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Latest news and updates about the Medicare and pharmacy industries.

Open Enrollment Period for Medicare Advantage Plans Begins January 1

Posted on in Industry Updates by Amplicare Team

Open Enrollment may be ending, but patients enrolled in Medicare Advantage (MA) plans still have time to make adjustments. During the extended Open Enrollment period from January 1 and March 31, patients unsatisfied with their current benefits will have the opportunity to find coverage that works better for them. Beneficiaries have the option to switch to a different Medicare Advantage plan or return to Original Medicare. Keep in mind, during this three-month window, they are only allowed to make one switch. 

The popularity of Medicare Advantage plans has grown significantly over the past decade with more than 20 million Medicare beneficiaries enrolled in MA plans in 2018. Between 2017 and 2018, total Medicare Advantage enrollment increased by about 8%. In 2018, one-third of Medicare beneficiaries were enrolled in a Medicare Advantage plan. The Congressional Budget Office projects that this number will only continue to grow, anticipating that plans will include about 42 percent of beneficiaries by 2028. 

Compared to Original Medicare, Medicare Advantage plans have closed doctor networks and some plans also offer additional benefits such as hearing, dental, and vision coverage. For pharmacies, this serves as another opportunity for you to offer your knowledge and expertise to your Medicare Advantage patients as they determine which plans are best suited for their individual needs.

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How does Amplicare help your pharmacy during this time? Conducting Medicare Advantage plan comparisons requires weighing many factors in addition to prescription drug benefits as MA plans are considered all-inclusive health plans. Using a plan comparison tool such as Amplicare helps you narrow down your patients’ plan options and determine which types of MA-PDP plans would be best for them. You can also help patients break down their total out-of-pocket costs, including costs for all health and medical services outside of drug out-of-pocket costs.  

Another important consideration for Medicare Advantage plan comparisons is the limited doctor networks of these plans. This means patients may not be able to see certain doctors if they were to switch to a new plan. Patients must confirm the doctor network for potential MA plans they are considering. Our new doctor lookup tool checks the network status (including any restrictions) of a patient’s primary care physician as well as additional doctors they would like to confirm. 

Additionally, the Open Enrollment report available during the traditional Medicare Open Enrollment period will be available exclusively for MA patients during this extended enrollment period. This will help you target your communications to patients most in need of your help.

While the annual Open Enrollment period is soon coming to a close, the opportunity to guide patients as they choose plans continues.

Access the tools and resources to help your Medicare Advantage patients. Schedule a demo today to get started.  

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