Assisting Clients With Medicare Part D Enrollment

1. Assisting Clients With Medicare Part D Enrollment April 10, 2019 Ellen McAngus-Jones, LCSW UNC School of Medicine

2. Medicare Part D • Optional prescription drug coverage for individuals eligible for Medicare Parts A and/or B • There are windows of eligibility for enrollment • During Initial Enrollment Period when first eligible for Medicare • Annually between October 15-December 7 (Annual Election Period) • Patients eligible for SPAP or Extra Help can enroll or change their plan without penalty • In order to receive SPAP a client MUST be enrolled in an active Medicare Part D plan • Option to enroll in Medicare Advantage Plan

3. Ways to Enroll in a Medicare Part D Plan • Finding the plan that’s right for you • What to look for? • Monthly Premium • Deductible and Out of Pocket Maximum • Coverage of specialty tier medications • How do I enroll? • Using the Medicare Plan Finder • https://www.medicare.gov/find-a-plan/questions/home.aspx • Complete paper enrollment form • Call the insurance company • Call 1-800-MEDICARE for over the phone assistance • Contact your local SHIPP Counselor • http://www.ncdoi.com/SHIIP/Default.aspx or call 855-408-1212

4. Enrolling Online Option 1: Option 2:

5. Selecting Medicare Status

6. Entering Medication List & Selecting Pharmacy

7. Choosing Your Plan

8. Tips For Helping Clients Choose a Plan • Client’s Priority • Coverage vs Cost • Premium vs Deductible • Out of Pocket Maximum • Select the top three plans that match the client’s needs • Compare the levels of coverage • Allow client to make decision

9. Comparing Plans

10. Confirming Enrollment Eligibility

11. Next Steps • Provide requested demographic information • Select how to pay premium • Deduct from SSA benefit • Receive a monthly bill • Print copies of enrollment confirmation for you and client • Client will receive Medicare Part D card in the mail within 60 days • Plans can be changed during yearly enrollment periods (October-December) • Consider applying for Extra Help

12. Resources • Applying for Extra Help • https://www.ssa.gov/benefits/medicare/prescriptionhelp/ • Need help enrolling in Part D? • https://www.ncdoi.com/shiip/Search_For_a_Counselor_By_County.aspx • Call toll free 855-408-1212 • Patient Advocate Foundation • Helps with copay relief for the donut hole • https://www.patientadvocate.org/connect-with-services/copay-relief/

13. Thank you!! Contact Information: Ellen McAngus-Jones, LCSW 984-974-0710 Ellen_mcangus@med.unc.edu