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Medicare races to fix flaw in new tool that lets millions of seniors find cheap drug plans

Elise Amendola/Associated Press/Associated Press

For older Americans navigating the thicket of drug insurance plans offered under Medicare, there’s been one online tool they’ve turned to the most: a link that lets them quickly calculate the total cost of each plan for their specific medications and circumstances.

But late in August, when Medicare unveiled a revamp of its website for Part D, the prescription drug benefit, that feature was omitted, sparking an outcry from senior advocates, brokers, and volunteers who help enrollees sift through the options.

Federal officials are now racing against an Oct. 15 deadline to fix the flaw in their redesign — reinstating a function enabling total-cost comparisons in competing plans — before tens of millions of Medicare beneficiaries log in to select the cheapest drug plans for the coming year.

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At issue is an upgrade of the online tool called Medicare Plan Finder, the most commonly used feature on the Medicare website for seniors searching for affordable insurance coverage for their medicines. The legacy plan finder allowed individuals or their advisers to enter the names and dosages of the drugs they take and quickly calculate which of the multiple Part D policies available in their region and pharmacy carries the lowest annual out-of-pocket costs.

But that total-cost calculator is missing in the redesigned Medicare plan finder, which went live on Medicare’s website on Aug. 27 in advance of the annual open enrollment period that starts in October. Instead, the new plan finder enables users to tally separately the costs of premiums, deductibles, and copays under different plans — but not the total cost of each one. That makes it much harder for seniors to compare plans and choose the cheapest.

“This needs to be fixed,” said Ann Kayrish, senior program manager for Medicare at the National Council on Aging, one of many parties that have inundated Medicare officials with feedback since it released its new version. “It’s alarming that the most used and useful sorting tool isn’t in their new iteration. We’re keeping the pressure on.”

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Julie Jennings, a broker at the Sylvia Group in the Southeastern Massachusetts town of Dartmouth, said she uses the plan finder’s total-cost calculator at least two or three times a week to help clients entering retirement to transition from their employer’s insurance to Medicare drug plans. “We just put in all the meds and get the total rates,” she said. “I could do the math if I needed to. But it would be difficult for the average consumer to add it all up.”

In a Web conference with Medicare counselors on Thursday, officials from the agency that administers Medicare acknowledged the criticism they’ve received on the absence of a total-cost calculator and said they were working to add that function in time for the open enrollment period. That period, running from Oct. 15 through Dec. 7, is when millions of newly enrolled and existing beneficiaries shop for the cheapest drug policies, which often change year to year.

Representatives from the Centers for Medicare and Medicaid Services said their new plan finder — the first big update to the tool in a decade — “was designed to be simple and intuitive” for nearly 45 million Medicare beneficiaries. They said it offers many advantages over the current tool, including easier use on mobile devices and a feature alerting users to lower-priced generic versions of their prescription meds.

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“The redesigned Medicare Plan Finder is another example of how CMS is empowering beneficiaries with price and quality information to take advantage of lower rates and new benefits,” CMS administrator Seema Verma said in a statement in August.

In prepared responses to questions from the Globe, the CMS representatives said the total-cost calculator “is a feature that has always been on our list to include, but couldn’t be completed in time for the Aug. 27 public launch.” They said they received feedback on the plan finder revamp from “stakeholder groups” and shared prototypes with some Medicare beneficiaries.

The legacy plan finder will remain on Medicare’s website alongside the new one until the end of September, they said, enabling users to get used to the new one.

CMS officials declined to be interviewed about the process and rollout.

Justin Lubenow, executive vice president at the Moorestown, N.J., insurance brokerage firm Senior Advisors, called the plan finder upgrade “a poor technology with good intentions.” But if its flaw isn’t corrected, he warned, “the government’s going to get slammed by phone calls during open enrollment. This is significantly less useful without the total cost” function.

The absence of a total cost-calculator is one of a number of concerns that a range of critics have expressed about recent Medicare policy changes.

Some suggest a new requirement that beneficiaries shopping for a new plan set up an online My.Medicare account to store their medication lists could potentially compromise privacy. They also pointed out that many older and poorer Medicare beneficiaries may not have access to a computer and would need help creating online accounts.

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In a letter to Medicare administrator Verma, four advocacy groups — the Center for Medicare Advocacy, Justice in Aging, Medicare Rights Center, and National Council on Aging — also raised a host of questions about the process surrounding the new plan finder and whether federal officials will have enough time to incorporate feedback before open enrollment.

The plan finder upgrade has emerged as a bugaboo for counselors at free state Medicare assistance programs operated out of senior centers across the country. (In Massachusetts, the program is called SHINE, an acronym for Serving the Health Insurance Needs of Everyone.) The advisers worry that any delay in adding the total-cost feature to the new tool will greatly add to the time it takes them to assist beneficiaries, limiting the number of people they can help.

“This new plan finder makes it more complicated and time-consuming for people like myself,” said Howard Houghton, a volunteer at the state health insurance assistance program in Harrisonburg, Va. “The total cost is what people need to know so they can budget.”


Robert Weisman can be reached at robert.weisman@globe.com. Follow him on Twitter @GlobeRobW.