forced to gamble with our health or our finances, though we do need supplemental coverage, which can cost $4,000 a year. The federal government should not be allowing older adults to gamble with their care, under the guise of suggesting that they can make an informed choice with the information provided on the Medicare Plan Finder site. At the very least, the feds should be ensuring access to a network of top physicians, with predictable costs, in the Medicare Advantage plans. In fact, it should guarantee everyone affordable coverage from a large network of providers throughout the US to meet their every need, through one government-administered health plan.
Contrary to what the NCOA report suggests, it is not realistic to expect robust health plan competition in the Medicare marketplace or elsewhere, even if the Medicare Plan Finder were improved. So long as health plans are in the business of delivering profits to their shareholders, they will do everything in their power to provide information that deters people with costly and complex conditions from enrolling. And, they will limit access to specialists and/or impose high copays to encourage healthy members to disenroll when they become sick. That is not the kind of competition we want or need in our health care system.
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Here’s more from Just Care:
- Congress must protect our community health centers
- Four things to think about when choosing between traditional Medicare and Medicare Advantage plans
- If you want easy health care access and good quality care, you probably want traditional Medicare
- Three reasons why you can’t choose a health plan that’s “right for you”
- Seven reasons commercial insurance cannot meet our health care needs