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The Medicare Checkup Nobody Told You About | Insights Beyond the Counter · Pharmacy Podcast Network

• 0:05
  Speaker 1: You are listening to the global network of podcasters dedicated
• 0:09
  Speaker 1: to the pharmacy profession. Welcome to the Pharmacy Podcast Network.
• 0:26
  Speaker 1: In this episode of Insights Beyond the Counter, experts from
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  Speaker 1: Outcomes and HealthPilot are Break down Medicare in simple terms,
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  Speaker 1: explain why annual plan reviews matter, and discuss the key
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  Speaker 1: changes coming in 2027 that could affect healthcare and prescription costs.
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  Speaker 1: Here's today's host, Megan Urban.
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  Speaker 2: Hello, and welcome back to Insights Beyond the Counter. I'm
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  Speaker 2: Megan Urban from Outcomes, and today we're talking about something
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  Speaker 2: that's likely to impact almost every single pharmacy in the
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  Speaker 2: country over the next year, Medicare. Now let's be honest,
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  Speaker 2: when most people hear the word Medicare, they immediately think paperwork, regulations,
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  Speaker 2: and a lot of complexity. But what happens in Medicare
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  Speaker 2: doesn't stay in Medicare. It shows up at the pharmacy counter,
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  Speaker 2: it affects what patients can afford, the questions they're asking
• 1:19
  Speaker 2: your staff, and even the opportunities pharmacies have to improve
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  Speaker 2: outcomes and grow clinical services. January is right around the corner.
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  Speaker 2: As we look ahead to 2027, there are some important
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  Speaker 2: trends taking shape. Beneficiaries are navigating new coverage policies, plan
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  Speaker 2: options continue to evolve, and some pharmacies are increasingly finding
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  Speaker 2: themselves in the middle of helping patients understand what that means.
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  Speaker 2: Pharmacies are acting as a translator these days. To help
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  Speaker 2: us break it down, I'm joined today by Dave Nicholas
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  Speaker 2: from HealthPilot. HealthPilot works closely with Medicare beneficiaries every single day,
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  Speaker 2: helping them make informed coverage decisions and understand their options.
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  Speaker 2: We also have Rose Furitani from Outcomes. She's one of
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  Speaker 2: our product owners and subject matter experts. Dave, Rose, thank
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  Speaker 2: you for joining us today. So set the table for us, Dave.
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  Speaker 2: What's actually different about Medicare going into 2027?
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  Speaker 3: Yeah, thanks, Megan. I really appreciate the opportunity to be
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  Speaker 3: here today. So it's interesting because there's not a lot
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  Speaker 3: that's going to be necessarily different from 2026 to 2027.
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  Speaker 3: We've actually seen disruption now for two years in a row.
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  Speaker 3: So last year, many seniors felt the disruption for the
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  Speaker 3: first time in Medicare. Medicare for many, many years was
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  Speaker 3: just kind of advantageous for our seniors in Medicare. They
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  Speaker 3: got a lot of new things, right? They got a
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  Speaker 3: lot of new over-the-counter medications. They got a lot of
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  Speaker 3: new lower copayments. Medicare was always really just in favor
• 2:50
  Speaker 3: of the consumer. But last year for the first time,
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  Speaker 3: due to carrier pressures, we saw some degradation to services
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  Speaker 3: and benefits for the seniors. And that same trend is
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  Speaker 3: going to continue in an even bigger way in 2027.
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  Speaker 3: Just an example, there's about 29 million people that are
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  Speaker 3: on Medicare Advantage plans today. Out of those 29 million people,
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  Speaker 3: what we've seen in the data for January 1st of 2027,
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  Speaker 3: about 5.2 million of those people are going to have
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  Speaker 3: their plan completely changed. Some of them are going to just,
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  Speaker 3: it's going to be called a service area reduction. Their
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  Speaker 3: plan just goes away. It's just gone. So what they've
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  Speaker 3: known in 2026 is gone and no longer for 2027.
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  Speaker 3: And they're going to be thrown into the Medicare ocean
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  Speaker 3: to sink or swim. Many of those 5.2 million people,
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  Speaker 3: the carriers are going to do what they call crosswalk.
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  Speaker 3: They're going to offer a new plan, but it's not
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  Speaker 3: the same plan they've had. And so they're just going
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  Speaker 3: to migrate them over and send them a letter and say, hey,
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  Speaker 3: your old plan went away, but you now got a
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  Speaker 3: new one. Make sure you look at it because it's
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  Speaker 3: a little bit different. And so, right, those 5.2 million people,
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  Speaker 3: that's one in five seniors on Medicare, are going to
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  Speaker 3: have a really massive change. And many of them may
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  Speaker 3: not be fully aware of how that impacts them or
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  Speaker 3: how it doesn't impact them. So it's going to be
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  Speaker 3: a real change for the seniors in Medicare this year,
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  Speaker 3: for the second year in a row.
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  Speaker 2: And I think it's really important for pharmacists to be
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  Speaker 2: prepared for those changes. So let's get specific. Rose, What
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  Speaker 2: does a pharmacist actually see change at the pharmacy counter?
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  Speaker 4: Yeah, so when January 1st, 2nd hits, right, patients are just,
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  Speaker 4: they're kind of coming through the door expecting their refills,
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  Speaker 4: their new medications, they're going to be filled. They're expecting
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  Speaker 4: no hiccups, right? They're assuming that, well, I didn't change
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  Speaker 4: my plan, but, you know, quite honestly, the plan was
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  Speaker 4: good enough for me. So I went ahead and went
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  Speaker 4: with what I had. pharmacy's going to take their new
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  Speaker 4: insurance cards or maybe, you know, any updated information, process
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  Speaker 4: those prescriptions. And to their surprise, they might see a
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  Speaker 4: hard reject, right? They're going to see something from the
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  Speaker 4: insurance that says either medication's not covered, a PA is required.
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  Speaker 4: You know, in some instances, some pharmacies will see that
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  Speaker 4: they're no longer in network and their patients can't even
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  Speaker 4: fill out their pharmacy. They may have gone to those
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  Speaker 4: pharmacy for years and it almost seems like it, kind
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  Speaker 4: of stinks at that point, right? Patients are kind of
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  Speaker 4: stuck in this, well, what am I supposed to do?
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  Speaker 4: They've got to now transfer their prescriptions out. They've got
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  Speaker 4: to go to a different pharmacy that they are not
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  Speaker 4: familiar with and see if that pharmacy will actually cover
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  Speaker 4: those meds or cover them as a patient, right, with
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  Speaker 4: the new plan. You know, this is where reality hits.
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  Speaker 4: Medicare has changed on them. You know, we've got upset patients,
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  Speaker 4: frustrated pharmacy staff, Nobody knows what to do next. I've
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  Speaker 4: seen this when I used to work in the pharmacy.
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  Speaker 4: One big one was when Blue Cross Blue Shield no
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  Speaker 4: longer was covered at our pharmacy, and we had to
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  Speaker 4: just put up a sign that said, if you're a
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  Speaker 4: Blue Cross Blue Shield member, you'll have to take your
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  Speaker 4: prescriptions elsewhere. We'll walk you through how to transfer your
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  Speaker 4: scripts out, but there was tons of patients that had
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  Speaker 4: to do transfers. You know, so as we look at
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  Speaker 4: what that could look like, we want to be able
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  Speaker 4: to avoid that, you know, and as we talk about
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  Speaker 4: what Medicare open enrollment looks like and that's starting soon
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  Speaker 4: in October. So we definitely want to kind of get get.
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  Speaker 2: Going on that.
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  Speaker 3: If you don't mind, I'll just add one more thing
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  Speaker 3: to that. Right. So I talked before about one in
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  Speaker 3: five patients are going to get something completely new to them.
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  Speaker 2: Right.
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  Speaker 3: And at least those people are likely going to engage
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  Speaker 3: a little bit here in October, November, December, because they
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  Speaker 3: have to they have to pick something new. But the
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  Speaker 3: other four out of five people, the other 25 million seniors,
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  Speaker 3: as Rose said, maybe they've had their plan and they've
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  Speaker 3: loved it. And that's the case with my own father.
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  Speaker 3: My dad has had some medical issues. He's had the
• 6:37
  Speaker 3: same plan for 17 years. Here, a local plan in
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  Speaker 3: Wisconsin where he lives, and he's loved it. He's never
• 6:43
  Speaker 3: wanted to change, and he'll never change because he loves
• 6:45
  Speaker 3: the company and they've done really good. Well, he just
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  Speaker 3: got a letter for the first time in his mail
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  Speaker 3: that says the plan you're currently on. Don't worry. It's
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  Speaker 3: good until the end of 2026. You don't have to
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  Speaker 3: take any action right now. Oh, but by the way,
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  Speaker 3: in 2027, this plan is gone and you need to
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  Speaker 3: make a change. Right. And so thankfully, my dad handed
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  Speaker 3: me the letter. Right. And I'll help him navigate that.
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  Speaker 3: But he didn't really understand that that plan is going
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  Speaker 3: to go away. But those four out of five seniors
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  Speaker 3: that aren't going to get that letter. Things are going
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  Speaker 3: to change in their current benefits. To Rose's point, they're
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  Speaker 3: going to have some surprises at the pharmacy. Formularies are
• 7:20
  Speaker 3: going to change. Some drugs that have always been covered
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  Speaker 3: might not be covered anymore, or they might have moved
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  Speaker 3: to a different tier level. What that's going to mean
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  Speaker 3: to the senior is that they're going to walk to
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  Speaker 3: the counter expecting the same $ 5 copayment they had last
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  Speaker 3: year or last week at the end of December. And
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  Speaker 3: the pharmacist is going to say, oh, you owe $ 125
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  Speaker 3: because you've got a higher deductible and it's now a
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  Speaker 3: tier three medication. And that's going to be a surprise, right?
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  Speaker 3: And that's going to end in frustration, maybe tears, right?
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  Speaker 3: Everybody confused. And that, to Rose's point, is exactly what
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  Speaker 3: we'd love to avoid by helping educate everybody here in October, November,
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  Speaker 3: and December. So five out of five are aware. They
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  Speaker 3: all are aware of what's changing around them. So they're
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  Speaker 3: not surprised at the pharmacy counter on January 3rd, standing there, right,
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  Speaker 3: talking to a pharmacist and being very frustrated.
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  Speaker 2: You're absolutely right, Dave. I think what you really hit
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  Speaker 2: on that I heard is why should a pharmacist care, right?
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  Speaker 2: Most of these plans are not necessarily a plan that
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  Speaker 2: people employed at the pharmacy have as their own current benefits.
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  Speaker 2: So it comes back to that question, why should pharmacists care?
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  Speaker 2: And you bring up an excellent point about your father
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  Speaker 2: even having the confusion that came from receiving that letter.
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  Speaker 2: When we see these letters and these elderly population having
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  Speaker 2: these changes, they don't know how to navigate them. So
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  Speaker 2: tell me a little bit more. Why should pharmacists care
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  Speaker 2: about these changes coming up in October for the new year?
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  Speaker 3: Yeah, and I would say the more education we can
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  Speaker 3: give to the senior population, and a lot of times
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  Speaker 3: the pharmacists, right, they're at the forefront of this. At
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  Speaker 3: the pharmacy counter, myself, my father, most of us, we
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  Speaker 3: are at the pharmacy usually once a month at minimum, right,
• 9:11
  Speaker 3: picking up our prescriptions or interacting somehow through the pharmacy.
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  Speaker 3: Most people don't, they only see their primary care provider
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  Speaker 3: once a year or once every six months, right? So
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  Speaker 3: you're seeing the pharmacist in the pharmacy most often. And
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  Speaker 3: what the pharmacy can help with is not that they
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  Speaker 3: have to take on and become Medicare experts themselves, but
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  Speaker 3: to just pass that knowledge to the consumer that says, hey, Mrs. Smith,
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  Speaker 3: you really want to pay attention. You're going to be
• 9:36
  Speaker 3: getting letters from your current plan carrier, or you can
• 9:39
  Speaker 3: go to a tool like HealthPilot, and I know we'll
• 9:41
  Speaker 3: talk about HealthPilot in a few minutes, or talk to
• 9:43
  Speaker 3: your current broker or your agent, just so they are
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  Speaker 3: aware and they're engaging on their own to make sure
• 9:51
  Speaker 3: they understand what is going on, what their current coverage is,
• 9:54
  Speaker 3: because I think the pharmacist can help them by understanding
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  Speaker 3: things are changing. You need to check, right? Maybe two
• 10:01
  Speaker 3: years ago, three years ago, four years ago, it was
• 10:03
  Speaker 3: all positive news. So many seniors didn't check. It was
• 10:05
  Speaker 3: just kind of all goodness. But times are different. So
• 10:09
  Speaker 3: the more we can help educate, and the pharmacy will
• 10:12
  Speaker 3: benefit greatly because they will be able to guide Mrs.
• 10:14
  Speaker 3: Smith in October, November, December to go and get education
• 10:17
  Speaker 3: through tools like HealthPilot or through Medicare.gov or some agent
• 10:21
  Speaker 3: or agency that they're used to. They can go, but
• 10:24
  Speaker 3: just get themselves educated. Because what happens then in January
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  Speaker 3: if they don't is now they're being reactive instead of proactive.
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  Speaker 3: And now Mrs. Smith is upset, in tears, crying, mad.
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  Speaker 3: And the pharmacy and the pharmacy staff is having to
• 10:38
  Speaker 3: deal with it reactively versus if we can be a
• 10:41
  Speaker 3: little more proactive and help guide seniors to go find
• 10:44
  Speaker 3: a tool like HealthPilot, because that will guide you to
• 10:47
  Speaker 3: make sure you are aware and you are understanding what
• 10:49
  Speaker 3: is about to happen to you. So my advice is, right,
• 10:53
  Speaker 3: let's get in front of this and be as proactive
• 10:55
  Speaker 3: as we can by telling all five out of five seniors,
• 10:58
  Speaker 3: all of them need to know, I need to check
• 11:00
  Speaker 3: and I need to engage, whether it's myself or my caregiver,
• 11:04
  Speaker 3: but I need to just make sure I know what's
• 11:05
  Speaker 3: happening around me.
• 11:07
  Speaker 2: Absolutely. And to echo that sentiment, it's all about education, right?
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  Speaker 2: As the pharmacist is the most accessible healthcare agent available today,
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  Speaker 2: the pharmacist has a distinct role as being an advocate
• 11:21
  Speaker 2: for those seniors and guiding them into education, like you said.
• 11:25
  Speaker 2: So I think As you mentioned, we are going to
• 11:28
  Speaker 2: talk about HealthPilot. So going to you, Rose, I really want,
• 11:32
  Speaker 2: as the product expert, I really want to hear your
• 11:34
  Speaker 2: perspective about building the entry point into HealthPilot directly into
• 11:39
  Speaker 2: our pharmacist workflow system. Why was this worth doing? And
• 11:43
  Speaker 2: can you tell us a little bit about how that works?
• 11:46
  Speaker 4: Yeah, I think, you know, when we talked about, you know,
• 11:49
  Speaker 4: having our Medicare plan finder tool you know, there's a
• 11:52
  Speaker 4: gap that we were solving for. You know, pharmacists are
• 11:54
  Speaker 4: getting asked these Medicare questions that they're not sure how
• 11:57
  Speaker 4: to answer, but they're also not sure where to send
• 12:00
  Speaker 4: their patients, right? We can talk about going to medicare.gov,
• 12:03
  Speaker 4: but that website is also sometimes a little confusing and
• 12:06
  Speaker 4: not sure what to do and where to start. You know,
• 12:08
  Speaker 4: and that's why we brought our trusted partner, like HealthPilot,
• 12:12
  Speaker 4: directly into the pharmacy workflow. So pharmacists have a clear
• 12:16
  Speaker 4: and convenient place to send their patients for Medicare support.
• 12:19
  Speaker 4: They'd simply just log into the Outcomes Platform, you'd go
• 12:22
  Speaker 4: to the patient's profile and get to Medicare Plan Finder.
• 12:26
  Speaker 4: At that point, you can simply refer your patient by
• 12:29
  Speaker 4: sending a text message, an email, or even accessing like
• 12:33
  Speaker 4: a printout that you can give to your patient. You know,
• 12:36
  Speaker 4: you can simply just hand it off to them and say, hey,
• 12:38
  Speaker 4: this is what we need to get started, right? You
• 12:40
  Speaker 4: can go ahead and go to the website and be
• 12:42
  Speaker 4: able to actually walk through the HealthPilot portal to be
• 12:45
  Speaker 4: able to find the best plan for yourself.
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  Speaker 3: That's awesome.
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  Speaker 2: I think that it's key to know that it's just
• 12:52
  Speaker 2: another tool that the pharmacist can leverage to guide those conversations.
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  Speaker 2: And again, not leave those seniors just out to dry,
• 12:59
  Speaker 2: especially when they're facing confusion or uncertainty about those healthcare benefits.
• 13:03
  Speaker 2: I think it's awesome that it's integrated into the workflow.
• 13:06
  Speaker 4: Yeah.
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  Speaker 2: So going back to you, Dave, I really want your perspective.
• 13:10
  Speaker 2: So you mentioned a couple of times about how important
• 13:13
  Speaker 2: an annual check or annual checkup is of your plan.
• 13:17
  Speaker 2: What is so important about that? And can you tell
• 13:19
  Speaker 2: me a little bit about what Healthpilot does that approaches
• 13:23
  Speaker 2: this differently?
• 13:25
  Speaker 3: Yeah, for sure. And I might reiterate a little bit
• 13:27
  Speaker 3: of what I said before, right? But it's so important
• 13:29
  Speaker 3: that seniors understand what's changed around them, right? Because their
• 13:31
  Speaker 3: Medicare Advantage plans encompass everything from their hospitalization to their doctors. Again,
• 13:37
  Speaker 3: just checking to make sure your doctor is still in network.
• 13:39
  Speaker 3: Because unfortunately, also, a lot of carriers are negotiating contracts
• 13:43
  Speaker 3: with hospitals and providers. And so your doctor may not
• 13:47
  Speaker 3: be in network next year, and they were this year.
• 13:49
  Speaker 3: So it's just critical that they're looking at this from
• 13:51
  Speaker 3: all aspects, their medical coverage, their hospital coverage. Their pharmacy coverage, right,
• 13:55
  Speaker 3: the formularies themselves, what drugs are covered and how they're
• 13:58
  Speaker 3: covered may or may not change. It's just important to
• 14:01
  Speaker 3: understand all of those moving parts and how they interact
• 14:05
  Speaker 3: at the end of the day for the senior and
• 14:07
  Speaker 3: for their pocketbook and how much things are going to
• 14:09
  Speaker 3: cost them and make sure they are properly covered. You know,
• 14:12
  Speaker 3: at HealthPilot, when the pharmacist sends somebody to HealthPilot, right,
• 14:15
  Speaker 3: they say, They take it off their shoulders because they
• 14:17
  Speaker 3: are not Medicare experts, right? They are not licensed Medicare agents.
• 14:20
  Speaker 3: But the pharmacy can then say, hey, here's a trusted partner, right?
• 14:24
  Speaker 3: And when Mrs. Smith gets that link to HealthPilot, either
• 14:28
  Speaker 3: from the pharmacy tool or from that piece of paper
• 14:31
  Speaker 3: that I handed out, and when they come to HealthPilot,
• 14:33
  Speaker 3: what we are, and we're a little bit different, we
• 14:35
  Speaker 3: are a digital tool, an online tool. I like to
• 14:38
  Speaker 3: think of it as, you know, an easy way to
• 14:40
  Speaker 3: do your research and understand. So we are a full agency.
• 14:44
  Speaker 3: So maybe you don't have to go and talk to
• 14:46
  Speaker 3: another agent afterwards. If you have an agent, I encourage
• 14:49
  Speaker 3: you to use HealthPilot. And then you can go use
• 14:51
  Speaker 3: your agent after you've used HealthPilot. HealthPilot is a digital tool.
• 14:56
  Speaker 3: You can use it on your iPhone, your tablet, whether
• 14:59
  Speaker 3: you have an iPad or a Samsung tablet, your laptop,
• 15:02
  Speaker 3: a computer, really any device. And by going to HealthPilot
• 15:06
  Speaker 3: and entering just a little bit of information about yourself,
• 15:08
  Speaker 3: your prescription drugs you take, your doctors, right, the pharmacy
• 15:11
  Speaker 3: you enjoy to go to, you'll be able to very
• 15:14
  Speaker 3: simply put those things in. I always say HealthPilot was
• 15:17
  Speaker 3: built to be kindergarten simple. I also say it's built
• 15:19
  Speaker 3: to be 85-year-old simple, right? So it is a very
• 15:22
  Speaker 3: simple process. It's not difficult at all. But when you
• 15:25
  Speaker 3: go in and put in your information about you and
• 15:27
  Speaker 3: you click run a quote for me, it'll then go
• 15:31
  Speaker 3: out and it'll tell you, here is the best plans
• 15:34
  Speaker 3: in your area for for you, Mrs. Smith, based on
• 15:38
  Speaker 3: you as an individual. And it's going to guide you.
• 15:40
  Speaker 3: And it may even show you your current plan. Your
• 15:42
  Speaker 3: current plan may show up as the third choice in
• 15:45
  Speaker 3: the option list. That's a flag that says there may
• 15:48
  Speaker 3: be something better for you. But inside this tool, it'll
• 15:50
  Speaker 3: navigate it to walk you through everything about your current plan,
• 15:53
  Speaker 3: the other plans that are in your area, and it'll
• 15:55
  Speaker 3: really help you understand. And you can see as much
• 15:58
  Speaker 3: detail or as little detail. You can then use that information.
• 16:02
  Speaker 3: If you have an agent you love, Get some knowledge
• 16:06
  Speaker 3: for yourself and then take that knowledge as you talk
• 16:08
  Speaker 3: to your agent. Because many agents out there that are
• 16:11
  Speaker 3: individual agents that live in certain areas, they may only
• 16:14
  Speaker 3: sell two or three certain carriers. You may come to
• 16:17
  Speaker 3: them with something that you saw in HealthPilot that says, right,
• 16:20
  Speaker 3: you don't want A or B or C, and maybe
• 16:22
  Speaker 3: that's all they're selling. So you don't care about option D. Well,
• 16:26
  Speaker 3: HealthPilot may show you option D might have been your
• 16:28
  Speaker 3: best option. So as you talk to your agent, you
• 16:30
  Speaker 3: can surface that and start having an engaged conversation. I
• 16:33
  Speaker 3: would love it. You can also just enroll through HealthPilot, right?
• 16:36
  Speaker 3: So we make it so easy when you see those recommendations,
• 16:38
  Speaker 3: you can click a simple button and you'll enroll and
• 16:41
  Speaker 3: it'll all go through behind the scenes. You don't have
• 16:43
  Speaker 3: to do anything further. But I would just encourage you,
• 16:45
  Speaker 3: HealthPilot is a very simple, easy to use tool for
• 16:47
  Speaker 3: you to do research, education, help teach yourself as a senior,
• 16:52
  Speaker 3: bring your caregiver in if you have a son or
• 16:54
  Speaker 3: daughter that helps you with those things. It's very easy
• 16:57
  Speaker 3: and you don't have to get on a phone and
• 16:58
  Speaker 3: talk to somebody for two hours. You know, I've worked
• 17:00
  Speaker 3: in some of those call centers. I'm a licensed agent myself, right?
• 17:03
  Speaker 3: Many times the agents, when you're working with them, they're very,
• 17:06
  Speaker 3: I don't want to say pushy, but they're going to
• 17:07
  Speaker 3: tell you, oh, you have to enroll soon or you
• 17:10
  Speaker 3: might miss the window. And you're going to feel pressure.
• 17:12
  Speaker 3: HealthPilot is not going to pressure you. It's a research tool.
• 17:15
  Speaker 3: You can engage yourself and enroll at the end if
• 17:18
  Speaker 3: you choose to. Or again, you can just build your knowledge.
• 17:20
  Speaker 3: So it's built to really be an educational way for
• 17:23
  Speaker 3: you to make sure you understand what's going on around you.
• 17:26
  Speaker 2: Truly, it's about making those informed decisions, which I think
• 17:29
  Speaker 2: you have resonated so clearly throughout this time that it's
• 17:33
  Speaker 2: about making informed decisions, not only for your own healthcare,
• 17:36
  Speaker 2: but for what your caregivers may experience if they are
• 17:39
  Speaker 2: brought into the process as well. So thank you for
• 17:41
  Speaker 2: that insight. I really want to switch gears and talk
• 17:44
  Speaker 2: a little bit about the importance of the enrollment periods.
• 17:48
  Speaker 2: So Rose, can you walk us through a little bit
• 17:50
  Speaker 2: about what the timelines look for the enrollment periods for Medicare?
• 17:55
  Speaker 2: I know that here in October, 1-1 feels so far away.
• 17:59
  Speaker 2: So why are we talking about it now? And what
• 18:02
  Speaker 2: are the key dates that someone needs to know if
• 18:04
  Speaker 2: they are Medicare eligible?
• 18:06
  Speaker 3: Yeah.
• 18:07
  Speaker 4: So when you're Medicare eligible, open enrollment starts on October
• 18:11
  Speaker 4: 15th and ends on December 7th. So this is usually
• 18:14
  Speaker 4: around the same time, you know, we've got flu season
• 18:16
  Speaker 4: coming around and we're having these conversations with our patients on,
• 18:21
  Speaker 4: you know, vaccines. But at the same time, we've got
• 18:23
  Speaker 4: to talk about Medicare, right? Medicare is coming soon. Let's
• 18:25
  Speaker 4: start talking about what those plans look like and maybe
• 18:29
  Speaker 4: just starting. I mean, I have some pharmacies who are
• 18:31
  Speaker 4: scheduling appointments to get ready for open enrollment, right? We
• 18:35
  Speaker 4: may not be able to see the plans yet, but
• 18:37
  Speaker 4: on October 15th, we'll be starting to get those plans in.
• 18:40
  Speaker 4: So it's definitely time to start making the plans, maybe
• 18:43
  Speaker 4: not having the conversations quite yet, but maybe putting up
• 18:45
  Speaker 4: the signs and, you know, getting things going until then.
• 18:49
  Speaker 3: Yeah, Megan, and I'll add one more to that, right?
• 18:51
  Speaker 3: So as Rose mentioned, October 15th to December 7th, it's
• 18:55
  Speaker 3: everybody's window to to make their change, right? So that's
• 18:58
  Speaker 3: their time that they can change their plan, make sure
• 19:00
  Speaker 3: they understand what they're going to enroll in for January 1st,
• 19:04
  Speaker 3: 2027 effective date. But they have that window. If they
• 19:07
  Speaker 3: don't do it by December 7th, they can't do anything
• 19:10
  Speaker 3: for the rest of December. They have to be done
• 19:12
  Speaker 3: by December 7th. They will, however, on January 1st, unfortunately,
• 19:18
  Speaker 3: if you do have some patients that missed the window
• 19:21
  Speaker 3: in October 15th to December 7th, People do have an
• 19:25
  Speaker 3: opportunity on January 1st until March 31st. There's a period
• 19:29
  Speaker 3: called the open enrollment window that they can make a
• 19:33
  Speaker 3: one-time change. It's very limited. But if you have somebody
• 19:35
  Speaker 3: that missed the window, and again, I'm going to say
• 19:37
  Speaker 3: it's so important that we guide people in October, November,
• 19:40
  Speaker 3: December to get engaged, make the right choice. If they
• 19:44
  Speaker 3: missed that window or they thought, ah, nothing's changed, I
• 19:47
  Speaker 3: love my plan, and they walk to your counter on
• 19:50
  Speaker 3: January 3rd and they are surprised and they are in tears.
• 19:54
  Speaker 3: All's not lost. There is a window from January 1st
• 19:57
  Speaker 3: till March 31st that they can make a one-time change
• 19:59
  Speaker 3: that you can guide them to, but it's pretty limited, right?
• 20:02
  Speaker 3: So they can only go from a Medicare Advantage to
• 20:04
  Speaker 3: a like Medicare Advantage, but they can go to a
• 20:06
  Speaker 3: different one, but they get one time to fix their mistake.
• 20:09
  Speaker 3: I will. And so again, I just encourage everybody, use
• 20:12
  Speaker 3: the annual enrollment period, the October 15th to December 7th,
• 20:16
  Speaker 3: educate pharmacies, guide people to go educate, make sure everybody's aware,
• 20:22
  Speaker 3: not just a few, not just the one out of five,
• 20:25
  Speaker 3: but five out of five. Every single senior needs to
• 20:27
  Speaker 3: make sure they understand their shopping this year.
• 20:30
  Speaker 2: Absolutely. I think five out of five would always be
• 20:32
  Speaker 2: the key takeaway because you can't make an informed decision
• 20:35
  Speaker 2: if you don't have the information available to you. So
• 20:38
  Speaker 2: Thank you for adding in especially that January timeframe as well.
• 20:44
  Speaker 2: So as we're wrapping up, Dave, Rose, I really want
• 20:47
  Speaker 2: to get your last insights on this conversation today as
• 20:51
  Speaker 2: we're rounding out the topic. If a pharmacist were to
• 20:54
  Speaker 2: take one thing away from this conversation heading into October,
• 20:58
  Speaker 2: what should that one thing be? Dave, I'll start with you.
• 21:02
  Speaker 3: Yeah, thanks. So, you know, and I'll probably be repeating
• 21:06
  Speaker 3: what I've been saying this whole time, but it's just
• 21:07
  Speaker 3: so important, right? When I think of my pharmacist, not
• 21:10
  Speaker 3: just the pharmacist, but the pharmacy itself, right? The whole
• 21:12
  Speaker 3: staff that's there when I visit them, right? I think
• 21:15
  Speaker 3: of they're always dispersing medication and it's a critical need, right?
• 21:18
  Speaker 3: Everything that they give to me that my doctor orders
• 21:20
  Speaker 3: and they're able to fulfill that and answer questions. And
• 21:22
  Speaker 3: they are really a medical expert that we rely on
• 21:25
  Speaker 3: more than even our doctors. So it's such an important
• 21:28
  Speaker 3: message that I think I can leave with them. is
• 21:31
  Speaker 3: beyond just dispersing that medication, I think especially in this
• 21:34
  Speaker 3: window for our senior population on Medicare to dispense some
• 21:38
  Speaker 3: knowledge to them. You don't have to be the Medicare experts.
• 21:41
  Speaker 3: So you're not dispensing your Medicare knowledge and trying to
• 21:43
  Speaker 3: do this yourselves. But just dispense some knowledge to them.
• 21:46
  Speaker 3: Help educate them that you need to look. There are
• 21:49
  Speaker 3: tools out there like HealthPilot. You need to educate yourself
• 21:52
  Speaker 3: and make sure you are aware. And if you're not aware,
• 21:55
  Speaker 3: they're there to help you. I mentioned we're a digital platform.
• 21:58
  Speaker 3: We also have customer service agents that they can pick
• 22:00
  Speaker 3: up a phone and call. They can text us. We'll
• 22:02
  Speaker 3: work with them to make sure they know what's going
• 22:05
  Speaker 3: to happen around them for that 1-1-2027 plan. Great.
• 22:10
  Speaker 2: And Rose, what about you? Same question. What is the
• 22:13
  Speaker 2: one thing you would want the pharmacist to take away
• 22:15
  Speaker 2: from this conversation today?
• 22:17
  Speaker 4: Yeah, I think just remembering that, you know, a lot
• 22:19
  Speaker 4: of patients, they don't get access to a lot of information.
• 22:22
  Speaker 4: They may also make it bombarded with tons of information
• 22:25
  Speaker 4: that they just don't quite understand. So when you have
• 22:27
  Speaker 4: a patient standing in front of you, they might experience
• 22:31
  Speaker 4: a plan change and they don't know it. You know,
• 22:33
  Speaker 4: you don't have to be the expert, like Dave said,
• 22:35
  Speaker 4: but you can be the person to just ask them
• 22:38
  Speaker 4: the right questions before an unexpected cost changes and catches
• 22:42
  Speaker 4: them by surprise. You know, we don't want to, we
• 22:45
  Speaker 4: want to avoid, you know, what January 2 could potentially
• 22:48
  Speaker 4: look like. And we want to make sure that, you know,
• 22:51
  Speaker 4: you do have a chance to make a real difference
• 22:53
  Speaker 4: for these patients.
• 22:55
  Speaker 2: Thank you, Rose. As we've discussed today, Medicare changes don't
• 22:58
  Speaker 2: affect plans and policies alone. They affect the real conversations
• 23:02
  Speaker 2: happening at the pharmacy counter every single day. The pharmacies
• 23:05
  Speaker 2: that stay informed and help patients navigate these changes will
• 23:09
  Speaker 2: be the ones in the best position to strengthen the relationships,
• 23:13
  Speaker 2: improve our outcomes, and continue delivering that exceptional patient care.
• 23:18
  Speaker 2: I want to just take a moment today and say
• 23:20
  Speaker 2: a big thank you to our partners at HealthPilot for
• 23:23
  Speaker 2: joining us and sharing their insights about the upcoming Medicare
• 23:26
  Speaker 2: changes for 2027. And to our listeners, thank you for
• 23:29
  Speaker 2: spending a few minutes with us. If you found today's
• 23:32
  Speaker 2: discussion helpful, please be sure to subscribe and share it
• 23:35
  Speaker 2: with your team. Until next time, thank you for listening.