Tips for Surviving "Blizzard Season" in the Access Space by Angie Lee

Tips for Surviving “Blizzard Season” in the Access Space
By Angie Lee

Open enrollment, also known as “Blizzard Season,” is one of the busiest and most complex times for biologic coordinators. With the influx of insurance changes, prior authorizations (PAs), and patient assistance program (PAP) renewals, it can be a challenging time. Here are some strategies to keep you organized, proactive, and ready to support your patients effectively through this critical period.

1. Get Ahead with Field Reimbursement Managers (FRMs)

Your FRMs are invaluable resources during Blizzard Season. Take these steps to ensure you’re on top of all updates:

• Proactively Reach Out: If you haven’t received a list of patients needing PAs or PAP renewals, contact your FRMs as early as possible. They can provide updated lists and highlight any changes to the renewal processes, saving you from last-minute surprises.

• Clarify PAP Changes Early: Many PAPs update their requirements annually. By understanding any changes to applications or appeal requirements upfront, you’ll avoid issues as deadlines approach.

2. Engage with Patients Proactively

Ensuring patients understand their options and changes in their coverage is key to avoiding coverage gaps:

• Discuss Medicare Part D Plans: For Medicare patients, early review of Part D options can prevent future issues. Guide them to resources like the Medicare Plan Finder or trusted tools like HeyMoe.com to compare plans and check coverage for biologic treatments.

• Promote the Medicare Prescription Payment Plan: In 2025, Medicare will cap annual drug costs at $2,000, providing substantial savings. Explain the benefits to eligible patients and encourage them to consider this option for cost savings.

3. Organize Patient Assistance Program (PAP) Renewals

Staying on top of PAP renewals reduces the risk of treatment interruptions:

• Prioritize Expiring Applications: Begin by identifying PAPs requiring annual renewals and organize patients by expiration date. For Medicare patients with low income, assist with Low-Income Subsidy (LIS) applications if needed.

• Document Renewal Requirements: Maintain a checklist of each PAP’s renewal requirements. This tool can help you track application statuses, PA requirements, and any additional appeal steps, ensuring you don’t miss critical steps.

4. Set Up Tracking Systems

Effective tracking can be a game-changer during Blizzard Season:

• Create a Master Tracker: Whether it’s a spreadsheet or dedicated software, track each patient's PA and PAP renewal status, deadlines, and required documentation. This master tracker should be updated frequently to ensure patients don’t fall through the cracks.

• Flag High-Risk Patients: Identify patients at risk of a coverage gap and reach out early. Discuss coverage alternatives and possible assistance options, so they have the support they need before it becomes urgent.

5. Stay Informed on Policies and Tools

Blizzard Season brings policy changes that impact both you and your patients. Staying up-to-date is critical:

• Know the Medicare Changes: Familiarize yourself with the 2025 changes, including the $2,000 cap, LIS/Extra Help, and new payment plan options. Share these updates with patients who could benefit, especially those on fixed incomes or who face high prescription costs.

• Lean on Support Networks: Tap into all available resources such as FRMs, access programs, and coordinator networks. Many PAPs offer dedicated support to coordinators during Blizzard Season to help navigate renewals effectively.

6. Plan Your Communication Schedule

Good communication is essential in maintaining a smooth workflow and reducing patient confusion:

• Set Regular Check-Ins: For patients needing additional support, set up a check-in schedule. Weekly check-ins may be helpful during peak times, with bi-weekly follow-ups as things start to settle.

• Be Clear and Organized: When contacting patients, ensure you have all relevant information on hand. Whether discussing Medicare options or PAP renewals, organized and concise communication makes a big difference in helping patients feel secure.

Additional Resources

Here are a few extra resources that may ease the load during Blizzard Season:

• National Council on Aging (NCOA): NCOA’s BenefitsCheckUp is an excellent tool to help patients explore benefits they may qualify for, especially those with limited incomes.

• Medicare Plan Finder: Encourage patients to use the Medicare Plan Finder to compare Part D plans, as it offers up-to-date coverage details on specific medications.

Conclusion

Blizzard Season can be overwhelming, but by proactively organizing and engaging with your resources and patients, you can make it a manageable period. Implementing these tips and accessing valuable resources will allow you to support patients effectively while maintaining your own workflow efficiency and peace of mind.

By taking these proactive steps, you’ll navigate Blizzard Season with confidence and ensure a smoother experience for both you and your patients.