CMS solicits information on AI tools for Medicare plan selection

CMS has issued a Request for Information, or RFI, seeking information about AI and machine learning platforms and services that can improve the Medicare experience.

According to the RFI document, navigating Medicare coverage options via Medicare.gov, Medicare Plan Finder and the 1-800-MEDICARE Call Center is challenging for Medicare beneficiaries.

"Current tools rely primarily on static comparison tables and documents that can be difficult to navigate, particularly for beneficiaries with limited health literacy, language barriers, or cognitive challenges," the RFI states. "During peak enrollment periods, wait times at the call center may be longer as call center representatives must explain the varying amount of coverage options and health plan types orally over the phone."

Now, CMS is seeking AI tools to help Medicare beneficiaries navigate this selection process. Specifically, the agency wants tools that provide personalized, claims-informed plan recommendations, use predictive analytics to match beneficiaries with plans, translate plan information and Medicare documents into plain language and automate routine call center inquiries.

Additionally, the agency is seeking real-time conversational AI tools, including chatbots, virtual assistants and AI voice advisors, as well as platforms that can generate insights about beneficiary preferences, plan performance and operational improvements.

The RFI aims to help identify vendors with AI and machine-learning capabilities for healthcare decision support and call center automation. RFI respondents must be able to demonstrate market readiness, organizational independence and technology and data ownership. They must also detail their approach to patient privacy and data security as well as their commitment to fairness and equity. The RFI period will close on March 31, 2026.

The request comes as government agencies increasingly incorporate AI into their operations.

According to a 2025 Government Accountability Office (GAO) report, AI use cases nearly doubled from 571 in 2023 to 1,110 in 2024, across 11 selected agencies. GenAI use cases, in particular, skyrocketed, increasing from 32 to 282.

The HHS had the largest increase in overall AI use cases, which jumped from 157 in 2023 to 271 in 2024, as well as GenAI use cases, which rose from 7 to 116 in the same time period.

Last year, the FDA rolled out Elsa, its generative AI platform, agencywide. The tool aims to assist FDA workers in performing tasks related to clinical protocol assessments, safety evaluations and internal workflow efficiencies. Other agencies, like the Centers for Disease Control and Prevention, have also released their own internal AI tools.

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.