Medicare Pricing
Transparency That Benefits the Beneficiary and the Broker
In the past, beneficiaries have noted that drug pricing estimates are often inaccurate by being both lower or higher than what they currently pay at their pharmacy.
By combining estimated pharmacy prices by zip code with Blue Button 2.0 claims data, the Trusty Select Pro pricing model creates an accurate drug cost estimate with completely traceable roots.
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Unique drug-pricing capabilities
Trusty Select Pro calculates the data from both the carrier and beneficiary
Access
Blue Button 2.0 integration provides:
- Medicare claims details
- Beneficiary Rx costs
- Health plan memberships
Analysis
Trusty Select Pro calculates:
- Insurance carrier Rx cost commitments*
- Current beneficiary drug costs paid at the cash register
*Insurance carrier information includes reports to CMS that show what they've committed to paying for a drug within a region (county) monthly.
Results
Trusty Select Pro recommended (if any):
- Changes for drug coverages
- Medicare plan updates
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Out-of-pocket cost estimates
Trusty.care prices are based on the price the beneficiary pays in their area, not on an industry average. This ensures more accurate costs in line with your client’s preferred pharmacy. The more beneficiaries who use Blue Button 2.0 to import their data, the closer Trusty Select Pro gets to the in-store costs seniors pay for their medications.
How it benefits your business
Price transparency reduces uncertainty for both broker and beneficiary.
With health plan member and Rx data coming from the beneficiaries zip code, Trusty.care delivers up-to-date information that shows where they can save using numbers they can confirm.
The pricing model builds broker knowledge.
Transparency in drug pricing demands a different skill set from a Medicare agent. A data-driven analysis will replace “gut feelings.” As a result, drug pricing discussions with beneficiaries can become more structured and focused.
Brokers can save time during AEP and throughout the year.
Agents can connect to ALL of their current beneficiaries at once via a bulk text provided by our Instant Drug and Review tool. Armed with these analytics, they can then target only those where it may be good to change drug plans.
How it empowers the beneficiary
Prescription drug costs have quickly become a problem for those seniors needing medications. For many, an affordable Medicare plan that meets their needs and efficiently covers the costs of prescriptions becomes a significant stressor in their lives.
A platform like Trusty Select Pro seamlessly integrates with a beneficiary’s current drug plan and their chosen pharmacy’s pricing. Comparing that data to like plans in an easy-to-understand format empowers the beneficiary (with help from their broker) to select their best options each year.
A trusted resource for year-round insight
Medicare costs and covered benefits may change from year to year. And though AEP creates an opportunity for people with Medicare to reexamine their coverage, it’s an exercise that should be done regularly during the entire year.
As a broker, capturing changes in a beneficiary’s drug data throughout the year will be essential in creating an accurate baseline of your client’s pharmaceutical history.
So not only will you have valuable insight during AEP to offer the best drug plan suggestions, but you’ll also have the opportunity to check in with them more than once a year.
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