Your Medicare patients are some of the most important patients for your pharmacy’s business. Medicare patients consume almost 30% of all medications prescribed in the United States1. That figure is likely to grow over the next several years as baby boomers continue to reach retirement age. Over the next 20 years it is estimated that every day 10,000 Americans will turn 65, making them Medicare eligible 2.
For seniors, Open Enrollment is an important time, but it is not the only time you can speak with your patients about their Medicare options. A recent survey conducted by PrescribeWellness found that 49% of Americans felt that choosing a Medicare plan was the most confusing part of the enrollment process. Patients are likely to have questions about their coverage year-round and many may even qualify for Special Enrollment Periods throughout the year and be able to change their plan. Establishing yourself as a resource for your patients when these questions arise will help differentiate you from competing pharmacies, strengthen your business, and increase patient satisfaction.
Special Enrollment Periods
Patients may elect to change their coverage once a year during open enrollment (October 15- December 7). Outside of this time frame patients may experience significant life changes that qualify them for a Special Enrollment Period, meaning they may change all or parts of their Medicare coverage. Such instances include:
- Moving residences
- Employment status change
- Health status change
- Being dual eligible
- Recently released from jail
Patients may be unaware that some of these life events will allow them the opportunity to review their coverage options. Educating your patients about these opportunities can increase patient satisfaction by allowing them the convenience of discussing their prescription drug coverage with the same team that will be assisting them with their medications year-round.
Why the Conversation Matters
There is no denying the importance of Medicare for those that rely on it. The evidence showing the true effectiveness of Medicare’s impact on health is astounding. A recent study published in the Journal of Health and Economics found that patients who were enrolled in Medicare Part D increased their use of cardiovascular medications up to 30%. This increase in adherence is great for your pharmacy’s ratings and revenue, but it is also immensely important to the patient’s health. Consequentially, Medicare Part D reduces senior mortality rates by over 2% which equates to tens of thousands of lives extended annually3.
Although enrollment is crucial, multiple studies have shown that the majority of individuals do not feel confident in their ability to understand insurance coverage and choose a plan4. Some states have as many as 63 Medicare plans available to patients, overwhelming them with information and options. As a pharmacist, you are able to help patients with their questions.
Using platforms like PrescribeMedicare allows you to provide value-added services by conducting plan reviews for your patients. PrescribeMedicare integrates directly with your pharmacy management system to pull relevant data to conduct thorough plan reviews. These plan reviews provide the necessary information for your patients to make an informed decision. Through PrescribeMedicare, you are able to show patients clearly detailed information such as plan ratings, medication co-pays, deductibles for the year, and how much the patient will be paying out of pocket for their Part D coverage.
PrescribeMedicare also simplifies your workflow by identifying your patients as they become Medicare eligible. PrescribeMedicare will send patients a message 3 months prior to their 65th birthday, kindly informing them that your pharmacy is able to assist them with Medicare plan reviews or any questions they have. This phone campaign ensures that your patients know, from the first day they become eligible, that you are available to assist them.
Helping patients with Medicare knowledge year-round will ensure they are finding the plan that will best fit their life. Even if a patient is unable to change their current coverage outside of Open Enrollment, they are more likely to come to you when Open Enrollment arrives to answer their questions.
- Maris, D. (2012, July 24). Who Is Popping All Those Pills? Retrieved May 03, 2017, from
- Kessler, G. (2014, July 24). Do 10,000 baby boomers retire every day? Retrieved May
03, 2017, from https://www.washingtonpost.com/news/fact-checker/wp/2014/07/24/do-10000-baby-boomers-retire-every-day/?utm_term=.8cca3d467afe
- Thorpe, K. E. (2017, March 30). Repeal of Obamacare Is Back, and Seniors Risk Being the Biggest
Losers. Retrieved May 03, 2017, from http://fortune.com/2017/03/31/ahca-trumpcare-obamacare/
- Morales, S., Riccardi, F., Carter, J., & Sanders, S. (2017, March 02). Medicare Trends and
Recommendations:. Retrieved May 03, 2017, from https://www.medicarerights.org/2015-medicare-trends