Get to know more about the Medicare Part D 2022 Plan here!
Following are some noteworthy observations made:
- The Donut Hole discount for brand and generic drugs will be 75 percent for beneficiaries. Just as in the preceding year, those who reach the Donut Hole phase could move through it at a faster rate because pharmaceutical suppliers portion counts towards the patient out of pocket threshold.
- If beneficiaries purchase medications with an average retail value below $370/month, they will not enter the Donut Hole phase.
- CMS projects that the average basic monthly premium will be $33, a 4.9% increase from 2021.
Eligibility Requirements for MTM:
Plan sponsors must auto-enroll targeted beneficiaries who meet the eligibility criteria
Beneficiaries are considered enrolled unless they decline enrollment
Targeted beneficiaries for the MTM program are enrollees who meet all the following criteria:
- Have multiple chronic diseases
- Plan cannot require more than 3 as the minimum for eligibility
- Are taking multiple Part D drugs
- Plan cannot require more than 8 Part D drugs as the minimum number
- Are likely to incur annual Part D drugs cost that meet or exceed threshold of $4,696.
- Classified as an at-risk beneficiary under a rule effective for January 1,2022 – defined with the use of frequently abused drugs
Information on the Top 10 Prescription Drug Plans!
Open Enrollment: October 15th – December 7th
Understanding Medicare Part D can be a challenge for customers and pharmacists. Keeping up to date with these changes will keep your stress to a minimum. As 2022 is offering new plans to the mix, learn as much as you can about all plans and how they will affect your patients, as well as your pharmacy. Get involved and educate as many employees as possible to be able to answer questions.
There are several Medicare Plan Finder Tools that you can use:
- Prescribe Medicare – PrescribeWellness Solution
- Amplicare – Freedom Data Systems Solution
- www.medicare.gov – Federal Government offers this at no cost
As a part of FPN, we have Prescribe Wellness Solutions that pharmacies now have access to at no cost. Pharmacies now have complete and complimentary access to the PrescribeWellness Medicare Plan Review solution. Look out for an email from us to learn more about this!
Through our partnership with Aspire Health, PPSC can help navigate the challenges associated with open enrollment. To learn more about our solutions, please connect with your PPSC Inside Sales Representative.