Medicare open enrollment began on October 15th and continues through December 7th. For those 65 and older, this is an important but confusing time for making choices that will govern their prescription coverage.
Some of the confusion they deal with may stem from:
- Enrollment dates
- Their current prescription coverage may have changed its formulary, which could leave a patient uncovered for the medications they require
- The “Donut Hole” gap in coverage has changed again (as it will each year until it is eliminated in 2020)
- Overzealous salespersons and marketing materials that present an incomplete picture of the plan they promote
- Identity thieves who trick seniors into giving up their information
As a trusted independent community pharmacy, you can play a critical role in helping patients make sound decisions. Here are five keys to doing just that.
- Explain what they can and cannot do during open enrollment (10/15-12/07), including:
- Change from Original Medicare to a Medicare Advantage Plan.
- Change from a Medicare Advantage Plan back to Original Medicare.
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
- Switch from a Medicare Advantage Plan that doesn’t offer drug coverage to a Medicare Advantage Plan that offers drug coverage.
- Switch from a Medicare Advantage Plan that offers drug coverage to a Medicare Advantage Plan that doesn’t offer drug coverage.
- Join a Medicare Prescription Drug Plan.
- Switch from one Medicare drug plan to another Medicare drug plan.
- Drop your Medicare prescription drug coverage completely.
- Warn them against scammers
According to AARP, Medicare open enrollment is “open season” for identity thieves who call and identify themselves as representatives of CMS, demanding information such as the person’s Medicare number, Social Security number, bank account information, and/or credit card information.
On their Medicare blog, CMS writes, “It’s illegal for someone to call and ask for your Medicare number, Social Security number, or bank or credit card information.”
- Through individual consultations, provide information tailored to their individual medication needs
Obviously, prescription plans that offer low prices but don’t cover the medications the patient need are not a bargain. Here are two websites where patients find plans that match their needs.
- Medicare Plan Finder on Medicare.gov (Includes video on how to complete a plan search)
- 2015 Medicare Part D or Medicare Advantage Formulary Browser on Q1Medicare.com
For the uninitiated, using these tools can be very confusing. Have someone in your pharmacy take care of this for them and you will strengthen your relationship with the patient while helping them make a sound decision.
This is also an excellent opportunity to tell them about and reinforce the value of your MTM services.
- Refer them to resources where they can get more help
- Your state’s official Medicare agency. Check with your state Health Department and get the correct contact information for your patients.
- Download this flyer (partially shown above) from CMS and customize it for your pharmacy
- Create a Frequently Asked Questions (FAQ) guide as a handout and/or webpage
Once you’ve addressed all of the issues addressed in this article, you’re well on your way to having all the information you need to create a comprehensive FAQ document you can hand out or even put on your website.
Need more inspiration for your FAQ page? Here are links to some Medicare open enrollment FAQs from non-governmental sources:
Want to do more? Here are a few ideas
Create a sign, banner, or display promoting your open enrollment consultation services. If you don’t tell people about it, they won’t know.
Have a sticker made to put on every receipt informing your customers that Medicare open enrollment is in progress and that you can help.
Put on a seminar and invite all your customers. Encourage those who aren’t old enough to qualify for Medicare to bring their relatives who do. Remember to serve healthy snacks. Good food goes a long way toward making any event a success.
What have we missed?
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