5 ways to prepare now for Medicare Open Enrollment

independent pharmacy blog

Take these steps now to be ready to roll on October 15

In brief:

  • Most Medicare Part D enrollees are not in the lowest-cost plan available to them, and comparing the options can be overwhelming for them.
  • Set up a system now to offer Medicare plan reviews during Open Enrollment, Oct. 15 to Dec. 7.
  • Prepare to promote the valuable service you provide.

The planning you do right now can make your pharmacy a valuable resource to those customers who will be negotiating Open Enrollment beginning Oct. 15 (and going through Dec. 7). Plus, planning ahead for Open Enrollment can make the workflow much easier for you and your staff.

Open Enrollment is a big deal

About 40 million Medicare Part D enrollees will have an opportunity to change their prescription drug plans this year. But comparing dozens of different plans is a daunting challenge that leaves many individuals paying hundreds of dollars more than they should.

One study found that only 5% of Medicare Part D enrollees were enrolled in the lowest-cost plan, and those who switched saved almost $700.1

Independent pharmacies can play a valuable role

To be ready to assist customers Oct. 15, start making these plans now.

  1. Find your expert. Designate someone within your pharmacy to be your Medicare expert, or consider hiring someone part-time during Open Enrollment. Whomever you choose, make sure that person has plenty of time for training about Medicare, along with how to use your systems and how to talk with customers about their options. While they can provide information, legally they are not allowed to steer a person to a plan. (See “Medicare Open Enrollment Allows Pharmacy Expertise to Stand Out.”)
  2. Choose your tools. A plan-finder tool, such as iMedicare, will estimate a patient’s drug costs based on his or her medications, and is likely to be much easier to use than the free plan finder on Medicare’s website. Look for a system that will integrate easily with your pharmacy software, to save time entering information about a patient’s medications. If you don’t already have such software, have it installed early enough for your staff to become comfortable using it.
  3. Establish a workflow. Each appointment with a Medicare beneficiary can take as little as 15 minutes, if your staff has prepared for the review in advance. Developing a workflow allows you to use time and staff efficiently. For example, a technician may be able to prepare information for a pharmacist to review.

Make Medicare appointments flow

With a well-planned system, a pharmacy can save time and use its staff efficiently in conducting Medicare plan reviews with patients. Follow these steps:

Before the appointment

  • Schedule appointments. Set times for talking with patients about their options, so the pharmacy can be prepared and people won’t have to wait. Designate days and times when you will have staff available, and then ask customers to schedule their time. While most reviews may take only 15 minutes, you may want to allot longer time slots, particularly for the first few while you fine-tune your system.
  • Check medication data. Have a staff member verify the customer’s current medications with that person. Customers may be taking medications that they don’t buy from your pharmacy, so don’t rely only on the data already in your pharmacy software. (Having patients on a medication synchronization program will speed up this part of the process.)
  • Ask about preferences. When you are scheduling the appointment and checking that the medication list is up to date, ask about the customer’s priorities in choosing a plan. For example, a couple may want to be on the same plan, even if they would save some money by each being under a different plan. They also may want to know about which plans require prior authorization or step-up therapy for certain drugs. Many beneficiaries say access to their preferred pharmacist is important to them.2
  • Process the information. Researching the options and comparing plans can take as little as 10 minutes per patient. With that done, your staff can focus on talking with patients when they come in.

During the appointment

Ensure you provide all the information that may influence a plan choice. Your Medicare expert should be able to discuss:

  • The cost of staying with their current plan, based on the changes made to it for the coming year. Customers may be unaware, for example, about how a plan’s formulary changes will affect their costs.
  • The estimated annual cost of various plan options, including the separate costs for premiums, deductibles, co-pays, and costs during the coverage gap known as the “donut hole.”

Be ready to show patients which pharmacies are available and which cost more under each plan, too. Even if they make a decision and choose to enroll in a plan right then, the entire appointment can take less than half an hour.

  1. Plan your marketing and outreach. Order marketing fliers, signs and other advertising to promote the plan review service you will offer during Medicare Open Enrollment. Also determine how to let customers know in which plans your pharmacy participates, following any restrictions on advertising.Develop a schedule for personal outreach to customers, too, such as asking them when they pick up medications in August whether they would like to schedule an appointment during Open Enrollment. Another option is to target groups of patients over a period of weeks to ensure their medication information is up to date in your pharmacy system and invite them to schedule a plan review in early October.Early scheduling will ease any last-minute rush from seniors who haven’t made a choice before Thanksgiving.
  2. Promote the savings. While pharmacies can’t legally steer a Medicare beneficiary to one plan or another, you can tout the value of the education you provide during Open Enrollment. Plan how you will record and promote that value.For example, you might post a note on social media immediately after an appointment saying, “XYZ Pharmacy just showed a Medicare customer which plan will save him $642 next year. Call now to schedule an appointment for your review.”Keep a running tally, too. “So far, XYZ Pharmacy’s Medicare reviews have helped 27 customers identify ways to save $18,559 on their medications next year. Let us help you, too. Call now for your appointment.”

Preparing now for Open Enrollment season can save your customers money and draw in new ones who see the valuable service you provide.


1 “Finding the Right Plan During Medicare Open Enrollment,” Lisa Zamosky, Los Angeles Times, Oct. 16, 2015. LINK
2 “Report, Briefing Examine How Seniors Choose Among Their Medicare Plan Options,” Kaiser Family Foundation, May 13, 2014. LINK