Changes will be coming to Medicare Part D in 2019...and will lead to questions during open enrollment from Oct 15 to Dec 7.
Explain what's new in 2019. The annual deductible for most Part D plans will go from $405 to $415. And the coverage gap, or "donut hole," will begin when TOTAL Rx costs reach $3,820...$70 more than 2018.
The amount patients pay in the donut hole will continue to drop.
Most Medicare D patients will pay 25% of the cost for brand-name meds...and 37% of generic costs...while they're in the donut hole in 2019.
Help patients sort through plan options. Tell them not to pick one based on monthly premiums alone...and to also look for possible changes in co-pays, covered Rxs, preferred pharmacies, etc.
Suggest checking plan Star Ratings on Medicare's website. Higher ratings can mean patients are more satisfied with the plan...and that the plan has good scores for safe and appropriate med use.
Remind patients that they'll automatically be re-enrolled in their current plan in 2019 if they don't make a change.
Point out that patients usually can't change plans after open enrollment. But they can switch to a plan with an overall 5-Star Rating once...from December 8, 2018, to November 30, 2019.
Share our patient education handout, How to Navigate Medicare's Prescription Drug Plan, to help answer questions...and give your techs our tutorial, The ABCs of Medicare, to get them involved.
- www.medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/costs-in-the-coverage-gap/more-drug-savings-coming-through-2020
- www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/PartDandMABenchmarks2019.pdf
- www.medicare.gov/sites/default/files/2018-07/11109-your-guide-to-medicare-prescrip-drug-cov.pdf
- Technician Tutorial: The ABCs of Medicare
- Patient Education: How to Navigate Medicare’s Prescription Drug Plan
Christine Martin September 29, 2018
link for "How to Navigate..." does not work within the article, but works in the resource section.
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