Medicare Drug Benefit: IFAS Outreach: Part II

1
Part D

• Medicare Drug BenefitIFAS Outreach Part II
• Traci Brooks Lacey Dillard, Senior Pharmacy
  Students
• University of Florida College of Pharmacy
• Carolyn S. Wilken, PhD, M.P.H
• Associate Professor Family Science
• University of Florida
• David M. Angaran MS, FASHP, FCCP
• Clinical Professor of Pharmacy
• University of Florida College of Pharmacy
• IFAS Program
• V8 033006

2
Expectations from the Case Studies

• Importance of an accurate drug history
• Determine patient preference
• Navigate www.Medicare.gov
• Entering appropriate client information
• Common missteps and results

3
Case 1 - Marie

• Important information
• She has no drug benefit
• Qualify for extra help
• Social Security (SS) partial, award letter
• Generics OK
• Maries Zip Code
• 33404

4
Case 1 Important Points

• Choosing Fosamax dosage regimen
• Changing doses of drugs when entering
• Impact of partial SS on plan selection and cost
• Medication History collection
• Needed but unused meds

5
As you can see, there are questions that need to
be answered when the client is eligible for
additional help
6
Pick the one the client is taking
7
(No Transcript)
8
(No Transcript)
9
(No Transcript)
10
(No Transcript)
11
Didnt Mark Additional Help

• .

• .

12
Checked Full Help Instead of Partial Help

• .

.
13
Update 30 Day Dosage Quantities Weekly vs.
Monthly
14
Undiscovered Fosamax
15
Unchecked Generic Substitution Brand Drugs
16
Case 2 - Elizabeth

• Important Information
• Select PDP
• Wants to use Westlab Pharmacy
• Generics OK
• Elizabeths zip code
• 32607

17
Case 2 Important Points

• How to find preferred pharmacy and those
  contracted with the selected plans.
• OTC products are not covered by any PDP.

18
(No Transcript)
19
(No Transcript)
20
(No Transcript)
21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
24
(No Transcript)
25
(No Transcript)
26
Out of Network Pharmacy
27
Case Scenario 3 - George

• Important Information
• Medicare information provided
• Interested in Medicare Advantage plan (HMO)
• Generics OK
• Georges Zip Code
• 33619

28
Case 3 Important Points

• Finding MA-PDs (HMO)
• NOT comparing MA-PDs (HMO) beyond premium,
• Explain relationship between part B and MA-PD
  advantage (HMO)
• NOTE MA-PDs (HMO) are VERY zip code dependent

29
(No Transcript)
30
(No Transcript)
31
(No Transcript)
32
(No Transcript)
33
(No Transcript)
34
(No Transcript)
35
Monthly Health Premium Only Seen with Advantage
Plan
36
(No Transcript)
37
(No Transcript)
38
So Many Drugs.. Be Careful!
39
Did Prescription Drug Plan Only
40
Changing Quantities Once a Month vs. Once a Week
41
Things we are NOT talking about

• Clients with insurance coverage from a previous
  employer or VA.
• Medications that are not taken year round
• Comparing MA-PDs.