Even though the Medicare Annual Enrollment period is still months away, now is the best time to learn how Medicare plans, especially Part D, affects you and your customers. According to Pharmacy Times, “Medicare patients are the highest users of prescription drugs and a major source of recurring revenue for community pharmacies”. As pharmacists, you have the industry insight to guide them through any questions they might have about their plans.
One of the most common questions that Medicare Patients tend to ask, is the difference between PDP and MAPD. While PDP only covers prescription drugs for Part D plans, MAPD covers that and extra benefits, such as dental or vision. Other than PDP and MAPD, there are many different tiers of Medicare for each individual to choose from, based on their medical needs. As a result, many patients look to their medication experts on recommending the better option based on their drug formularies.
A potentially large impact on your patient’s pocket can be the plan changes that occur every year. By advising them to review their plan’s annually, they can see if their drugs are still covered and edit their plan accordingly. If not, their drug costs can skyrocket, leaving them unprepared. Another impact is the deductible that has to be met. People tend to forget that they can have anywhere from $100 to $500 in deductibles, so it can be advised to save throughout the year in order to plan for the next. A great way to help your Medicare patients save money is to provide potential low-cost substitutes to the more expensive medications that they can discuss with their doctor.
Besides questions and advice, there is one large part of Medicare Plan D that affects the lives of pharmacists: Medication Therapy Management (MTM). The MTM program helps your patients, and their doctors, ensure that their medications are working properly. As a pharmacist, your job in this program includes, reviewing your patients’ medications and the reason why they take them, a written summary of this review, and an action plan to help make the best use of these medications. Other things to mention are possible side effects or interactions between the drugs being taken or simply asking if there are any problems are concerns.
Whether you are a part of the MTM program, answering vital questions, or even just giving advice, you are an essential part. Your patients rely on you to be their trustworthy pharmacists who will either know all the answers or will do everything in their power to find answers for them. Medicare can be confusing for those who are new to it, and who better than to advise them than the ones who have been building a meaningful relationship with them over the past years?