Many customers don’t have the best drug plan

elderly customers conversing with pharmacist

Help customers save by switching to lower-cost drug plans

In brief:

  • Many customers could save money by switching prescription drug plans, but few people switch.
  • Reluctance to switch is often based on confusion, lack of understanding of options, and lack of awareness of how easy and beneficial it is to switch.
  • Independent pharmacies can help customers understand their options, see how much money they could save and switch to a better drug plan.
  • Helping guide customers through this process can generate good will, loyalty and increased business.

Reluctance to switch drug plans

Medicare strongly encourages beneficiaries to compare options and consider changing drug plans each year.

Medicare’s website says, “It is important that you review your drug plan every year. Medicare private drug plans can change their costs and the list of drugs that they cover every year.” The site goes on to say, “Even if you are satisfied with your current Medicare coverage, you should check if there is another plan in your area that offers better coverage at a lower price.”1

However, research finds that only 13% of Part D enrollees switch drug plans during the annual enrollment period.2 Another study found that seniors often aren’t picking the Part D plans that offer the most value and that Medicare beneficiaries could have spent about 30% less in out-of-pocket expenses if they had chosen more suitable Part D prescription insurance plans.3

Reluctance to switch drug plans may be based on patients’ confusion and difficulty understanding the options that are available.

Benefits of switching plans

Switching to a different drug plan can be beneficial for customers. Benefits include:

  • Access to medications. Even if a medication was covered in the past, it might not be covered in the future. Customers may want to change plans to make sure that a necessary medication is covered by their drug plan.
  • Lower premium costs. Research found that almost half of enrollees (46%) who switched drug plans saw their premiums fall by at least 5% the following year.4
  • Lower out-of-pocket costs. Those who switch plans often move to plans with lower deductibles or co-pays, resulting in lower overall out-of-pocket costs.


“Relatively few people on Medicare have used the annual opportunity to switch Part D prescription drug plans (PDPs) voluntarily — even though those who do switch often lower their out-of-pocket costs as a result of changing plans.”5

How pharmacies can help

Independent pharmacies can provide in-store consultations about plan options, can provide customers with tools and information, and can direct patients to the best online resources.

  • In-store consultations can involve reviewing a patient’s medications, seeing which plans cover and don’t cover their medications, and assessing if there are lower-cost drugs or plan options. It is important to provide information and let Medicare enrollees make their own Part D decision. A pharmacy can provide information, but should not endorse any specific Medicare Part D plan.Taking the time to help a patient assess their drug and plan options is a service that mail order pharmacies and chains can’t replicate, and that builds relationships and loyalty.Providing Part D consultations requires developing the appropriate expertise and then marketing this service through signage, advertising and press releases, the pharmacy’s website, and social media.
  • Tools and information can include using iMedicare, which helps community pharmacies pull information from the pharmacy system and make personalized plan comparisons even faster than navigating the Medicare website.

Previously, Newbern Drug Health Mart in Newbern, Tennessee, conducted drug plan reviews for almost 200 Medicare enrollees. After those consultations:

  • 70% of patients decided to change to another drug plan.
  • Those who changed plans saved almost $700 per year.

Newbern Drug’s Medicare Part D expert, Dayton Keller said, “Other pharmacies’ patients come to us for help with their Medicare Part D. A portion of those transfer their prescriptions to us and become customers of Newbern Drug Health Mart.”

This is truly a win/win. Pharmacies can help patients win by providing access to the drugs that patients need, and patients may save significant amounts of money and lower their out-of-pocket costs. And pharmacies can win by providing a distinct and important service that Medicare enrollees value, which builds relationships, the pharmacy’s reputation, and ultimately, the business.



1 “Should I Review My Medicare Part D Plan Choice Every Year?” Medicare Interactive, accessed September 7, 2017 LINK
2 “To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans to Save Money?” Kaiser Family Foundation, October 10, 2013 LINK
3 “Seniors Aren’t Learning to Choose Better Prescription Insurance Plans,” Yale Insights, February 21, 2017 LINK
4 “To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans to Save Money?” Kaiser Family Foundation, October 10, 2013 LINK
5 “To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans to Save Money?” Kaiser Family Foundation, October 10, 2013 LINK