6 out of 10
Medicare patients don't review their health plans annually.
Are you making the most of Medicare Open Enrollment?
Three steps to success during Medicare Open Enrollment
Step 1
1. Identify eligible Medicare patients
Alisa Smith, Medicine Shoppe #1155, utilizes iMedicare to identify eligible patients and assigns her technicians to complete the plan consultations.
- Pro tip: Host staff competitions to see who can schedule and/or complete the most consultations. If your technicians do not complete the consultations, hold a competition to see who can bring in the most consultations.
Register now for the iMedicare webinar "How to Amplify Your Business Outcomes." It's offered regularly August through December.
Other ways to identify eligible Medicare patients:
Reimbursement Consulting Services (RCS) Med D Open Enrollment and Aging into Medicare reports
If you have been a RCS customer since at least August 2018, you will receive a Med D Open Enrollment report of patients currently enrolled in a plan you will not have preferred status for in 2019. The Patients Aging into Medicare report will help you keep track of your patients who are about to turn 65 and become eligible to enroll in Medicare. This will aid you in ensuring your patients sign up for a Medicare Part D plan that best fits their needs.
While you will still be able to fill for those patients next year, it will be important to have conversations with your patients to let them know of these changes.
Not on RCS? Learn more.
Step 2
2. Reach out to your community and eligible patients
Dale Erickson, Sardinia Pharmacy, reaches out to his Medicare eligible patients by generating letters through the iMedicare platform. He also offers Medicare educational sessions in his community, where his pharmacy has become known as a Medicare information destination.
Other ways you can promote your Medicare plan consultations:
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Step 3
3. Conduct consultations and engage throughout the year
JJ Bernabei, Tri-State Pharmacy, uses an appointment-based model for all of his Medicare consultations. His technicians do all of the preparation work, and a pharmacist performs the consultation when the patient comes in for the appointment.
- Pro tip: What about patients turning 65 years old outside of Medicare Open Enrollment? Promote your pharmacy as a place to receive plan consultations throughout the year for those aging into Medicare.
Patient consultation tools:
- Medicare.gov: The Centers for Medicare and Medicaid Services (CMS) offers a free plan comparison site you can use when discussing plans with your patients at medicare.gov.
- iMedicare: iMedicare not only identifies patients eligible to compare health plans, but offers a mobile tool so you can conduct consultations if you need to be flexible with space or are limited with desktops
Frequently asked questions
That’s okay — with Medicare plans, patients can still fill their prescriptions at any pharmacy, even if they are not preferred. You will need to make sure your patient knows they will pay a higher co-pay to fill at your pharmacy if they choose a plan you are not preferred in next year. If the patient really wants to stay at your pharmacy, you can review their medications and find other cost saving methods so that the co-pay differential may not be as high. Suggestions include — ensuring that their infrequent acute care medications are not included in their overall price quote for the upcoming year or talking to their doctor about switching to cheaper generic alternatives, if available.
Your patients want to know what plan makes the most sense for them financially. Walk them through their plan options using iMedicare or Medicare.gov and let your patient know that “If you want to be a patient at this pharmacy with a lower copay, this is the best option”. If they do choose a plan that will take them to a different pharmacy, remind them to come back next year as plans change annually.
Alisa, JJ, and Dale utilize technicians during the consultation process in different ways. Both Dale and JJ use technicians to help identify eligible patients and schedule consultations, while Alisa uses technicians throughout the entire process. When Alisa is making the technician schedule, she ensures that she schedules dedicated time for Medicare consultations. This ensures that the technician can focus on patient outreach, coordination and Medicare consultations (if applicable).
Resources for Medicare Open Enrollment
Preferred network recaps
For LeaderNET/MSInterNet members only
Medicare 101 guides
2018 Medicare 101 Guide
for LeaderNET/MSInterNet members only
2018 Medicare 101 Guide
for LeaderNET/MSInterNet members only