Medicare Part D. How to Use to Compare and Enroll in a Drug Plan

Size: px

Start display at page:

Download "Medicare Part D. How to Use to Compare and Enroll in a Drug Plan"

Harold Harris
5 years ago
Views:

Medicare Part D How to Use www.medicare.

1 Medicare Part D How to Use to Compare and Enroll in a Drug Plan 56 Main Street, Suite 202 Springfield, VT (Fax) 1

2 Go to Click on Compare Drug and Health Plans 2

3 To do a general search, type in Beneficiary s zip code Click on Find Plans

For a more personalized search enter required information 05156 123409876A Smith If your information is accurate this step will often provide the Beneficiary s current Medicare Part

4 For a more personalized search enter required information A Smith If your information is accurate this step will often provide the Beneficiary s current Medicare Part D status: Name of Part D Plan, Federal Benefits and if available, a saved Drug list. This works best when Beneficiary has been in and currently has a drug plan. Click on Find Plans 4

Click on relevant choice for How do you get your Medicare coverage. If doing a General Search click on Original Medicare. Click on relevant choice for help or how you pay for your Medicare drug costs.

5 Click on relevant choice for How do you get your Medicare coverage. If doing a General Search click on Original Medicare. Click on relevant choice for help or how you pay for your Medicare drug costs. Depending on how you answer you may need to answer a pop up follow up question. NOTE: If your personalized search was successful you will not see this page Click on Continue to Plan Results Click here for General Search 5

If you have information about a saved drug list, enter the drug list ID in the white box on the right with the password date. Click on Retrieve my drug list.

6 If you have information about a saved drug list, enter the drug list ID in the white box on the right with the password date. Click on Retrieve my drug list. If you do not have information about a previously saved drug list, Enter first drug in white box at the left of the screen until you have added all of the Beneficiary s medication (do not add over the counter medications). _ 6

7 We have used Simvastatin as an example The website provides the generic Simvastatin and the brand name Zocor Click on +Add Drug for the appropriate choice * You can search alphabetically, but that is often more difficult. A Google search helps with identifying medications; class of drug, dosing, Medicare exclusions, spelling etc. 7

8 Next the website provides a list of common dosages for the drug you have entered. Check the dosage, fill in the qty and check the frequency to match the Beneficiary s needs Click on Add Drug and Dosage 8

You have just added a drug Notice to the right of your entered drug there are three edit buttons if needed: to change a dose, add another dose or remove the drug completely Continue to add

9 You have just added a drug Notice to the right of your entered drug there are three edit buttons if needed: to change a dose, add another dose or remove the drug completely Continue to add all current prescription drug medications until the list is complete Make note (or print) of the Drug list Id and Password date in Box at top right corner. Click on My Drug List is Complete 9

10 Select up to two pharmacies by clicking on Add Pharmacy If your pharmacy does not show in the list, increase the miles at the top of the green box, or add zip code to find. or You can select I don t want to add pharmacies now if you don t want specific pricing, or have no need for the pharmacy. 10

11 This screen shows the pharmacies added and allows you to modify your choices. Note at left, the Beneficiary Profile continues to be visible from one step to the next. 11

12 12

If Beneficiary is looking for a Drug Plan Only-Click Box for Prescription Drug Plans (with Original Medicare) x X X OR If Beneficiary is looking for a Medicare (Advantage-Part C) Health Plan that

13 If Beneficiary is looking for a Drug Plan Only-Click Box for Prescription Drug Plans (with Original Medicare) x X X OR If Beneficiary is looking for a Medicare (Advantage-Part C) Health Plan that will cover prescription drugs- Click Box for Medicare Health Plans with drug coverage Click on Continue to Plan results OR You can fine tune your search by adding filters shown listed on the left of the screen. These filters are useful if Beneficiary is specifically interested in a plan that will meet State and Federal premium guidelines, a plan without a deductible and/or a plan that will cover all of the beneficiary s drugs (but it may limit your choices). _ 13

14 Your Plan Results screen first lists the beneficiary s current plan if the information was provided at the beginning of the search (under Original Medicare, See page 4) and The annual estimated costs of the Beneficiary s Original Medicare including monthly premium, co-pays and deductible. 14

15 Under Prescription Drug Plans is a list of drug plans available in the State of Vermont in order of Lowest Estimated Annual Drug costs. The annual Estimated drug costs includes drug plan monthly premiums, deductibles and drug costs at the pharmacy of choice. Each plan listing includes the plan premium, deductible, drug restrictions info and Plan ratings. Clicking on the Blue Yes or No after Formulary or Restrictions will provide further details National Plan Plans with a Blue Circle with the Letter N are national plans. Important benefit for Beneficiaries who spend time out of state. To compare plans with even more detail click the box in the first column. Check 3 max. Click Compare Plans 15

16 This shows your 3 choices side by side. 16

17 This detail makes it easier to compare plans by itemizing the various costs side by side. At any time you can highlight the drug plan name and see details of that plan specifically. 17

As you scroll down through the screen the cost of each of the beneficiary s drugs is compared across the three plans Scrolling further the screen provides a snapshot of what the monthly costs will be

18 As you scroll down through the screen the cost of each of the beneficiary s drugs is compared across the three plans Scrolling further the screen provides a snapshot of what the monthly costs will be for the beneficiary. Remember the monthly cost includes not only the cost of the drugs but the plan s monthly premium as well. Our Simvastatin example does not demonstrate the donut hole scenario, but with a long list of drugs this screen would show when in the year the beneficiary might fall into the donut hole and when they may or may not reach the other side before year end. _ 18

After estimated monthly costs you will see Drug coverage information; specific drug restrictions such as Prior Authorization, Quantity Limits, Step Therapy Click on

19 After estimated monthly costs you will see Drug coverage information; specific drug restrictions such as Prior Authorization, Quantity Limits, Step Therapy Click on Quantity limits to get actual amounts the plan will cover per month You can continue to compare plans three at a time until you find a plan that most closely meets your need. _ 19

Example: When Client has Extra Help or Medicaid If you have done a personalized search and learn that the Beneficiary has extra help listed under Current Subsidy found here

20 Example: When Client has Extra Help or Medicaid If you have done a personalized search and learn that the Beneficiary has extra help listed under Current Subsidy found here on the Enter your Drugs page proceed as previously noted. You can also see what that detail is by looking at Important Coverage Info. The Plan information will look different 20

When a Beneficiary receives Extra Help or other Federal Subsidy such as Medicaid and you have done a personalized search, the Beneficiary s current

21 When a Beneficiary receives Extra Help or other Federal Subsidy such as Medicaid and you have done a personalized search, the Beneficiary s current drug plan will appear at the top of the list on the Your Plan Results Screen. This feature is especially helpful during the Annual Enrollment Period. _ 21

Note Premiums and Deductibles Compare Plan results will show premium, and deductible adjustments associated with the Beneficiary s subsidy. The yearly benchmark amount is set by Medicare (2012= $32.

22 Note Premiums and Deductibles Compare Plan results will show premium, and deductible adjustments associated with the Beneficiary s subsidy. The yearly benchmark amount is set by Medicare (2012= $32.04) So premiums that show more than $0.00 are over the Federal Benchmark amount. As soon as the benchmark is determined the information is provided to the Department of VT Health Access, and the SHIP offices. Drug plan prices can also be found in the back of the Medicare & You Booklet each year. Plans are listed by Lowest Estimated Annual Costs, and comparisons can be done by selecting 3 plans at a time to look at details. 22

23 When you are ready to Enroll find the blue Enroll button associated with the Plan of choice (on the compare Plans screen, see left, it is at the far right under each plan). On the screen where you are comparing three plans at a time the Blue Enroll button is at the top of the screen under the Plan contact information. Click on Enroll 23

24 To Enroll: Click Enroll button Next to desired Plan The next screen provides information about Open enrollment dates, effective date of coverage and Special enrollment periods. 24

25 The list on this screen is a list of the specific situations that will allow a drug plan enrollment outside of Open Enrollment. If you do not find your beneficiary s particular situation in this list, your beneficiary is not eligible to enroll in a drug plan at this time and will have to wait until the next Open Enrollment Period, October 15 through December 7 th. Click on Continue Enrollment Note: VPHARM allows 1 extra special enrollment during the year and Medicaid up to 1 per Month. 25

26 This screen shows the Four Steps to Complete a Drug Plan enrollment. Make note: Are you enrolling in the Plan for the year you require and is the Plan name represented the Plan in which you wish to enroll. 26

27 If your beneficiary is enrolling in a plan outside of open enrollment, read and check all the options that apply to the beneficiary s situation Click on Continue 27

28 Fill in Personal Information. It is vital that this information is correct. The name provided should match the Beneficiary s Medicare Card precisely. 28

29 Continue to fill in contact information. Note that both a permanent residence and mailing address should be provided if they are different When complete, click on continue 29

30 Fill in the Medicare Claim number from your card. DO NOT GUESS. 30

31 Paying your Plan Premium: the website automatically selects Have the Plan bill me monthly. We recommend this option to our clients because if you decide to change plans from one year to the next and Social Security has been deducting it from your benefit monthly, it often happens that for several months your old plan and your new plan premiums will both be deducted, until the paperwork catches up. A refund will eventually be paid for overpayments but it does take time. Click on Continue 31

32 Continue to fill in information as required. Will you have other coverage refers to either state or federal assistance programs. If your beneficiary is in VPHARM or getting Extra Help from Social Security for example you would check Yes. Vpharm/SPAP Soc. Sec # State of VT Name of Other Coverage ID for this Coverage Group # for this Coverage Are you a resident in a long term care facility Click on continue 32

33 Step 2: Review The Next Screen provides a summary page of the information you have just provided. Check the information to be sure it matches your records; if not hit Back to Beginning Button to edit or if all looks okay hit the. Agree/Submit Enrollment Button Step 3: Read and Submit Are you the person enrolling or a Representative of enrollee Do you agree to the etc. Step 4: Confirmation Page Review the confirmation page. Print one for you records and one for the Beneficiary s records (this action may vary per Agency but is recommended). You may also it. 33

34 Presented by: State Health Insurance and Assistance Program 56 Main Street, Suite 202 Springfield, VT June 2012

Medicare Part D Drug Presentation

Medicare Part D Drug Presentation May 8, 2018 The Insurance Committee under the direction of the NCRO Board has developed the following slide presentation that provides a step by step guide to using the