The CMS has made it easier for seniors to compare and pick Medicare coverage options. While unveiling the initiative known as eMedicare, CMS Administrator Seema Verma denied advocates' concerns that the agency was attempting to steer seniors into Medicare Advantage, which provides a private option to the country's entitlement program but has narrower networks.
Under the eMedicare initiative, seniors can use an improved coverage wizard to decide whether Medicare or Medicare Advantage is right for them. The CMS also launched a calculator that estimates out-of-pocket costs on service and prescription drug costs. There's also a webchat option.
"Many people coming into Medicare expect an intuitive and seamless customer experience, but unfortunately Medicare has not kept pace and over the next few years, eMedicare will try to bridge that gap," Verma said at a news briefing Monday.
Surveys of Medicare Advantage enrollees generally show that satisfaction is high and that quality of care is better than traditional Medicare. The federal government, which pays private insurers to cover the costs of those choosing Medicare Advantage, is better able to set budgets for this population. However, insurers have found this line of business lucrative. The companies tend to spend less on care, but as evidenced by a federal suit charging UnitedHealthcare with excessive billing, can end up costing the federal government more than Medicare.
Reporters viewing the demonstration of the updated Medicare.gov website shared concerns from patient advocacy groups like the Center for Medicare Advocacy that the Trump administration favored Medicare Advantage over fee-for-service and that it was trying to get more seniors to choose the private plans. For example, the demonstration more frequently showed Medicare Advantage as being the cheaper option compared to original Medicare in terms of out-of-pocket costs. For instance, a Baltimore enrollee in good health was estimated to pay $400 less out of pocket if they chose an MA plan over original Medicare with a drug benefit.
Also during the briefing, Verma reiterated that MA plans will have their lowest premiums in years in 2019 and that they will be able to cover a wider breadth of supplemental benefits, such a wheelchair ramps that allow seniors to remain home.
Despite these benefits, advocates argue that MA plans can pose a hardship for some seniors due to their narrow networks and prior authorization requirements.
Verma insisted that the agency was not showing favoritism between the two options.
"All we are doing is giving seniors additional tools," Verma said. "There isn't an organized attempt to push people in any way."
Medicare Advantage enrollment is projected to increase to an all-time high of 22.6 million, or more than 36% of Medicare beneficiaries, in 2019. That's up 11.5% from 2018, which had enrollment of 20.2 million.