Some of the highlights of the show include: 

• The two most common times Medicare beneficiaries are able to make changes to their prescription drug coverage
• The downfalls of not selecting drug coverage
• What Zach and Nick do to ensure their clients get the right prescription coverage
• The differences between the four different tiers of Medicare Part D prescriptions
• The four different stages of prescription drug plans
• What the maximum deductible is for 2020
• How prescription drug plans operate a lot like car insurance
• What the Medicare doughnut hole is and why it’s a bear for so many people
• Why beneficiaries are most likely to complain about Medicare Part D vs. other types of Medicare
• What patients should do if they are prescribed a drug that isn’t on their plans
• Why it’s important for Medicare beneficiaries to choose a national drug chain as their pharmacy
• What Aetna has in store for 2021
• What the process of enrolling in a prescription drug plan looks like
• And more!

Quotes

“These drug plans are regulated by the government and Medicare, and there's only certain election periods throughout the year that people can make changes or elect different coverage, so we get complaints about these plans non-stop throughout the year.” — Nick

“Your Tier 1 drugs are typically going to be the most inexpensive in most cases. Lots of drug plans offer these drugs free of cost. Tier 2 are going to be preferred generics in a lot of cases or non-preferred generics that are a little more expensive but still relatively inexpensive; Tier 3 are going to be your brand name drugs, and Tier 4 are going to be your specialty drugs, like cancer drugs.” — Nick

“You're going to pay the full cost of your prescriptions until you get through the deductible phase of your prescription drug plan.” — Nick

“The reason the doughnut hole can be such a bear is for people that have higher, more expensive medications, their cost-sharing within this period goes up pretty substantially.” — Nick

“We're going to be able to tell you when to expect to hit that doughnut hole, or if you're going to hit it at all, or when you hit that catastrophic phase moving forward there.” — Zach

“We always try to make sure when we're running PDPs for our clients, you know, making sure—a lot of them like those little local drugstores; we try to get them to at least check the big chains out there in case they do travel.” — Zach

“The key is always to choose a preferred pharmacy for lower drug costs. That's always the key.” — Tausha

“CVS is now allowing patrons to use PayPal, which I think is pretty cool. And then possibly in the future, they might be able to use Venmo as well.” — Tausha

“I just really wanted to just highlight the support that CVS Aetna has given around COVID-19. We waived all COVID related copayments, and I think what's probably stands out the most for me is that we opened multiple COVID-19 testing sites throughout the United States where we kind of had those hotspots. And CVS acted quickly and implemented those hotspots to help with testing.” — Tausha

Links:

• Aetna: https://www.aetna.com/

Transcript

Announcer: Welcome to our fireside chat with Seniors Living Healthy, the podcast that helps prepare and educate you as you enter and live out your golden years. With over 10 years of experience, Nick and Zach are experts in the senior market and are here to help you live a healthy, full life. And now fireside with your hosts, Nick Keene and Zach Haire.

Zach: Hello, and welcome to episode three of our inaugural season of Seniors Living Healthy. I'm your host Zach, and here with me, as always, is Nick.

Nick: Hey, folks.

Zach: So, this month's episode, we're going to talk about Part D of Medicare, which is your prescription coverage. Nick, what is our number one complaint?

Nick: Prescription drug plans, no doubt, Zach. For whatever reason, these drug plans are regulated by the government and Medicare, and there's only certain election periods throughout the year that people can make changes or elect different coverage, so we get complaints about these plans non-stop throughout the year.

Zach: That's right. With our hands being so tied, it's really, really hard. We can't tell the future. So, we can't see what people are going to be doing, taking prescription-wise down the road; really, all we can do is what's working for them there in October when those annual enrollment period comes. So, I know we've touched there briefly on enrollment period but, Nick, what are the two most common times people can enroll in drug coverage?

Nick: So, the two most common times people can make changes to their prescription drug coverage is going to be their initial enrollment period when they first become eligible for Medicare, which is a three-month window both before and after their eligibility, and then also the annual enrollment period, which is that period from October 15th, through December 7th each year, that they're allowed to make changes to that coverage.

Zach: Great. Yep, definitely. Yeah, those are our two most common times. There are a couple of different scenarios out there. If you guys want to subscribe to our newsletter, that’s something we'll, kind of, touch in that, here in the next couple days we'll be getting out to you guys, to see the different options you may have out there enrollment-wise. So, Nick, when we were working with people looking at things, what should our clients keep in mind when we're working with them to select a drug plan? Because like I said, we can't tell the future?

Nick: Sure, absolutely. So, Zach, what we try to do is find the best drug plan and drug coverage for our clients at the time. Not only that, but we want to make sure people newly eligible to Medicare know about the downfalls of not selecting drug coverage, whether that's being penalized for not having credible coverage through Medicare prescription drug coverage, group insurance, or retirement benefits, whether that is someone who is not taking prescriptions and just thinks they don't need it, we want to make sure they're not getting penalized. We also want to make sure that folks have the best drug coverage for them. So, it's our job to ask questions to make sure that we're informed, that we take care of our clients.

Zach: Definitely, yeah. Trying to put the client there first is always want to make sure we get what works best for them. So, moving forward there, looking at the different parts of the prescription plan, the first thing we want to cover there are the tiers. Prescriptions are broken down into various tiers, that kind of breaks them down into cost, types of prescription, things like that. Nick, you want to touch on those real quick, what the different tiers are, and what that means.

Nick: Yeah, absolutely. So, Zach, the way the tier system works, and by the way, Medicare is who is dictating what prescriptions are in what different types of tiers based on their cost. So, your Tier 1 drugs are typically going to be the most inexpensive in most cases. Lots of drug plans offer these drugs free of cost. Tier 2 are going to be preferred generics in a lot of cases or no...