Getting Ready for Open Enrollment – Medicare Part D

Oct 11, 2018 | Independent Pharmacy Insights, Pharmacy Growth

Open enrollment for Medicare is just around the corner. From October 15th to December 7th customers 65 and older will be reviewing their medical coverage and health care needs, including Medicare Part D.

Don’t Lose Your Patients to Confusing Information and Misinformation

When open enrollment time comes around, your customers are getting phone calls, emails, and mail loaded with advertisements, offers, information and misinformation from pharmacies and programs competing for their business. Spend a half hour watching a cable TV channel, and count how many open enrollment advertisements you see, promising huge savings and convenience.

And, just like previous enrollment periods, many of your customers – even those who have been through it all before, are going to receive incomplete or confusing information about the pharmacies they can use in a plan’s Part D network.

One of the biggest miscommunications in this information is patients thinking they cannot use your pharmacy if you’re not listed as preferred in a plan.

Because the enrollment period is already historically confusing, it’s always wise to start educating your patients early. If it’s getting down to the wire, however, be prepared to offer advice, answer questions, and assist your customers in plan comparisons in as many ways as possible:

  • Contact your customers who qualify and ask them if they have questions – they may feel a bit embarrassed about not understanding the process. Reaching out to them first can help put them at ease and get them to enroll quicker and with less anxiety.
  • Print up flyers and bag stuffers letting customers know the enrollment period is coming up and you’re there to answer any questions they may have.
  • Update social media graphics to include reminders about the enrollment period and your pharmacy’s ability to help.
  • Schedule some time every day to be available to speak to customers and address any concerns they may have regarding their Medicare Part D coverage.

Be Prepared for Confusion

If your pharmacy is not preferred with a given Part D plan, that does not mean your patients need to find another pharmacy or plan. Patients choose their Part D plan around many different variables. Some variables include:

  • Monthly premiums
  • Annual deductibles
  • Co-pays
  • Coverage during the donut hole
  • Formulary and
  • The plan’s pharmacy network

Your customers come to your pharmacy for many reasons. Identify what values they see in your pharmacy and pharmacy team and reinforce them.

One of the best ways you can do that is by being helpful and knowledgeable while you assist them in navigating their Medicare Part D enrollment. Not only will you be providing a valuable service to your customer – who will remember the time and effort you put into helping them, but you will be boosting your standing as a trusted medical voice in the community.

Make Sure You’re Up to Date On Changes as Well

While you’re getting your customers up to speed on their Medicare Part D Enrollment, don’t forget that there may be some changes that affect your pharmacy. For example, there are a few important Part D Changes for 2019 that CMS is implementing including:

  • Summarized current Part D Star Ratings system (with modifications) for the 2019 contract year and lengthened the process for modifying existing measures or adding new ones, making Star Ratings changes part of its annual Notice and Call Letter Process.
  • CMS will allow Part D plans to begin making midyear formulary changes as well as quick substitutions for certain generic drugs.
  • CMS has clarified that the Any Willing Pharmacy provision (AWP) applies to all types of pharmacies. While Part D plans may still define terms and conditions for different types of pharmacies, they cannot legally exclude any willing pharmacy from network participation.

Closing Thoughts

Understanding Medicare Part D can be a challenge for customers and pharmacists alike. Make it less of a challenge by keeping up to date on CMS Plan changes, educating yourself and your customer and keeping confusion and stress to a minimum.

You’ll be doing more than helping your customer find the best plan for their needs –– you’ll be helping your pharmacy gain a position as a thought leader and knowledge base in your community. That’s a very nice position to be in.

What processes has your pharmacy used to educate and assist Medicare Part D enrollees? Is your pharmacy ready for 2019’s enrollment period? What processes have you found that work better? Have they had any impact on customer retention? We’d love to know and may even share those experiences in future blog posts, white papers, and e-books. To share your story, please contact Jessica Gardner.

And, of course, be sure to subscribe to our blog for more tips, insights and bulletins that can help grow your pharmacy and save you money – all from your partners at AlliantRx.