There’s one thing Medicare clients ask their agents more than anything else: How can I save money on prescription drugs? Let us help you answer that question!
Whether your client is enrolling in a stand-alone PDP or a Medicare Advantage Prescription Drug plan, considering a plan’s formulary is only part of the decision. In order to save your clients money, it’s just as imperative to examine the preferred pharmacies for each plan.
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A preferred pharmacy is one that’s part of a Medicare drug plan’s network, in which the member may pay lower out-of-pockets costs for some prescription drugs. Conversely, a standard pharmacy refers to the pharmacies that still participate in your plan’s network, but charge a higher copayment or coinsurance than a preferred pharmacy.
When analyzing a plan, the directory will outline which pharmacies are considered in network and out of network. Your clients will want to go to pharmacies that are within their plans’ network to avoid high out-of-pocket costs. And the next step is just as important. Once you distinguish which pharmacies are in network, you should determine which of those pharmacies are preferred and standard. Knowing the differences between these two and explaining them to your clients could lead to significant financial benefits.
Put it into Practice
Let’s use an example of Tier 1 generic drugs from one of our carriers. For a 90-day supply at a preferred pharmacy, a member could pay $3. For the same 90-day supply at a standard pharmacy, the member could pay $18. That’s six times more for the exact same product!
Unfortunately, many members are unaware of these lower costs and just choose the same pharmacy they’ve been going to for years. But if they knew there were options that could benefit them financially, they may be more inclined to choose them. Perhaps instead of your clients switching pharmacies entirely, the best course of action may be to find a PDP that includes their local pharmacy as preferred. This way, they can keep their day-to-day life the same while saving more money.
Most carriers have a pharmacy look-up tool that helps people find pharmacies that are not only within their plans’ network, but also which ones are preferred.
Most carriers have a pharmacy look-up tool that helps people find pharmacies that are not only within their plans’ network, but also which ones are preferred. Many of them will even show the exact address of the pharmacies and allow you to search by zip code. With this information so readily at your fingertips, a little research can end up saving your clients a lot of money.
At your next sales appointment, be sure to start the preferred pharmacies conversation with your clients. Ritter’s Regional Team or Carrier Representatives (depending on your request) can help you find plan directories and teach you how to use pharmacy look-up tools. They can also help you determine whether or not your client’s pharmacy is preferred. Saving your clients money in any way possible is a surefire way to satisfy your customers and build lasting relationships.