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Latest news and updates about the Medicare and pharmacy industries.

Plan Comparisons Don’t Have to Be Scary

Posted on October 30, 2020 by Amplicare Team

The Medicare Open Enrollment period is upon us, and this time of year can be terrifying for both patients and pharmacies. For patients, the sheer amount of information needed to understand their plan options is overwhelming. Pharmacists, on the other hand, face the challenge of helping a significant number of Medicare beneficiaries while maintaining the day-to-day workflow of the pharmacy. 

Before you run screaming for the hills, keep in mind that with the right plan — and the right resources — you can easily make the most of the Medicare Open Enrollment period without breaking a sweat. Below, we break down three simple steps to help make plan comparisons a little easier and a lot less scary. 

Use a Plan Finder

When it comes to helping patients navigate their Medicare options, there are a lot of factors to consider. Are all their medications covered? Will their doctors continue to be in network with their chosen plan? How much can they expect to pay out of pocket? Will your pharmacy be preferred with their plan? 

Using a plan finder can help you easily answer these questions for your patients. Amplicare Match, our plan comparison tool, is one of the only — if not the only — plan finder outside of Medicare.gov that lists all available plans for patients. This includes new pharmacy friendly plans such as Indy Health and Exemplar Health. Even better, the preferred status of the pharmacy is clearly indicated, so patients have an accurate idea of how much out-of-pocket costs to expect and the pharmacy has an estimate of DIR fees for each plan. Additionally, our formulary and doctor lookup tools help you easily verify whether or not a patient’s medications and physicians respectively will be in network with a plan in the coming year.  

Go Digital

If your pharmacy serves a large Medicare population, you may have a few questions of your own regarding helping your patients. How do you ensure each eligible patient knows they have a limited time to select or switch plans? How can you make sure they have the resources they need to make an informed decision? And, more importantly, with the added challenge of COVID-19, which is starting to spike once again, how do you do all of this safely?

Running online and in-store marketing campaigns, scheduling automated phone calls, and providing handouts are all great ways to let patients know about your plan comparison services (and all easy to do with Amplicare). This year, we also launched Navigate, an online enrollment portal, designed to address these specific concerns. Navigate is a secure, CMS-approved portal that enables patients to compare plans in-network and preferred with your pharmacy from the comfort of their homes. They are also able to see plan comparisons you’ve started in the pharmacy, which helps to facilitate phone consultations and collaboration between you and your patients. There’s also a help center with Medicare resources if they need extra guidance, and they can get enrollment help from a pharmacy friendly broker if you choose to go that route.

By providing an online option for patients, you can ensure they’re carefully considering their Medicare options while still having time to consult with multiple patients.  

Target DIR Fees

From a bottom line perspective, what’s scarier to a pharmacy than DIR fees? The nature of these fees make them a challenge for many. During Medicare Open Enrollment, however, there are a few steps you can take to make them less ominous in the coming plan year. One way to do this is to address win-win opportunities for your patients and your pharmacy. With our platform, for example, you can easily identify which patients have a more cost-effective plan option that is also beneficial to your pharmacy’s bottom line. You can also try the “Mitigation by Migration” strategy, which uses adherence measures to identify plans that work better for both you and your patients. Once you know who these patients are, prioritize plan comparisons for them as switching to a new plan would save them money in the coming year. 

The bottom line: plan comparisons — and the Medicare Open Enrollment period — don’t have to be a gut-wrenching, sweat-inducing affair. With the right tools in place, your pharmacy and patients can come out on the other side unscathed. To learn more about how Amplicare can help you make the most of the opportunities of Medicare Open Enrollment, reach out today to schedule a consultation

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