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The federal government recently redesigned a digital tool that helps seniors navigate complicated Medicare choices, but consumer advocates say it’s malfunctioning with alarming frequency, offering inaccurate cost estimates and creating chaos in some states during the open enrollment period.
Quote:
More than 60 million people use Medicare, which covers those over 65 and the disabled. Users have to pick their plans annually. The current open enrollment period ends Dec. 7. Medicare advisers — as well as advocates for seniors — worry that the full weight of the tool’s inaccuracies will not be felt until the 2020 coverage year begins and seniors head to pharmacies to fill prescriptions or show up for medical appointments. For many Medicare participants, selections made during open enrollment are irreversible.
“Millions of people are going to be absolutely affected,” said Ann Kayrish, senior program manager for Medicare at the National Council on Aging. “And you hate to think about millions of people having the wrong plan. That’s kind of crazy.”
“It’s not like there’s one consistent problem that you can fix and then be addressed,” said David Lipschutz, associate director of the Center for Medicare Advocacy. “It’s really like a game of whack-a-mole.”
Reminds me of the health.gov debacle. The government workers had millions and millions of dollars - and four years - to turn out a functioning website, and it was a disaster. And what's worse? The contractor who developed the disaster was hired again - at an exorbitant hourly rate - to fix their own mistakes!
(When I owned a business, if I made a costly error - which fortunately was rare or I wouldn't have stayed in business - the time and money it took to fix it came out of MY bottom line.)
I take care of my mom's Medicare for her. She barely adapted to the widespread introduction of the rotary phone. Government + computers? Might as well run her head through a wall.
Anyway, two hours on the phone with them two weeks ago. Two hours on the phone with them last week. It's an open enrollment tradition.
Maybe I'll send a bill to D.C. for the robbing of my time and labor. You know, like the one they send me due April 15th.
Also, I'm doing this from L.A. and she's in Ohio. Adds to the fun.
Reminds me of the health.gov debacle. The government workers had millions and millions of dollars - and four years - to turn out a functioning website, and it was a disaster. And what's worse? The contractor who developed the disaster was hired again - at an exorbitant hourly rate - to fix their own mistakes!
(When I owned a business, if I made a costly error - which fortunately was rare or I wouldn't have stayed in business - the time and money it took to fix it came out of MY bottom line.)
Our taxpayer dollars at work.
You are mistaken about the developer.
Ad Hoc was formed by two of the independent leads who fixed healthcare.gov.
There was likely no bigger flawed federal rollout than the initial open enrollment of Medicare Part D/ prescription drug coverage in 2005. That is the legacy system that was replaced this year. Not only was the initial data flawed, the users were more unlikely to be comfortable with technology than younger populations and found it challenging to navigate the online system.
The new plan finder uses different navigation/ sorting tools. Different is not necessarily better or worse. Older users are less likely to easily adapt to change than younger users.
Then there’s the ongoing issue of data integrity. Outputs are only as good as data entered by the plans which is variable by plan and state, who and how data is entered.
States rely heavily on certified State Health Insurance Assistance Program ( SHIP) counselors, most of whom are VOLUNTEERS. They are the front line human interface between Medicare and the end consumer. They are also the front line user testers.
Many seniors find is easier to rely on independent brokers who are paid by insurers to sell their plans.
Insurers bombard seniors with direct mail advertising, TV and print ads during Open Enrollment. The cost of this marketing is baked into every premium. No need to mess with the federal site or brokers when you can buy from the insurer who will tell you their product is the best for you.
There are also independent online data consolidators that compare and contrast some of the plans offered in any given state. Most don’t show all the plans and are paid for referrals to their sponsors.
The number of Advantage and Medicare Part D and Medi- Gap plans available in most states is evidence of the profitability of of this sector of the healthcare market.
I have no idea why Bernie and Warren chose to refer to their healthcare pitches as Medicare for All , given what they are pitching is nothing like Medicare.
Then again, who knows what Trump was talking about when he campaigned on the promise of “ replacing Obamacare with something wonderful that would take care of everybody and the government was going to pay for it. He had no plan to deliver and sold it as free healthcare for all, as if government is not the tax payers.
Some programmer took a shortcut by using the simplest search algorithm.
We don’t know what, if any, sorting requirements were specified and accepted by the federal employees who created the business requirements. Or, perhaps more importantly, why.
Most consumers seem to shop by price. Makes sense when all things are equal. Not the case with insurance products.
Most consumers seem to have a preference of pharmacy. This preference impacts which plan, premiums and out of pocket. So if a consumer specifies say CVS, is there sufficient intelligence within the software to recommend say Walgreens a block away for better pricing or medications by mail?
Not all plans cover all medications or costs. While a consumer can be prompted to enter all prescription meds, some consumers fail to do so or make other mistakes.
A consumer may not take any medications during open enrollment only to receive a diagnosis during the subsequent year requiring a medication not covered by their plan.
It makes me more than a tad uncomfortable that the federal/ state governments impose in what is a private transaction between an insurer and consumer. Yet the federal government has been funding states and doing so since 1990, 15 years before passage/ introduction of Medicare Part D- prescription medications and the explosion of Medicare Advantage plan offers, consistent with an aging population.
Then there are the occasional anecdotal claims that SHIP counselors steer business to plans that kick back, under the table. All it takes is someone making such a claim on Facebook and some media or blogger to pick it up.
What one never hears is that the complainer is prescribed a costly medication not covered by the cheaper plans.
I can appreciate how our friends to the north shake their heads at the complexities of US healthcare and I say this as someone not particularly enamored with so called Single Payer options.
The real insanity here was that the original tool was NOT difficult to use... and it worked.
I've read the tool was redesigned to guide people to choose Medicare Advantage plans. When I looked at it a while back, the splash page had a big button in the middle that took you to only Medicare Advantage plans, leading the unaware to believe that was all that was offered.
We all thought the Wicked Witch of the East was dead until Seema Verma crawled out from under the house.
I've read the tool was redesigned to guide people to choose Medicare Advantage plans. When I looked at it a while back, the splash page had a big button in the middle that took you to only Medicare Advantage plans, leading the unaware to believe that was all that was offered.
We all thought the Wicked Witch of the East was dead until Seema Verma crawled out from under the house.
EXACTLY. Anything to destroy government insurance. If one didn't know Medigap supplements existed, one would think their only choice is an Advantage health plan. Try to find the Medigap supplement link on the home page of medicare.gov. It's way at the bottom. The tab itself to search for supplements only appears sporadically when visiting medicare.gov.
Trump's EO directed that government insurance NOT be promoted over Advantage. Instead, Advantage, an inferior form of coverage which is a huge cash cow for the private for-profit Advantage companies, is now promoted over Original Medicare plus a Medigap and Part D. Irritates the heck out of me. I've now bookmarked the supplement search page to avoid searching for the link. Never had to do that before.
Sorry to hear they've messed with the Part D tool. I don't take medication and have never used that tool, but others here have used it for many years successfully.
"I'm here from the government to help you." Not.
Last edited by Ariadne22; 11-30-2019 at 06:48 PM..
OMG...……….Please tell me they are going to fix this!!! I decided to check with Wellcare to make sure I had the correct information. I did NOT! In order to save $200/year I have been on the phone for over 1.5 hours!! Talked to 2 reps, neither one of which I could understand well, and had to end up giving them all the information they could have gotten if they had just listened to me and brought up my member ID!!! If I had known this I would have gone to the Medicare site. I looked up the correct info on Wellcare's site and thought I had to change through them.
My DH will end up paying $30/year more for total cost because his info was incorrect but I will eat that because I am not going through this all again.
To the government...……...IF IT AIN'T BROKE, DON'T FIX IT!!!!!
BTW, not only was my drug cost wrong on the Medicare site, but so was my pharmacy. My initial plan said WalMart was the pharmacy I needed to use. Now Wellcare's site doesn't even list WalMart as an in-network provider. If they insist on having seniors choose their plans they need to fix this or else go back to the old one. They should be forced to allow people a six month special enrollment the beginning of 2020 so that they can change if what they got was based on faulty information.
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