Helping a Patient Navigate Open Enrollment

Published 12/15/2020
by Kathryn Edwards

This story was shared by Sarah Lancrain, one of Trellis Rx’s pharmacy liaisons who works on-site at a health system in the Midwest.

We care for an oncology patient who has been coming to this health system for a long time. Earlier this year, he informed Maija, our specialty pharmacy liaison, that his insurance situation was changing. Knowing that his specialty medication is very expensive, he asked if the specialty pharmacy team could provide guidance on selecting a Medicare plan during the open enrollment season. Maija added an outreach task in our Arbor® specialty pharmacy technology platform, and in October I received a notification to reach out to the patient.

Insurance benefits are an interest of mine, so I was eager to help the patient find a plan that met his needs and preferences. After identifying several Medicare plans that would provide the simplicity and thorough coverage he wanted, I met with him to discuss his options. Like most people, he had limited understanding of the various “parts” of Medicare. We spent time discussing the benefits of Traditional A and B + optional Medigap + Part D, as well as the benefits of an Advantage plan and why Part D coverage is important. Based on this information, he decided an Advantage Plan would suit him best, so we narrowed his options down to three cost-effective plans with thorough coverage. He ultimately chose a Blue Cross Blue Shield of Minnesota plan because of its reasonable price point and his positive past experiences with the company.

The patient was truly appreciative to have perspective on what his out-of-pocket costs would be under his new insurance plan. He was also grateful to know that the health system’s patient assistance program would assist with the copays for his specialty medication. He told me he sincerely believes in receiving guidance from people with experience in specific industries. Just as he trusts his mechanic with his Harley Davidson tune-ups, he is very happy to have access to health care providers who are willing to provide the attention and time to discuss subjects that feel overwhelming to him.

Why is this story meaningful to you?

This experience was fun for me, because I do really love digging into benefit information to help people identify what choices are best for them. Health insurance is confusing to many people. I find it fulfilling to break down costs and benefits and provide clearly information so people can make their own educated choices.

It was also meaningful to experience how our Arbor® specialty pharmacy technology platform makes it possible for Trellis Rx’s specialty pharmacy liaisons and pharmacists to proactively help a patient with a unique situation like this. I think in another setting, this patient’s needs may have fallen by the wayside.

Why do you enjoy working at Trellis Rx?

I really appreciate how Trellis Rx encourages me and other specialty pharmacy liaisons to give each patient the attention and time required to discuss important topics like insurance. This isn’t always the case in pharmacy, so I am grateful to have the opportunity to be part of a team dedicated to ensuring each patient receives personalized care and support. Our culture and workflows at Trellis Rx are designed to make experiences like this one possible, which benefits our patients and brings me fulfillment personally and professionally.

Interested in growing your career as a specialty pharmacy liaison? Watch our video to learn about professional development opportunities for specialty pharmacy liaisons at Trellis Rx.