Outreach to members with high drug costs

During Medicare’s Open Enrollment (October 15th to December 7th ) Prescription Advantage will be reaching out to members with high drug costs to encourage them to compare Part D plans for next year.  There may be a better plan available that could lower your cost.  The information listed below explains this outreach project and also includes the letter that members will receive.  All letters will be mailed by October 9th.   A new Medicare plan year begins on January 1, 2015.  If your Part D plan has a deductible, you will pay the entire amount which may be as much as $320.00.  Once the deduction is paid, your part D plan will pay for covered drugs and you will pay the plan’s co-payment.  When the total combined amount paid by your drug plan is $2,960, Prescription Advantage co-payment assistance will begin.  Because your drug costs increased this year, we encourage you to review the Part D plans available for 2015.  There may be a plan that can lower your expenses.  The  MCPHS University Pharmacy Outreach Program (MCPHS) will assist with this project by reviewing the Part D plans using Medicare’s plan finder, identifying any lower-cost plan options that are available, and, if the member wishes to change plans, MCPHS can assist the member with the enrollment process or refer them to Medicare or the Part D plan.   Prescription Advantage identified 1,721 members that had a total drug cost ranging from $450 to more than $1,000 each month for a (3) month period. From this total 1,225 members had monthly drug costs of $600 or higher.  These 1225 members will receive a letter along with a list of medications that the member is currently taking.  This medication list was prepared using information from the members claims submitted to Prescription Advantage.  If the member would like to have the drug plan options researched the member must review the list, edit if necessary, and return it using the postage -paid address envelope provided.   These drug lists will go to MCPHS for review.  Initial phone calls have been made to these members to explain the outreach project and to let them know that the letter and drug information list will be arriving soon. The remaining 496 members had a monthly drug cost of $450 -$599.  These members will receive a letter encouraging them to review their Part D plan options for 2015 and to contact SHINE, MCPHS or Medicare for assistance if needed.  There may be a plan that will lower your costs. If you have any questions, please call the Prescription Advantage Customer Service at   1-800-243-4636 and press 2 to be connected to a service professional.  PLease call the North Andover Senior Center to