Help Your Customers Navigate Medicare Part D
Regulations and Legislation
By becoming a Medicare Part D expert and offering Part D reviews, you can help boost customer loyalty and build word of mouth, while serving your community
A new autumn ritual has emerged. Each fall, in addition to football and Halloween, tens of millions of Medicare beneficiaries must now decide upon their Part D plan for the next year. And many of them need help.
For 2013 there were more than 1,000 Medicare Part D prescription plans across the U.S. — with more than 30 competing plans in most states.[1] And each year there may be coverage changes, formulary changes, and changes to a patient’s health and medications, making the annual process of selecting a Medicare Part D plan confusing and intimidating.
As pharmacy professor Jeannette Y. Wick recently wrote in Pharmacy Times, “Patients are likely to be confused by the various Medicare prescription drug plans available to them as well as the year-to-year coverage changes.”[2] Eric Zint of Corner Pharmacy in Greenfield, Ohio completely agrees. He said that Medicare is extremely confusing and most people have no idea what insurance they have or how it works.
This confusion among customers presents an opportunity for community pharmacies.
Reducing Confusion, Increasing Loyalty
When Medicare Part D began in 2006, Columbus, Montana pharmacist Mike Matovich saw how confusing it was for his own grandparents to wade through the immense amount of mail they received about various Part D plans. He figured that if his grandparents were overwhelmed and confused, then other seniors must be having the same problems. He saw this as an opportunity to provide help to his customers, who were confused and didn’t know where to turn.
However, Matovich admits that at the time, he and his staff at Columbus Health Mart “didn’t know what we were doing.” But they soon did. Matovich and others at Columbus Health Mart went to www.Medicare.gov, found additional resources, and reviewed everything they could to become knowledgeable about Medicare Part D.
Once prepared and knowledgeable, the team at Columbus Health Mart was able to assist customers by conducting a Medicare Part D review. This review involves understanding each customer’s medication profile and then identifying which Part D plans best match the individual’s needs. The team at Columbus Health Mart is extremely careful not to steer anyone to a particular plan, which is not allowed. They provide information about the choices available so eligible beneficiaries can make more informed decisions.
Corner Pharmacy will plug a customer’s current drug information in the Medicare website to show them the costs of various Part D plans. In some situations, customers see that alternative plans might save them hundreds of dollars. Also, reviewing a customer’s current drugs can at times show opportunities for savings by switching to generic options.
For both Columbus Health Mart and Corner Pharmacy, becoming an expert on Medicare Part D and offering reviews to customers has resulted in tremendous customer loyalty and contributed to better business results. Matovich estimates that the retention rate for those who have had a Part D review is about 90% — and many customers have Columbus Health Mart conduct a new Part D review each year.
In addition, offering Medicare Part D reviews has produced tremendous word of mouth. Customers who have had a Part D review at Columbus Health Mart have told friends and relatives, who have flocked to the store to get their own review. Among new customers who have come in for a Part D review, about 70% have converted to become ongoing customers, having all of their prescriptions filled there.
Zint’s experience has been similar. Offering Medicare Part D reviews differentiates Corner Pharmacy, strengthens retention, and creates traffic and positive word of mouth.
Important Lessons Learned
The experience of Columbus Health Mart and Corner Pharmacy in becoming Medicare Part D experts and conducting Part D reviews has yielded many important lessons. Among them are:
- The annual enrollment period is the most important time. Most Medicare beneficiaries select their Part D plan for the coming year between October 15 and December 7, making this the busiest time of the year to conduct Part D reviews. Knowing this, Columbus Health Mart has sent out mailers in advance reminding Medicare beneficiaries that: “Open enrollment is coming up. Contact Columbus Health Mart to schedule a review.” Corner Pharmacy runs radio advertisements, posts signage on sidewalks and uses in-store flyers to create awareness of the store’s Medicare plan review services.
- Still, Part D reviews take place throughout the year. While the busiest time is when beneficiaries select their Part D plan for the coming year, newly eligible beneficiaries can select a Part D plan throughout the year, whenever they become eligible for Medicare. With 10,000 new individuals entering Medicare each day, providing ongoing reviews is a valuable offering. Matovich estimates that Columbus Health Mart conducts 1–2 reviews each week.
- There are opportunities to be proactive. At Corner Pharmacy, when the prices for certain Part D plans increase from one year to the next, Corner Pharmacy may proactively identify which customers were on such a plan in the previous year, and will help these customers see if there are alternative plans that might save them money in the coming year. In all situations, Corner Pharmacy and Columbus Health Mart use government resources to provide customers with unbiased information, and customers always make their own choice on their preferred Part D plan.
- Offering this service can be labor intensive. At Columbus Health Mart, pharmacists will do the final review with customers, but technicians can do much of the work, saving pharmacist time. Technicians load a patient’s drug information and ZIP code into Medicare.gov to identify the best plans for a patient.
- Also become knowledgeable about Medicare Part A and B. While Columbus Health Mart initially began providing customers with information about Medicare Part D — since this part of Medicare deals with prescription drugs — customers are also confused about Medicare Parts A and B, and are looking for assistance. As a result, the team at Columbus Health Mart has also become knowledgeable about Parts A and B, to provide further assistance to customers.
From both Matovich and Zint’s perspective, offering Medicare Part D reviews is an important community service that builds enormous trust and loyalty with customers. It takes time and effort to develop the appropriate expertise, but this investment is worth it in serving the community, providing differentiation versus competition, and building retention and word of mouth.
Getting Started
To pursue this opportunity, Matovich and Zint recommend:
- Learn about Medicare Part D. Go to www.Medicare.gov and review the many other resources about Medicare Part D to become knowledgeable and comfortable answering customers’ questions and providing information to help them choose the best plan for their particular situation.
- Understand the laws. As with any Medicare program, there are rules and penalties for violating these rules. So, before you get started, make sure you understand the rules. For example, a Part D review may not “steer” customers; it may only provide information to help inform customers, who must make their own choices. Also, a Part D review is not to be combined with an MTM session.
- Create processes to manage reviews. Determine the tasks that need to be performed (like entering prescription information) in order to conduct Part D reviews, and who will perform each task. Have clear processes and guidelines so the reviews are done consistently. Schedule reviews when possible, and to improve efficiency, even consider conducting some reviews over the phone. This may be appropriate for customers who are already on a good plan and whose situation hasn’t changed from year to year.
- Promote your service. Send out flyers, post information about this service on your website, run radio ads and consider in-store signage near the pharmacy. Many consumers are confused about Medicare and are looking for help; let them know that you can assist them in this process.
Helpful Resources
To help you become and stay knowledgeable about Medicare Part D, a wealth of resources exists. A few examples are:
- www.Medicare.gov
- Consumer Reports AARP
- Medicare Resource Center
- CMS’s Pharmaceutical, Pharmacy, and Device Manufacturers Open Door Forums
Also, click here to see an interview with Mike Matovich discussing his pharmacy’s experience in building loyalty and word of mouth by offering Medicare Part D reviews.