Medicare is making a big change to its enrollment period that could benefit new and existing members – but create more work for already-swamped health plans.
Starting next year, Medicare Advantage enrollees will have from Jan. 1 to March 31 to choose the health plan that is right for them, according to the Centers for Medicare and Medicaid Services (CSM). That period had previously ended more than a month earlier, on Feb. 14.
Medicare Advantage members can make changes to their plans during that window, including:
– Switch to a different Medicare Advantage plan that is a better fit for them
– Drop Medicare Advantage in favor of Medicare Part A and Part B
– Enroll in a stand-alone Medicare Part D prescription drug plan (although Medicare Advantage plans already include prescription drug coverage)
– Drop their stand-alone Medicare Part D Prescription Drug Plan
While Medicare Advantage plans offer terrific benefits, including all Part A and Pat B benefits, prescription drug coverage, vision and more, plans can change from year to year. Covered medications, for example, are a common change. That’s why enrollees may consider switching plans.
Health plans should be preparing for the longer enrollment period – and the ability to switch plans – now.
Make sure your data is in order and that the process for members is as seamless as possible. Your website should be updated and easy to navigate so members aren’t confused about their options. And most importantly, your members need to know the change is happening in the first place.
Marketing is key here. It’s important that every new and existing member knows what to do as of Jan. 1 through your website, emails and all other marketing materials. Education is crucial so that members understand what to do and avoid choosing the wrong plan for them.
TV, radio and newspaper ads are also options to ensure the word is out.
It’s going to be a lot of work – complicated work that many plans don’t have the time or expertise to accomplish properly. That’s where Tier 1 Pharmacy Consulting can help.
The Tier 1 team will ensure CMS compliance by developing and reviewing all of the formularies and updating marketing materials. We can also ensure your downstream entities like your PBM are prepared for a longer enrollment period and that monitoring and oversight is in place to ensure compliance with CMS standards. Contact us today.
About Tier 1
Tier 1 Pharmacy Consulting is a Denver, Colorado-based pharmacy benefit consulting firm offering customized services to healthcare plans that offer prescription drug benefits. Whether your health plan is big or small, Tier 1 offers strategic, cost-saving solutions that boost the plan’s overall value and help its members by providing high quality care.
Tier 1’s founder is a clinical pharmacist with more than a decade of experience in pharmacy benefit management. We are passionate about collaborating and developing effective strategies to improve health plan outcomes.
Tier 1 offers health plans a new perspective on how to manage their pharmacy benefit. Our team is made up of experts who strive to make effective plans even stronger and fill in any gaps due to a lack of time or resources.
We’re here for you. Drop us a note at firstname.lastname@example.org and let’s get connected.