Is New App From Feds Your Answer To Navigating Medicare Coverage? Yes And No

Millennials, beware: Your grandparents are about to start calling you for help downloading the new Medicare smartphone app.

The iPhone and Android app, which launched Feb. 6, is called “What’s Covered,” and true to its name, it mostly answers one simple, yes-or-no question: Is this medical procedure covered by traditional Medicare?

Milt Roney, a 71-year-old retired government worker in a well-to-do suburb of Washington, D.C., agreed to check out the app with me, though he was skeptical from the outset.

“I wouldn’t use an app like that,” Roney said. “[My procedures are] going to be covered, and I’m not going to worry about it.”

Still, the app, available free from the Google Play and Apple App stores, is part of a broader Centers for Medicare & Medicaid Services initiative, called eMedicare, to put more tools and information about Medicare online. (CMS declined a request for an interview.)

But much like the medicare.gov website, it doesn’t delve into individual beneficiaries’ specifics. It doesn’t ask what other coverage they might have, so it can’t take into account supplementary insurance, deductibles, coinsurance or other factors that determine cost.

“While usable and good for general information, it doesn’t provide personalized information that might be more helpful in making treatment or access decisions,” said Casey Schwarz, senior counsel for the Medicare Rights Center, a nonprofit organization.

Milt’s wife, Lisa Roney, 70, joined him to participate in my own “expert panel,” to download the app and try it out.

It’s worth noting that these experts were my backup plan. The first couple I approached told me they’d love to help, but they had “dumb phones” and couldn’t download anything.

This highlights perhaps a more fundamental problem. Many people of Medicare age don’t have a smartphone, and aren’t familiar with apps or comfortable manipulating screens.

According to a report from AARP, 46 percent of people in their 60s do not have smartphones. Only 29 percent of the 70-and-older crowd do. The report suggests that the trend will tick upward, with more older Americans owning mobile technology each year.

The Roneys both have Medicare Parts A and B, which cover hospitalizations and doctor visits. They both have smartphones. As retired government workers, they also have insurance from GEHA, the Government Employees Health Association, which covers their dental care, prescription drugs and some other expenses. Milt Roney gets some money from GEHA to hand out brochures at health fairs.

They consider themselves pretty tech-savvy. They have iPads, personal computers and iPhones. Lisa Roney wears a Fitbit.

But they immediately questioned the necessity of the app.

“I’d just pick up the phone and call if I had a question about what was covered,” Milt Roney said.

“I’d probably just look it up in the [Medicare] book,” Lisa Roney said, pulling the 2-inch manual from a drawer in her office.

Then came the first hurdle: downloading the app.

Searching “Medicare” in the Google app store, which is where Android users go, yielded many results. “What’s Covered” was first on the list, but it’s far from the only Medicare-related app on the platform. Same experience in the Apple app store, where it took the Roneys a few minutes to sort out exactly which one was the CMS tool. (It’s the one that says “Official Medicare coverage app,” made by the “Centers for Medicare & Medicaid Services.”)

Having completed this part of the process, we moved on.

Opening the app immediately gave each of us a search bar to type in a product or service. (I was experimenting, too, though still 40 years shy of Medicare eligibility.) There’s also an option to browse all items and services to see what is covered.

A note to readers: I wouldn’t recommend telling your friends you have a fun new game on your phone and then ask them to call out medical procedures to see if they’re covered by Medicare. I can say from experience, it will not make you the most popular 20-something at brunch.

The Roneys’ next challenge: figuring out the “search” function.

Lisa Roney typed in “dexa scan,” a test her doctor recommended she, like many women her age, undergo to check for osteoporosis.

It yielded no results. To find it, Lisa had to browse through the list of covered procedures and go to “bone mass measurements.” There, she found out that Part B covers such tests once every two years, but nowhere in the information did the word “dexa scan” — the term her doctor used — appear.

Along the way, she checked her coverage manual and found no additional information. And, in the time it took her to go through these steps, her husband, Milt, got fed up and just Googled it. He found the answer immediately.

Such problems with search specificity may be common. One reviewer on the Apple Store lodged a similar complaint.

“You have to know the correct terms or browse the entire alphabetical index and select likely candidates,” the user wrote. “For instance ‘knee brace’ comes up with nothing (you have to know to search for generic term ‘brace’).”

Ultimately, the app is just another way for beneficiaries, their families and providers to find the same information available on the website and printed in the old-fashioned paper manual they receive by mail. It even uses the same fonts and little apple icons that denote which procedures count as “preventive.”

Schwarz, from the Medicare Rights Center, said a lot of beneficiaries will use the electronic resources to figure out coverage, but they also get help from social workers, volunteers at nonprofits and family members in their research. The app might help those people access information when they don’t want to use the mobile medicare.gov site, which Schwarz called “not particularly great.”

There is also no information about how to choose a prescription drug plan, or other supplemental insurance like Medicare Advantage or Medigap plans, which are the real and complicated decisions beneficiaries must contend with. But those decisions require more personal information, which the app can’t support right now.

It’s also important to remember, Schwarz said, that Medicare doesn’t cover only seniors. People of all ages with disabilities also rely on Medicare for health coverage, and they might find the app easier to use than the traditional website.

The Roneys were unimpressed.

“I’m probably going to delete it right after you leave,” Lisa Roney concluded.

Kaiser Health News (KHN) is a national health policy news service. It is an editorially independent program of the Henry J. Kaiser Family Foundation which is not affiliated with Kaiser Permanente.

Crédito: Rachel Bluth, Kaiser Health News