By Dr. Diana Rangaves, PharmD, RPh and Ryan Haddock
As of October 2021, almost 64 million people use Medicare plans for their health insurance. A patient’s Medicare plan determines their premium, out-of-pocket costs, the services included, the doctors and pharmacies they can use, and the quality of care they receive.
For these reasons, it is crucial for patients to choose the right Medicare plan. However, the sheer volume of Medicare plans available makes choosing the right plan more difficult than it should be. Without the right tools to compare options efficiently, seniors who choose the wrong plan could end up jeopardizing their health or their financial well-being.
There are plenty of online options and software solutions out there that help patients choose a Medicare plan. However, some help more than others. So, what can patients do? And, as their pharmacist, how can you help?
It’s Hard for Patients to Choose the Best Plan on Their Own
Patients often have trouble choosing the best Medicare plan by themselves. Even with access to a Medicare plan comparison tool, they may not understand the differences between plans, making it hard to choose wisely.
The most popular and well-known plan comparison tool is Medicare.gov. Unfortunately, while this tool can help a patient find an affordable plan that can cover their medical needs, it doesn’t necessarily help preserve existing provider relationships. Medicare.gov doesn’t consider the patient’s chosen pharmacy when showing plans, so it might recommend plans that put your pharmacy out of network. This severs the trusted pharmacist-patient relationship that benefits both patients and the pharmacy alike.
Aside from Medicare.gov, many other plan comparison tools also fall short. Some do not allow users to compare Medicare Advantage plans with Medicare Part D plans, making it hard for patients to evaluate which is right for them. Others only show health plans from certain insurance carriers instead of providing all the available options. Others only show Medicare Advantage plans.
How Pharmacists Can Use Medicare Comparison Software to Help Patients
After years spent building a relationship with their doctors and their pharmacy, most patients don’t want their Medicare plan to force them to find new ones. They’re more comfortable when their doctors and pharmacists are familiar with them, their medical needs, and their financial situation.
The best plan comparison tool considers the patient’s needs and well-being along with the interests of your pharmacy. Using a plan comparison solution like Medicare Match from EnlivenHealth®, you can help patients choose the right Medicare plan for their individual healthcare and financial needs while also ensuring that they can continue using your pharmacy.
Choosing a health plan can be overwhelming for patients. Assisting your Medicare-eligible patients with this task strengthens the pharmacist-patient relationship. A 2020 proprietary study by EnlivenHealth showed that Medicare-eligible patients were 30 percent more likely to stay with a pharmacy that performed a plan comparison for them.
Conclusion
There are a lot of options out there for patients who need help selecting a Medicare plan — but that doesn’t mean they’re the same. While numerous online tools and software solutions are available to help patients choose a Medicare plan, few ensure that they choose the ideal option for their medical and financial needs.
As a pharmacy, you can provide Medicare plan comparisons that empower your patients to choose a plan that is right for them. And when you’re the one guiding them through the process, it benefits your pharmacy, too.