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Drug chains provide help in sorting out PDPs

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NEW YORK — As Medicare recipients continue to explore the various prescription drug plans (PDPs) available, community pharmacies across the country are helping beneficiaries understand their options.

“This year there are substantial savings available to beneficiaries in Medicare Part D, so it’s important they learn as much as possible about their options to realize these benefits,” says Richard Ashworth, vice president of pharmacy operations at Walgreen Co. “Our pharmacists are among the most trusted and accessible sources for help with making an informed plan choice.”

Just as at Walgreens, pharmacists at a host of other drug chains are helping Medicare beneficiaries comprehend the intricacies of the various prescription plans available to them and helping them choose the plan that best fits their needs.

Medicare beneficiaries have until December 31 to enroll in a prescription plan.

Meanwhile, at least one retailer — Walmart — has seen rising interest in its cobranded plan. A joint effort with Humana Inc., the Walmart Preferred Rx Plan is the lowest-price option available to Medicare patients.

“As the world’s largest retailer, Walmart is uniquely positioned to help drive down the costs associated with prescription medications,” says Dr. John Agwunobi, president of Walmart’s Health and Wellness division.

Unlike many Medicare Part D plans that have a varying cost structure based on where a person lives, the Humana Walmart plan features one nationwide monthly plan premium of $14.80. According to Walmart and Humana officials, the plan could reduce a Medicare beneficiary’s health care spending in 2011 by more than $450.

Nearly 18 million Americans rely on a stand-alone Medicare Part D plan for their prescription drug needs, and health care experts expect that number to grow to 26 million by 2015.

Seniors account for a third of all prescriptions in the United States and, on average, people enrolled in stand-alone Medicare Part D plans fill 42 prescriptions per year.

“There are important decisions to be made during Medicare Part D enrollment that can affect one’s health care costs in the coming year,” points out Mitch Betses, vice president of retail pharmacy operations at CVS, who adds that the choice of a plan often involves the input of people other than the Medicare beneficiary.

“Caregivers can play a big role in helping their loved ones make the right choices, and CVS/pharmacy has the tools to help simplify the process,” he says.

Besides its pharmacists helping patients understand the various plans available to them, CVS is offering help online. Seniors can access the 2011 Medicare Plan Finder at cvs.com/medicare to compare plans. The site also lists helpful information and provides answers to questions about Medicare Part D plans.

Similarly, Walgreens and Rite Aid Corp. are offering detailed analyses of the various plans available to Medicare recipients.

Rite Aid, for instance, is providing a variety of free resources, including a Medicare Part D for Seniors guide and the Web-based Medicare Advisor.

At Walgreens, pharmacists can provide a free Part D plan comparison report that makes it easier for Medicare beneficiaries and caregivers to choose a plan for the first time or determine if their current plan is still the best fit for their needs.

“Our free report simplifies the decision-making process by providing information tailored for each individual in a way that makes it easy to compare Medicare Part D plans,” Ashworth says. “Even if there have not been changes to their current plan, seniors need to consider how their needs may have evolved over the year. In some cases, people have not reevaluated their plan costs since they enrolled four years ago, even though their medications may have changed.”

Under the health care reform law passed earlier this year, there have been some significant changes to the Part D program, and many plans that were offered in 2010 will not be available next year. For example, the new law has made it easier for seniors to cover their prescription costs after their expenditures reach what was previously a coverage gap.

Seniors who reach this so-called doughnut hole will get a discount of about 50% on most branded drugs and 7% on generics.

The federal government estimates that the average Medicare Part D beneficiary who reaches the doughnut hole next year will save $500 because of these new discounts. Under health care reform, the Medicare Part D coverage gap will be phased out by 2020.


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