Medicare
Community pharmacies provide cost-saving medication and pharmacy services to millions of Medicare Part B and D patients. Congress and the Centers for Medicare and Medicaid Services (CMS) are making changes to the program all the time. This section lists important changes that community pharmacists should know.
As Medicare beneficiaries review their 2020 Medicare Part D choices, you are sure to get an abundance of questions, so be prepared. The Open Election Period, or OEP, for beneficiaries runs October 15- December 7. NCPA has produced resources with specific information for the 2020 year to help you in assisting your patients.
Resources
2020 Medicare Part D Pharmacist Quick Reference Guide
2020 Medicare Part D Fact Sheet
Bagstuffer for Patients and Caregivers about Annual Election Period
Ensuring Seniors Access to Local Pharmacies Act – H.R. 4946
Medicare beneficiary access to prescription drugs is impeded by mandates from insurance middlemen
(pharmacy benefit managers or PBMs) that effectively dictate which pharmacy to use based on
exclusionary “preferred pharmacy” arrangements between PBMs and, often, Big Box or mail order
pharmacies. Independent community pharmacies are not allowed to participate in some of these
arrangements, even if they offer to accept the Part D plan’s same contract terms and conditions. This can
raise access issues for patients in underserved and rural areas in which independent community
pharmacies are predominantly located, which means seniors in these communities often face either
higher copays or trips of 20 miles or more to a "preferred" pharmacy .