Medicare site wrong (I know you're shocked)

Oct 15, 2007

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  1. sman
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    sman Guru

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    Man are they waaaaaaaayyyyyyyyyy off. I just ran a comparison for Rx using an MA-PD plan. Medicare site shows total out of pocket for Rx at $1,192. Decided to give it a try on Humana's site just to see how close it is and they are showing $4,251. The Medicare site never shows them entering the gap (total full cost of meds is $760 a month with Humana site and $400 with Medicare site).

    Don't rely on the Medicare website to give you accurate numbers. Again, not that anyone would. It sure would be nice to have a central place to run the comparisons.
     
    Last edited: Oct 15, 2007
    sman, Oct 15, 2007
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  2. Cenla Agent
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    I seem to recall something like that happening on the Medicare website when I crunched the numbers for someone last year too. But normally it is pretty accurate. It won't always be exactly the same as Humana because they are basing costs on an avg. wholesale price, not retail.
     
  3. sman
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    sman Guru

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    I don't expect it to be EXACTLY the same, but a difference of over $3,000? That's not the difference in retail and wholesale. The problem is that the Medicare site isn't showing the Humana plan going into the gap. Even using their (Medicare site) prices of $400 per month, this person would reach the gap in the 7th month. Yet it's not reflected on the Medicare site.
     
    sman, Oct 16, 2007
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  4. midwestbroker
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    midwestbroker Guru

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    I have ran numbers with the Medicare web site and it was all over the place. I have since stopped doing so and ball parking it with the client.

    And before someone pipes up...no I am not misleading the client by ball parking it. They know that is what I am doing, and they appreciate it (taking my time to do so).
     
  5. Kimber
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    Kimber Super Genius

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    I believe that the Medicare Web site is consistantly off with most carriers. I would stick with the cost calculators many carriers offer to help you figure out costs. They tend to update more frequently than CMS does.
     
    Kimber, Oct 16, 2007
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  6. Cenla Agent
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    I have had the Medicare site be wildly off like that too, but I haven't used it lately.
     
  7. insurance0707
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    I noticed in Michigan that some of the Humana plans say that they will continue to cover some namebrands and generics through the gap. Maybe that is what happened when you ran the prescriptions. Did you look to see if it's one of Humana's plans that will continue to cover certain drugs through the gap? (Although I don't know why it wouldn't show it on Humana's site)
     
  8. retread
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    Be advised that some of the CMS estimates are for total annual expense to the beneficiary, not just the cost of the annual premium. I don't know if this is what you are running into or not, but read the columns carefully.
     
    retread, Oct 17, 2007
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  9. sman
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    sman Guru

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    I understand this fact. However, the Medicare site showed a total expense of $1,192 and the Humana site was $4,251. Which one would you consider to be more accurate? I would think the carrier would be more accurate. In addition, the Medicare site shows the monthly cost of the meds to be $400. Even if that were accurate, they would still reach the gap. The Medicare site doesn't have them reaching the gap.

    My original post was just a heads up to everyone. You can take it or leave it.
     
    sman, Oct 17, 2007
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  10. allhealthandlife
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    allhealthandlife Guest

    Two things:

    First the CMS website is estimating average annual cost for " people like you " which users can determine in drop down boxes for age and health status. They then calculate average annual cost based how many much this person would utilize benefits as well as co pays and premiums.

    Second:

    The MA carriers file to CMS for plans and counties they may never be operational in.Always look to the MA carriers website for up to date benefits.Humana is a good example of this.They have chronic illness plans posted on Medicare.gov for Florida but not on Humana - Guidance when you need it most.
     
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