Ahead of the open enrollment period for Medicare Advantage plans that began Wednesday, the Trump administration created a directory to help millions of seniors look up which doctors and medical providers accept which insurance.
But the portal frequently produces erroneous and conflicting information, The Washington Post found, setting off a scramble inside the federal government to fix it. Left unaddressed, the problems could confuse older adults as they sift through dozens of options, or force them to foot the bill for regular medical appointments, according to Medicare experts and patient advocates.
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Trump administration officials in June announced plans for a national directory of health care providers and the insurance plans they accept, saying that it would bring clarity to patients’ efforts to navigate America’s byzantine health care system. They have since touted it as part of a broader “Make Health Tech Great Again” push to modernize health care technology.
Then in August, officials said that they would develop a temporary directory limited to Medicare Advantage plans. Development of that narrower portal was rushed to coincide with the start of this year’s Medicare Advantage open enrollment, according to three people who spoke on the condition of anonymity to discuss federal operations. Without the directory, people trying to choose a Medicare Advantage plan offered by a private health insurer have long faced a daunting task of comparing dozens of websites.
But The Post found that the results in the directory are inconsistent and often contradictory. In some cases, the tool includes duplicative addresses, with the same provider appearing to be simultaneously in-network and out-of-network. In other cases, the tool initially informs users that a provider is covered by a plan but lists that provider as out-of-network on other pages. Outside Medicare experts who used the tool Wednesday said they identified similar problems.
After The Post raised the problems to the Centers for Medicare and Medicaid Services on Wednesday morning, officials were working quickly to address the errors and seek potential solutions, according to an official who spoke on the condition of anonymity to discuss internal operations. As Thursday afternoon, some of the problems were still visible on the Medicare Advantage website, including duplicative addresses that provided different responses about whether a provider was covered by a health plan.
The Department of Health and Human Services, which oversees CMS, did not respond to questions about whether the agency had been aware of the problems before The Post’s inquiry and whether it had identified the cause. But the agency acknowledged errors that needed to be fixed.
Andrew Nixon, an HHS spokesman, said the agency is addressing “some user interface and data alignment issues to ensure the best possible experience” for users. He also said the new tool developed with a private vendor was intended as a stopgap until the agency could launch a more comprehensive national directory of health care providers as “the long-term solution to these broader data accuracy issues.”
“This year’s updates to Medicare Plan Finder are not intended to address longstanding issues that exist with health plan-published provider directories across the industry,” Nixon said in a statement.
David Lipschutz, co-director of law and policy at the Center for Medicare Advocacy, a nonpartisan law firm, said it’s been a long-standing goal to be able to look up doctors on the government Medicare plan-finder website to see if they are considered in-network. Instead, users must toggle between websites for the government and individual plans and often must contact providers directly to make sure potential visits will be covered.
“In the past, there have been glitches and problems. The hope was this would help make it easier for folks to do their due diligence,” Lipschutz said. But, he said, the new directory is adding “its own glitches and problems.”
About 34 million Americans are enrolled in Medicare Advantage plans this year. Many Advantage plans bring together the various parts of Medicare such as hospital care, doctor visits and prescription drug coverage into a single package that usually offers additional benefits such as dental and vision coverage. The plans have been criticized by lawmakers and advocates for costing the federal government more than traditional Medicare.
Federal officials have touted their new efforts to allow Medicare beneficiaries to search for plans by navigating a directory of health care providers, framing it as an overdue improvement and part of the Trump administration’s initiative to modernize health care technology. That broader agenda includes the planned creation of a new national directory, which has been led by Amy Gleason, the acting administrator of the U.S. DOGE Service and a senior CMS official.
“We’re clearing the path for innovation by building the long overdue national provider directory, a kind of digital map for healthcare that connects systems in real time and helps patients get more coordinated care,” Gleason said at a White House “Make Health Tech Great Again” event in July, sharing a dais with President Donald Trump, CMS Administrator Mehmet Oz and other top officials.
Gleason and her team also have helped with the Medicare Advantage provider directory, said two of the people familiar with the project. But there were signs of a bumpy launch.
CMS said in August that it was using an outside vendor, SunFire Matrix, to supply data for a Medicare Advantage provider directory this year while the agency worked on its long-term national provider directory initiative. CMS also urged all organizations that participate in Medicare Advantage to quickly submit provider data to SunFire, warning that its records were incomplete.
SunFire referred questions to CMS.
Signaling the potential for errors, federal officials in September said that anyone who selected a Medicare Advantage plan based on incorrect information about their preferred providers would have three months to select a new plan, according to a letter shared with organizations that participate in the insurance program.
“CMS expects that the provider directory information in Plan Finder will be accurate,” according to the letter from CMS official Jerry Mulcahy. “However, despite our best efforts, individuals might still see incorrect information on the [Medicare plan-finder] provider directory, especially in the first year of implementation.”
The message that people can get a new insurance plan if they’ve been led astray isn’t necessarily trickling down to seniors, said Diane Omdahl, a Medicare consultant in Wisconsin. The explanation outlining the circumstances in which consumers are guaranteed insurance companies will sell them supplemental plans is now hard to find on the website and can’t be saved or downloaded, she said.
“When is this going out to the people who really matter?” said Omdahl, president and founder of 65 Incorporated.
Several health policy experts said that they supported the Trump administration’s work to allow Medicare beneficiaries to search for their preferred health care providers, but they cautioned that they were worried about the new directory’s limitations and errors.
Tricia Neuman, a senior vice president at KFF, a nonpartisan health care research organization, said that she is optimistic about the new tool but that it also has shortcomings, such as its inability to allow users to search by hospitals or skilled nursing facilities. The tool is also limited to searching for providers within 50 miles, while many rural patients travel farther than that to see their providers.
“This seems like a step forward – but a work in progress,” Neuman said.
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