Medicare’s new plan tool has errors—what seniors need to know before choosing coverage
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If you've ever felt overwhelmed by the number of Medicare Advantage options, you're not alone.
Each fall, millions of older Americans search for a plan that covers their doctors, prescriptions, and care needs—while also trying to avoid costly surprises.
To help with this, the federal government launched a new Medicare directory tool, meant to make plan comparison easier.
But for many seniors, the tool may be doing more harm than good.
Errors in the system are now raising concerns that some users may be getting the wrong information—and it could be affecting your coverage.
A tool that promised clarity, but delivered confusion
The idea behind the new Medicare Advantage provider directory was straightforward: create a single, reliable website where seniors could look up their doctors and immediately see which plans include them.
It was meant to replace the frustrating process of checking multiple insurance company websites or making endless calls.
However, during open enrollment, watchdog groups including The Washington Post discovered that the system was riddled with mistakes.
In many cases, the same doctor was listed as both in-network and out-of-network depending on where you clicked.
Some addresses appeared more than once, and provider listings often contradicted themselves.
In other cases, a doctor shown as covered on one page might suddenly appear as out-of-network on another.
For people making important health decisions based on this information, these glitches could have serious consequences.
Also read: Changes ahead for Medicare Advantage in 2026
Why these errors are more than just annoying
When you're choosing a Medicare Advantage plan, you're not just looking for the lowest premium.
You're deciding which doctors and hospitals you'll be able to visit—and whether those visits are affordable.
If a plan falsely claims to cover your providers, you could end up with a surprise bill, or worse, you might miss an important appointment altogether.
David Lipschutz, co-director of law and policy at the Center for Medicare Advocacy, noted, "The hope was this would help make it easier for folks to do their due diligence. But the new directory is adding its own glitches and problems."
The tool, which was intended to simplify the decision-making process, has instead introduced new challenges for some seniors.
Also read: The hidden Medicare gaps that could drain your retirement savings
How the rollout unfolded
The new provider directory was introduced as part of a broader health technology effort led by the Trump administration, known as "Make Health Tech Great Again."
The initiative was announced in June, and by August, officials moved forward with a temporary version focused on Medicare Advantage plans to coincide with open enrollment.
To meet the timeline, the Centers for Medicare and Medicaid Services (CMS) worked with the vendor SunFire Matrix and asked insurers to quickly submit provider data.
The accelerated development timeline contributed to some initial issues with the tool’s performance.
CMS has acknowledged the challenges. "We are addressing some user interface and data alignment issues to ensure the best possible experience," said HHS spokesperson Andrew Nixon.
Officials also noted that this tool is a temporary solution while work continues on a more comprehensive system.
Also read: When to sign up for Medicare: Key dates and tips to avoid penalties
Can you switch plans if you chose the wrong one?
There is some encouraging news: If you enrolled in a Medicare Advantage plan based on inaccurate provider information, you may have the opportunity to switch plans within a three-month window, depending on your situation.
However, this policy is not widely publicized, and some individuals may not be aware that this option exists.
Medicare consultant Diane Omdahl expressed concern about how this information is being shared. “When is this going out to the people who really matter?” she said.
The explanation of these rights is currently difficult to locate on the Medicare website and cannot be easily downloaded, which may create additional barriers to access.
Also read: Are you unknowingly falling for Medicare scams? Here’s how to protect yourself
The bigger issue with Medicare Advantage tools
Roughly 34 million Americans are now enrolled in Medicare Advantage plans, and that number continues to rise.
These plans offer bundled coverage for hospital visits, doctors, and prescriptions—and often include extras like dental or vision.
But they’re also known for being difficult to compare, with some experts saying they cost the government more than traditional Medicare.
The new directory was designed to simplify the process.
Tricia Neuman of the nonpartisan KFF noted that while the tool is a positive development, it still has limitations.
Users can’t search for hospitals or skilled nursing facilities, and the search radius is capped at 50 miles, which may be restrictive for those in rural areas.
“This seems like a step forward, but a work in progress,” Neuman said.
Also read: Medicare covers 10 surprising services for free—are you missing out?
What you can do to protect yourself
If you’re currently exploring Medicare Advantage plans, don’t rely only on the new directory.
Here are some actions that can help you avoid costly mistakes:
Also read: Lower drug prices are finally coming to Medicare. Here’s what to expect in 2026
Looking ahead to a more reliable future
Federal officials say they are developing a more advanced, real-time provider directory that could eventually serve as a “digital map for healthcare.”
The goal is to improve coordination of care while giving patients access to clearer and more accurate provider information.
While this initiative is still in progress, many hope it will lead to a more reliable and user-friendly experience.
In the meantime, it's important for individuals to stay informed, ask questions, and verify details when reviewing Medicare Advantage plans.
Navigating the system can be complex, but with careful attention and the right support, it is possible to make confident, informed choices.
Read next:
Have you experienced confusing or incorrect information on the Medicare plan portal? Were you able to find out if your providers were actually covered? Share your story and any advice you have in the comments below. The GrayVine community is here to help each other navigate these challenges together.
Each fall, millions of older Americans search for a plan that covers their doctors, prescriptions, and care needs—while also trying to avoid costly surprises.
To help with this, the federal government launched a new Medicare directory tool, meant to make plan comparison easier.
But for many seniors, the tool may be doing more harm than good.
Errors in the system are now raising concerns that some users may be getting the wrong information—and it could be affecting your coverage.
Double-checking plan details during Medicare enrollment can help avoid costly coverage surprises. Image Source: The GrayVine.
A tool that promised clarity, but delivered confusion
The idea behind the new Medicare Advantage provider directory was straightforward: create a single, reliable website where seniors could look up their doctors and immediately see which plans include them.
It was meant to replace the frustrating process of checking multiple insurance company websites or making endless calls.
However, during open enrollment, watchdog groups including The Washington Post discovered that the system was riddled with mistakes.
In many cases, the same doctor was listed as both in-network and out-of-network depending on where you clicked.
Some addresses appeared more than once, and provider listings often contradicted themselves.
In other cases, a doctor shown as covered on one page might suddenly appear as out-of-network on another.
For people making important health decisions based on this information, these glitches could have serious consequences.
Also read: Changes ahead for Medicare Advantage in 2026
Why these errors are more than just annoying
When you're choosing a Medicare Advantage plan, you're not just looking for the lowest premium.
You're deciding which doctors and hospitals you'll be able to visit—and whether those visits are affordable.
If a plan falsely claims to cover your providers, you could end up with a surprise bill, or worse, you might miss an important appointment altogether.
David Lipschutz, co-director of law and policy at the Center for Medicare Advocacy, noted, "The hope was this would help make it easier for folks to do their due diligence. But the new directory is adding its own glitches and problems."
The tool, which was intended to simplify the decision-making process, has instead introduced new challenges for some seniors.
Also read: The hidden Medicare gaps that could drain your retirement savings
How the rollout unfolded
The new provider directory was introduced as part of a broader health technology effort led by the Trump administration, known as "Make Health Tech Great Again."
The initiative was announced in June, and by August, officials moved forward with a temporary version focused on Medicare Advantage plans to coincide with open enrollment.
To meet the timeline, the Centers for Medicare and Medicaid Services (CMS) worked with the vendor SunFire Matrix and asked insurers to quickly submit provider data.
The accelerated development timeline contributed to some initial issues with the tool’s performance.
CMS has acknowledged the challenges. "We are addressing some user interface and data alignment issues to ensure the best possible experience," said HHS spokesperson Andrew Nixon.
Officials also noted that this tool is a temporary solution while work continues on a more comprehensive system.
Also read: When to sign up for Medicare: Key dates and tips to avoid penalties
Can you switch plans if you chose the wrong one?
There is some encouraging news: If you enrolled in a Medicare Advantage plan based on inaccurate provider information, you may have the opportunity to switch plans within a three-month window, depending on your situation.
However, this policy is not widely publicized, and some individuals may not be aware that this option exists.
Medicare consultant Diane Omdahl expressed concern about how this information is being shared. “When is this going out to the people who really matter?” she said.
The explanation of these rights is currently difficult to locate on the Medicare website and cannot be easily downloaded, which may create additional barriers to access.
Also read: Are you unknowingly falling for Medicare scams? Here’s how to protect yourself
The bigger issue with Medicare Advantage tools
Roughly 34 million Americans are now enrolled in Medicare Advantage plans, and that number continues to rise.
These plans offer bundled coverage for hospital visits, doctors, and prescriptions—and often include extras like dental or vision.
But they’re also known for being difficult to compare, with some experts saying they cost the government more than traditional Medicare.
The new directory was designed to simplify the process.
Tricia Neuman of the nonpartisan KFF noted that while the tool is a positive development, it still has limitations.
Users can’t search for hospitals or skilled nursing facilities, and the search radius is capped at 50 miles, which may be restrictive for those in rural areas.
“This seems like a step forward, but a work in progress,” Neuman said.
Also read: Medicare covers 10 surprising services for free—are you missing out?
What you can do to protect yourself
If you’re currently exploring Medicare Advantage plans, don’t rely only on the new directory.
Here are some actions that can help you avoid costly mistakes:
- Call your doctors and specialists directly to confirm which insurance plans they accept.
- Contact insurance companies to get written confirmation that your providers are in-network.
- Save emails, notes, or names of people you spoke with to keep a paper trail.
- Know your rights—if you were misled by the portal, call Medicare or your local State Health Insurance Assistance Program (SHIP) to find out if you can switch plans.
- Ask for help—Medicare counselors, SHIP advisors, and trusted sources can guide you through the process.
Also read: Lower drug prices are finally coming to Medicare. Here’s what to expect in 2026
Looking ahead to a more reliable future
Federal officials say they are developing a more advanced, real-time provider directory that could eventually serve as a “digital map for healthcare.”
The goal is to improve coordination of care while giving patients access to clearer and more accurate provider information.
While this initiative is still in progress, many hope it will lead to a more reliable and user-friendly experience.
In the meantime, it's important for individuals to stay informed, ask questions, and verify details when reviewing Medicare Advantage plans.
Navigating the system can be complex, but with careful attention and the right support, it is possible to make confident, informed choices.
Read next:
- Medicare bill could protect home health care access for millions
- Why reviewing your Medicare plan every year could save you money and stress
- Is your Medicare Advantage plan about to get more expensive? Here’s what to know
Have you experienced confusing or incorrect information on the Medicare plan portal? Were you able to find out if your providers were actually covered? Share your story and any advice you have in the comments below. The GrayVine community is here to help each other navigate these challenges together.
