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Home Medicare

Important Medicare Plan Finder Improvements Planned This Fall, More Work Needed

by TheAdviserMagazine
4 weeks ago
in Medicare
Reading Time: 3 mins read
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Important Medicare Plan Finder Improvements Planned This Fall, More Work Needed
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When people consider enrolling in Medicare Advantage (MA) plans, one of their major tools is Medicare Plan Finder (MPF). This tool allows people to compare the plans available in their zip code, including being able to enter prescription drug information to get a rough idea of what their costs will be for the year.

Current Plan Finder Omissions

MPF is useful, but it has some glaring weaknesses. Currently, if a person is interested in a plan and has a provider they want to keep seeing, they must leave the MPF tool and go to the plan’s website, call the plan directly, or call their provider to ask if they are in the plan’s network.

Currently, if a person is interested in a plan and has a provider they want to keep seeing, they must leave the MPF tool.

In addition, MPF does not show detailed information on supplemental benefits. As Medicare Rights and Justice in Aging recently highlighted, MPF displays detailed information only for dental, hearing, and vision coverage. Other benefits only get high-level treatment like “some coverage” or “not covered.”

In our cluttered MA landscape, with various enrollment and access barriers and complications, these omissions can make the search for a good plan fit ever more difficult.

Previous Efforts on Directory Integration

In late 2024, the Biden-Harris administration proposed a rule that would have required MA plans to submit directory information so the Centers for Medicare & Medicaid Services (CMS) could incorporate it into MPF. We strongly supported this change in our comments, as well as related proposals that would have required plans to attest to the accuracy of the directory information and that it and the underlying network complied with network adequacy rules. Unfortunately, the incoming Trump administration chose not to finalize these provisions.

New Updates in the Works

In a surprising twist, CMS announced last month that it will be updating MPF to allow beneficiaries to search by provider and see directory information on the MPF site. Some plan types would be included automatically, while others are permitted, but not required, to submit directory information.

For supplemental benefits, CMS plans to update MPF to show additional details for benefits beyond dental, hearing, and vision and to add new types of benefits to the list shown for each plan.

CMS plans to update MPF to show additional details for benefits beyond dental, hearing, and vision.

CMS plans for both the directory and supplemental benefits changes to be in effect for the upcoming Fall Open Enrollment.

More Changes Needed

At Medicare Rights, we applaud these plans and encourage CMS to go further. While these updates will help many people with Medicare make better choices for their coverage, more still must be done to ensure provider directories are accurate. Historically, they are riddled with errors that may disguise inadequate networks and inferior access to care. If MPF uses inaccurate information, the problems will increase.

For supplemental benefits, we urge CMS to allow users to filter by benefit and display benefits in a way that allows users to compare plans by coverage for specific needs.

We also continue to urge all policymakers to prioritize funding State Health Insurance Assistance Programs (SHIPs). These programs provide trained, objective, and one-on-one services to help people learn about their options and make the right enrollment decisions for their circumstances.

Further Reading

Read more about the longstanding issue of inaccurate provider directories.

Read more about the need for more information about supplemental benefits.

Read more about SHIPs.



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Tags: FallFinderImportantImprovementsMedicareneededplanplannedwork
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