Presenting Part D Plans

Plan presentations are straightforward for Part D.

You’ve put in the work to find which product fits, now you need to communicate those plan details to the client.

Before we dive into what you’ll be presenting, let’s touch on a few disclaimers.

First, you’ll want to use a client facing tool to do this like Medicare dot gov, Integrity’s PlanEnroll tool, or a carrier’s client-facing website.

Second, requirements for plan presentations vary from carrier to carrier. We’re providing a general overview here but refer to the Part D plans’ required policies before presenting them to your client.

With those disclaimers behind us, let’s dig into what you’ll be presenting.

To start, you should review the cost of their prescribed drugs in each plan.

You should also review how their costs will change through the year as they move through different coverage stages and if they will be impacted by drug management tools like prior authorization, step therapy, or quantity limits.

Then, review their pharmacy options.

Like a network, Part D plans will have preferred and standard pharmacies.

Prescriptions filled at a preferred pharmacy tend to cost less than a standard pharmacy.

Similarly, your client may have access to additional savings using a mail-order pharmacy through the plan as well.

Review the costs for the client’s preferred pharmacy and how those costs compare to other options they may use.

This comparison helps the client understand their costs throughout the year and at different pharmacies.

And, of course, ensuring the client understands their anticipated costs with each plan, that’s the goal of your plan presentation!

After you present each plan and discuss options, your client should be ready to select and enroll in a plan.

You’ll learn more about enrollment in our next lesson!

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