The most important advice is that you cannot steer your patients, as it's a violation of CMS regulations, but your advice is still extremely valuable. Learn more about the "do's and don'ts" of helping patients with a plan comparison.
- Show multiple plan options to the patient. Patients need to make the decision themselves, so you need to show several options and let them decide what's right for them. Use the Patient View when reviewing plans with patients.
- Explain that plan formularies change each year. It's important that patients understand the plan they like this year may change drastically next year. Plus, this encourages them to come back for plan comparisons every year!
- Print out a plan comparison summary for the patient to take home with them to refer to. This way the patient has it to refer to if they ever have any questions. Do this by selecting the plans they are considering, clicking "Compare Plans", and then "Print Preview". There is also an option to email the plan comparison directly from the "Print Preview" page if you prefer.
- Help the patient understand their of out-of-pocket cost throughout the year and restrictions associated with each plan.
- For patients who have never enrolled in Medicare before, engage them in a conversation rather than just sending them a letter or stapling a printed handout to their prescription bag. Help these patients understand what it means to be eligible for Medicare, and let them know how YOU can help them choose a plan that will work for them! Brokers will begin reaching out to patients as soon as they are eligible for Medicare, so this is your opportunity to get to them first! Starting the conversation will show your patients that you care, and this can help build trust in your pharmacy. Send them a voice message using this script, or take a look at the best practices for getting these patients into the pharmacy for a plan comparison!
Empower your patients to make educated decisions. This is a crucial step for creating trust in your community, and it saves patients from being upset by unexpected changes in their costs. These topics are some of the most important to review with your patients:
- Phases of Coverage -- What are they? When will my costs change and why? When do I hit the Donut Hole and why?
- Restrictions -- What are my restrictions? What does it mean for me? Why is my cost so high (Not Covered Drugs)?
- Late Enrollment Penalty -- What is the penalty for waiting to pick a plan?
- Enrollment windows -- When can I enroll in a Part D plan?
- Changing Costs Explained -- Patients may get upset by changing costs throughout the year. Ensure there aren't any surprises, and hand out this document to all of your Medicare patients (download in your Resources).
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