The countdown is on. Medicare’s annual open enrollment period closes Monday, Dec. 7.
Any plan changes patients make by midnight Dec. 7 will take effect on Jan. 1, 2016. After Dec. 7, most patients will only have a limited opportunity to change their 2016 Medicare plan coverage before the 2017 open enrollment period.
Are you actively assisting your Medicare Part D patients before the open enrollment period ends?
Why Medicare Part D matters
In 2014, Medicare Part D covered 34 percent of all prescriptions filled in independent community pharmacies, according to the 2015 NCPA Digest produced by the National Community Pharmacists Association (NCPA),
As a significant chunk of your pharmacy’s prescriptions, you can’t afford to lose Medicare Part D patients. And, making sure those patients keep coming to your pharmacy starts by assisting them with enrollment.
What you can do
Pharmacies aren’t allowed to encourage, promote or advertise a particular Medicare Part D plan to beneficiaries. You can, however, provide an objective needs assessment that outlines Medicare Part D plan options that best fit patients’ overall needs, including accommodation for their prescription regimen.
Patients’ needs include appropriate access to their prescribed medications and the services they rely on, affordable costs, generic alternatives, convenience, medication synchronization, trusted consultation and more.
Providing patients with an objective needs assessment doesn’t have to be difficult or time-consuming. iMedicare, a tool that directly compares the features of various plan options based on patients’ needs, is a great way to identify the plans available to patients for their pharmacy of choice. It also allows you to estimate how much each plan will cost the patient, and you can use iMedicare on your desktop computer, laptop or tablet.
The Centers for Medicare & Medicaid Services (CMS) also offer outreach and media materials for the open enrollment period. You can use these materials to help your patients understand their plan options. Materials include toolkits, fact sheets, ads, flyers and Spanish-language outreach materials.
Special enrollment periods
Some Medicare patients can enroll in Medicare plans for an extended period, which means you have an additional opportunity to assist these patients with an objective needs assessment.
For example, beneficiaries currently enrolled in a non-renewing or discontinued 2015 Medicare plan will be granted a special enrollment period, so they can join a 2016 Medicare Part D or Medicare Advantage plan. The special enrollment period lasts from Dec. 8 through Feb. 29, 2016. Other special circumstances exist where patients receive an additional two months to switch plans, including if they move or if Medicare terminates the plan’s contract.
For more information on special enrollment periods, visit cms.gov.
This article is by TriNet Third Party Network by PBA Health, a pharmacy services administration organization (PSAO) that provides third party contracting services.
