The Insurance Agent's Guide to Medicare.gov's Plan Finder

The Insurance Agent's Guide to Medicare.gov's Plan Finder
October 26, 2020

Last year, Medicare redesigned the Plan Finder tool, which was the first redesign in over a decade. The new version of Medicare.gov's Plan Finder is easy to use, mobile-friendly, and much easier on the eyes.

If you plan on helping clients select and enroll in Medicare Advantage (MA) and Part D prescription drug plans (PDPs) for 2021, here's a quick guide to make sure you're familiar and comfortable with Medicare.gov's Plan Finder.

Originally published September 3, 2019. Updated October 26, 2020.


We're covering a lot of ground in this article, so we've split it up into sections that you can jump ahead to at any time:

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Why Did CMS Redesign Plan Finder?

The entire Medicare.gov website has been given a refresh as part of the Trump Administration’s eMedicare initiative, which expands and improves on current Medicare consumer service options.

Plan Finder was given its huge overhaul, the homepage was updated, a What's Covered app was released, and the MyMedicare.gov consumer portal has been given a refresh. Several other changes and updates are underway.

“Since day one, President Trump has been committed to strengthening the Medicare program—eMedicare puts his leadership into action by giving Medicare beneficiaries a simpler, more intuitive customer experience,” CMS Administrator Seema Verma said (CMS).


In sum, CMS is working to modernize the online experience since most of us use our smartphones and tablets to access information nowadays.

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Plan Finder Updates - What Changed?

If you've used the Plan Finder in the last year or so, you're familiar with some of the biggest changes. However, there are also some changes for the 2021 plan year.

User-friendly Updates

First, the entire plan comparison process is less confusing. The required steps are so much clearer, and the process is more visually appealing.

Old Medicare Plan Finder

old-medicare-plan-finder

New Medicare Plan Finder

New-Medicare-plan-finder

Plan Finder is also mobile-friendly now, making it so much easier to help clients from a tablet or even your smartphone. A laptop or desktop is still easier, but at least you have options.

Goodbye Drug List ID

The second major change was the removal of the saved Drug List ID. We definitely panicked at the time, but we've all adapted.

New Medicare Plan Finder Has no Drug List ID

In the old Medicare Plan Finder, you could jot down the Drug List ID and Password Date. This allowed agents to come back to this step in the future without having to re-enter all of the prescriptions again.

And when you have a client with 25 meds... that was a big time saver.

With the new Medicare Plan Finder, that's gone.

The best solution today is to ensure your clients create a MyMedicare.gov account. Their account will automatically populate all the prescriptions they've filled within the past 12 months, and they can modify their drug list from there.

If you use MedicareCENTER, our new quoting and enrollment system, you can import their saved drug list with Medicare's Blue Button. The process is very easy - your client simply has to grant you access via email.

importing-drug-list-from-medicare-gov

Register for a MedicareCENTER account

Compare Up To Five Pharmacies

On the old Plan Finder, you could only choose up to two pharmacies (three if you count mail order).

On the new Plan Finder for 2021, you can compare up to five pharmacies.

choose-up-to-5-pharmacies-medicare

That's just a nice feature for clients who don't care where they go and want the most competitive pricing available.

Check the Insulin Savings Box

New for 2021 is the Insulin Savings program, formally called Medicare's Senior Savings Model.

By checking the "Insulin Savings" box under "Filter Plans," you'll only see plans that participate. These plans cover several types of insulin at a maximum $35 copay for a 30-day supply in the deductible, initial coverage, and coverage gap phases of the Part D benefit.

insulin-savings-medicare

Automatically Sorted By Lowest Total Cost

Last year, plans were sorted by lowest premium. Now, plan results are automatically sorted by lowest drug + premium cost. This just makes it easier to see which plan has the lowest total cost for the year, regardless of premium.

sort-plansNew Pharmacy Search Options

Another new feature for 2021 is the ability to sort and choose pharmacies.

You can type in your home address to find pharmacies closest to your home, and you can also type in the name of your preferred pharmacy to speed up the search process.

new-pharmacy-search-options

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How to Run a Medicare Part D Drug Comparison on Medicare.gov's Plan Finder

To get to Plan Finder, you can go to the direct link, which is medicare.gov/plan-compare, or you can go to Medicare's homepage and click on "Find Health and Drug Plans." That language changes throughout the year; for example, before AEP starts, it usually says "Preview Health and Drug Plans."

medicare-drug-plan-finder

Once you get to the Plan Finder homepage, your client can sign into their MyMedicare.gov account, or you can Continue without logging in.
 
plan-finder-page


For the purposes of this tutorial, we'll click "Continue without logging in."

For this walkthrough, we'll go forward with a Drug plan (Part D) comparison in our zip code.

Skip ahead to Medicare Advantage comparison

New-Medicare-plan-finder


The system will then ask if you get any extra help. For the purposes of this tutorial, we'll say no.

extra-help-medicare

Next, you'll be asked if you want to see your drug costs when comparing plans. We'll select Yes, and we'll also say that we fill our prescriptions at Both retail and mail order pharmacies.

Plan Finder drug comparison

Then, you enter your drugs. Once you start typing, the system will populate some recommendations. We'll do some common drugs for this example.

confirm-drug-list


When you're done entering drugs, you'll be prompted to select up to five pharmacies. Last year, you could only add two, so that's a nice addition.

choose-up-to-5-pharmacies-medicare-plan-finder

Finally, we see the available drug plans sorted by lowest drug + premium cost.

plans-sorted-medicare

 

Analyzing the Plan Results

At this point, you can continue with selecting a plan and completing the enrollment. The plans are automatically sorted by lowest total cost (including copays, coinsurance, and premium), so your top plan is the most competitive option.

You might scroll down a bit and consider the next couple options if they're close in price - perhaps one of them has a higher star rating, or your client has a brand preference.

To view more details, click "Plan Details."

plan-details

There, you'll see the premium and drug deductible at the top. You also have a table of contents to the left, which allows you to jump to any section of the page.

plan-details-page

The pharmacies section is really important, because going to the wrong pharmacy could cost your client hundreds. 

pharmacies

There are several tiers:

  • Preferred in-network pharmacy: Best pricing
  • Standard in-network pharmacy: Average pricing
  • Out-of-network pharmacy: Highest pricing

Even the difference between preferred and standard can be significant, so make sure you coach your client on which pharmacy they should go to.

In this example, a client would pay $543.60 per year on drug + premium costs at the standard in-network pharmacy versus just $87.60 per year at the preferred in-network pharmacy.

If the star rating is important to your client, you can get a breakdown of their ratings on several categories by clicking the dropdown:

star ratings

You can also print this plan details page by clicking the "Print" button at the top right.

print-drug-plan

Comparing Plans Side-by-Side

You can also compare up to three plans side-by-side. On the results page, check the "Add to compare" box.

compare-drug-plans-side-by-side

Click the "Compare" button when you've selected the plans you want to compare.

You'll then see all three of your plans in a side-by-side comparison.

comparing-three-drug-plans

This feature is particularly helpful when considering the pharmacy of choice.

comparing-pharmacies

You can continue with Enrollment right from this page once you determine which plan suits your client's needs the best.

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How to Run a Medicare Advantage Comparison on Medicare.gov's Plan Finder

To get to Plan Finder, you can go to the direct link, which is medicare.gov/plan-compare, or you can go to Medicare's homepage and click on "Find Health and Drug Plans." That language changes throughout the year; for example, before AEP starts, it usually says "Preview Health and Drug Plans."

medicare-drug-plan-finder

Once you get to the Plan Finder homepage, your client can sign into their MyMedicare.gov account, or you can Continue without logging in.
 
plan-finder-page


For the purposes of this tutorial, we'll click "Continue without logging in."

For this walkthrough, we'll go forward with a Medicare Advantage Plan comparison, and we'll use a Chicago zip code.

MA-comparison

The system will then ask if you get any extra help. For the purposes of this tutorial, we'll say no.

extra-help-medicare

Now, you'll want to enter all of your client's prescriptions.

For the purposes of this example, we'll enter some common medications.

confirm-drug-list

Next, you'll choose up to five pharmacies.

choose-pharmacies

Now, all of the Medicare Advantage plans in that county will populate, automatically sorted by lowest drug + premium cost.

In Chicago, there are 52 Medicare Advantage plans available, so it can be helpful to filter the plans based on your client's needs before analyzing the results.

For 2021, there are expanded filter options, such as choosing to show only PPOs or checking the Insulin savings box.

Filter-MA-plans

If you choose to filter based on plans that include drug coverage, don't forget about the Lasso Healthcare MSA. It does not include drug coverage, but you can purchase a separate Medicare Part D drug plan.

Once you're done filtering, you can view the available plan options, which are already sorted by lowest drug + premium cost.

analyzing-MA-plan-results

Many plans include extra benefits, and the most common ones are now a part of the Plan Finder search results.

MA-extras

While we all know these are simply extras and should not be the basis for which a client chooses a plan, they certainly add extra value your beneficiaries will appreciate.

Analyzing the Plan Results

When it comes to Medicare Advantage, analyzing the results and helping your client choose the best plan for them is the most difficult part.

What's best for the client in terms of mitigating claims expenses isn't always the plan they want. More and more, we're seeing clients choose a plan based solely on the extra benefits that come with it. I've had clients whose first question to me was: "But does the plan include SilverSneakers?"

Clients also tend to have a loyalty or attachment to whatever healthcare company they've used in the past. Their particular plan may not be the most competitive, but they may not care.

I did a sales seminar with a broker up in Chicago church last year. When we were talking to the people there about the medical plans available, I can't tell you the number of people that didn't want to change plans. They want to keep the plan they've had. That really surprised me - how tightly people hold on to the insurance they've had.

Find Your Client's Motivation

So, I think the best way to approach the results is simply to have a discussion with your client. Find out their motivation and pair them with a plan that best serves that motivation.

  • Is money their motivation? The Lasso Healthcare MSA is the answer.
  • Is it making sure they have a debit card that allows them to buy over-the-counter items at the pharmacy? We need to find a product that has OTC benefits.
  • Is it SilverSneakers? We need to filter by plans that include that benefit.
  • Is it having the lowest possible out-of-pocket expenses for the year? Filter the plans accordingly.
  • Is it making sure their doctor is in their plan's network? Check the provider networks.
  • Is it having more choices when it comes to physicians? Maybe you'll steer the client in the PPO direction instead of an HMO.

Bottom line: Find out what's important to your clients.

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How to Run a Medicare Advantage Comparison on Our Quote Engine

Frankly, I never go to Medicare.gov to find MA plans. I simply go to our quote engine and go from there.

Our quoter has everything, and you can easily fill in the plan gaps with a Hospital Indemnity plan.

This video tutorial by Jason Ferguson, CMO, walks you through the steps:


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Use MedicareCENTER to Quote and Enroll Part D and Medicare Advantage Plans

If you plan on being compensated for enrollments, we highly recommend registering for your free MedicareCENTER account.

MedicareCENTER Agent Invitation Email Header

There, you go through all of the same steps as you do on Medicare.gov, but only carriers you're appointed with will populate in the results.

Another nice feature in MedicareCENTER is being able to import your client's drug list via the Blue Button.

Here's a video taking you step-by-step through that process:

Agents who have chosen to do complimentary plan comparisons in the past are finally getting certified so they can be compensated, and that's all thanks to how easy MedicareCENTER is to use.

Register for a MedicareCENTER account

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Conclusion

Medicare.gov's Plan Finder is easier to use than ever. Plus, with the introduction of MedicareCENTER, it's the perfect time to help your clients with Medicare Advantage and Part D.

If you need help getting comfortable with Medicare Advantage, be sure to schedule a consultation with Steve Spinner.

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Also, be sure to download a copy of our Medicare Part D Cheat Sheet, a printable step-by-step tutorial to help you run a Part D comparison on Medicare.gov's Plan Finder.

You can use this tutorial to help yourself, to train interns and assistants, or even to help your clients enroll on their own.

Get the Medicare Part D Cheat Sheet

Good selling!

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