New Medicare Advantage navigation tool contains inaccuracies, faces hiccups as open enrollment begins

Dow Jones
2025/10/16

MW New Medicare Advantage navigation tool contains inaccuracies, faces hiccups as open enrollment begins

By Jessica Hall

The directory contains inaccuracies that could confuse beneficiaries or lead them to sign up for the wrong plan

Medicare Advantage plans make up as much as 54% of the marketplace nationwide, according to KFF, a health-policy research group.

The federal government's new directory that allows older adults to look up which doctors and hospitals accept their Medicare Advantage insurance contains errors, creating confusion at the start of the annual Medicare open-enrollment period.

The newly created portal features errors and conflicting information that could lead seniors to sign up for the wrong plan and face higher costs down the road if their doctor isn't covered, according to a report by the Washington Post.

Medicare's annual open-enrollment season runs from Oct. 15 through Dec. 7. During this period, beneficiaries are able to make changes to their Medicare plans, such as moving between original Medicare and Medicare Advantage or by adding or dropping coverage, such as Medicare Part D for prescription drugs. There is also a separate enrollment period specifically for Medicare Advantage plans, which runs from Jan. 1 to March 31.

Read: Medicare open enrollment begins amid the government shutdown. Here's everything you need to know.

The directory for Medicare Advantage plans contains inconsistent and at times contradictory information, according to the Washington Post report. For example, the tool sometimes shows the same provider as both in-network and out-of-network. In other instances, the directory initially tells users that a provider is covered by a plan but then lists that provider as out-of-network on other pages, which could lead to confusion or to users making the wrong choices.

The Centers for Medicare & Medicaid Services did not immediately respond to MarketWatch's request for comment.

The creation of a new directory was announced in June and the scope was narrowed in August to focus just on Medicare Advantage, rather than on the entire range of Medicare caregivers. Previously, beneficiaries had to wade through listings on dozens of websites.

Provider directories can often contain inaccuracies, "and as we are seeing with the current Medicare enrollment period, could be missing altogether for certain plans," said David Lipschutz, co-director of law and policy at the Center for Medicare Advocacy, a nonpartisan, nonprofit law organization. "The best option for individuals is to check with their individual providers' offices to ask about what plans they contract with. Even if an individual's desired provider contracts with a given plan at the time of enrollment, though, that is no guarantee that the provider will continue to do so."

Anyone who selects a Medicare Advantage plan based on incorrect information about their preferred providers would have three months to select a new plan, according to the Washington Post report.

Medicare Advantage plans make up as much as 54% of the marketplace nationwide, according to KFF, a health-policy research group. Medicare Advantage plans offer extra benefits such as vision and dental coverage but have a limited choice of doctors and requirements for specialist referrals. Medicare Advantage also caps annual out-of-pocket costs.

Read: Why fewer seniors are expected to enroll in Medicare Advantage next year - and opt for original Medicare instead

-Jessica Hall

This content was created by MarketWatch, which is operated by Dow Jones & Co. MarketWatch is published independently from Dow Jones Newswires and The Wall Street Journal.

 

(END) Dow Jones Newswires

October 16, 2025 11:34 ET (15:34 GMT)

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