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People can choose not to take many of the drugs that doctors prescribe. I have turned down meds that doctors told me that I had to have or I would die. I'm still here.
One thing I have discovered with Part D plans is that the one sure thing is that no matter which plan you choose, you will be prescribed something that it doesn't cover, or only partially covers!
Getting older for me is frightening, not because I'm aging, but because I don't know how I am going to survive off SSI and SSDI with no job pension. Single no children and no husband. 😢
I am in Florida, not getting an advantage plan,also not getting standard G or N. Going to be G high deductible. About $60 to $70.a month. Worse case on a bad year 2,800 out of pocket. I will stash that much away. I get Medicare in less than a year
Yes, and be sure to see if you qualify for the "Extra Help" plan. Many people do and don't realize it. If your income from two years ago exceeds their limit they'll notify you by mail and you have 60 days to enroll in a plan D. Specialty doctors like cardiologists usually have a storage room full of medications provided by their pharmaceutical reps. If you have a heart valve replaced and need a blood thinner like Eloquis they be happy to provide it for a few months. Hope this helps, thanks!
Unfortunately my husband's cardiologist office told him they could only give him 2wks and told him not to become dependent on them for this med. (Eliquis)
I’m glad you recommended “compare”as an option. I’m on a statin and a couple of other RXs. I find between Optum Perks and Good RX apps and Costco pharmacy pricing, I’m not hitting my Part D deductible at all. If you are on lower cost drugs, you get more savings by shopping than by your Part D plan choice. I’m on the cheapest part D plan available without concern of the benefits.
Thank you. Many more people need to be aware of the "compare options". Cuban's Cost Plus Drugs and the Canadian Pharmacies are also worth exploring. My understanding also that you do not need to be a Costco member to utilize the pharmacy.
@@mazy03 I have Wellcare also and am puzzled how it has gone to zero per month? You know why it went to zero? I'd call and ask, but I'd get somebody in the Phillipines who knows nothing.
We pay 113. 40 each because we needed coverage through the donut hole. I can't imagine premium increase, increased deductable and then a 2000. Out of pocket cap. So these new plans make you pay the 2000 out of pocket up front.. On top of that. We take expensive meds. I got sick after covid vaxx.
Two years ago I had part D for 5 years then two years ago I wanted to change insurance companies and I was out of the plan for ONLY 2 weeks then new plan charged a penalty. They are a bunch of THIEVES!
Just like car insurance if you drop it without a new one in place at same time you are penslized..you should know what the rules are before you start making changes. That's on you to know what you are doing.
That will work for some, but not all conditions. Cancer, Parkinson's Disease, Multiple Sclerosis are a few examples of diseases that medications are necessary.
I just started September 1st i do have Wellcare STAND ALONE DRUG PLAN AND ONLY ORIGINAL MEDICARE A AND B PERIOD ❤ BECAUSE I DO NOT NEED TO PAY MONEY BEFORE I AM SICK. I CANNOT AFORD A MEDIGAP PLAN BUT I HAVE A TON THAT WILL COVER MY BILLS IF I HAVE TO BE IN HOSPITAL. THANK YOU MR MARVIN FANTASTIC VIDEO ❤
I have regular Medicare and a supplement plan but no part D. I get most of my medical care from the Indian health service including prescriptions from the pharmacy. If I should ever need an expensive drug that they don’t carry I can get a letter of creditable coverage and sign up for a part D plan with no penalties. If the timing is bad I guess I can sign into the Indian hospital and let them take care of it.
I am an enrolled member of a Native American tribe. The Indian health service runs clinics and hospitals all over the country for tribal members. Right now I use a large clinic near my home for primary care, lab work, pharmacy, dental and vision.
Hi Marvin, I have a question. If you need an expensive medication not on the formulary of your drug part D plan and you pass the 2k out of pocket spent, is your part D plan required to.pay for the medication ?
Medicare will not cover any medication not on your formulary regardless of the out-of-pocket max but you can get a letter from a doctor explaining the necessity of the medication to get it added to your formulary, however.
One thing I am doing and will do is if I have a covered drug, but I use a non-insurance way of buying it, such as GoodRX, Cost Plus drugs, or Walmart’s low-cost Prescription Program, I will save the receipts and submit them to my insurance drug plan. The idea is to get it credited against my deductible and my $2000 cap. My insurance company company, Aetna, seems to be ok with it. As are most companies. It certainly pays to ask them if they will take such receipts and apply them.
Try contacting the drug manufacturer and ask if they have any assistance programs. Don't worry about it if you think your income is too high. Let them be the judge of that. Most manufacturers have 3 types of assistance: finds set aside for people on Medicaid, funds set aside for people on Medicare, and funds set aside for people with regular insurance. Some manufacturers also work with special pharmacies that lower the price, but you have to get the medication by mail-order only. Best of luck!
Plan D sounds about as confusing as anything! LOL, One thing that isn't entirely clear to me (I'm still 4+ yrs away from Medicare) is that there are different premium prices for different Part D companies, and I completely get the part about your formulary and seeing that any meds you take are in that... But if someone is relatively healthy and maybe even taking NO meds, or just one or two common generic meds, and they go for the cheaper plan because their meds are in the formulary, but, unbeknownst / unexpectedly they need a new med that is very expensive a couple of months down the road, and that med or equivalent is NOT in the formulary, that means what, they are stuck paying full cash price until the Oct 15-Dev 7 window? Yikes? I'm thinking like a chemo drug or something exotic, but necessary.
Marvin also mentioned something about having your doctor fill out some kind of form to get a non-formulary med placed into your formulary. Without going back and watching again, I can't recall the details but he did mention it. He said it "usually gets approved".
You are right don't go without a ( Creatable) drug plan for more than 63 days. Plan Premium $3.70 Penalty $8.70. I had to appeal their penalty (2) times and I won. Excellent Video.
Medicare should charge same style penalty when Medicare Advantage Plans fail!!! 40% of American retirees will be re-entering Medicare Supplemental Plans. Only fair way to deal with issue.
Actually the medication costs are going to be capped at $2000. The base premium will go up $2.08. Yes 2 dollars and 8 cents. There will be NO prescription "donut hole" which was a gap Before the cap you could have to pay $5000 in copays THEN be in a gap and pay at least 25% of the medication costs until a set amount is paid, then the gap closes.for an example- if you pay $5 a copay for your $100 medication- and you get into the gap, you will have to pay 25% ( $25) in the "hole" of the donut. You will be in the donut until you and your plan spends $8000. IN 2025 THERE WILL BE NO GAP AND YOUR COSTS ARE CAPPED AT $2000 A YEARS THANKS TO OUR GOVERNMENT.
I heard that when the Biden administration found out the insurance companies were going to raise the monthly premiums way up they said hold on a minute we'll give you billions of dollars to keep quiet for a little while.Thats because they were going to be increased just before the election.
I purchased Medicare A And B and G high deductible at 65..From 58 to 65 had no insurance and paid the Obama care fine several times. 20 to 58 had employer insurance and mostly never used it i did keep teeth cleaned regularly and so this seems to be the only ongoing medical exspense since i also had braces as a kid. I dont use tobacco products, alcohol, coffee or tea. Dont use recreational drugs and seldom take a over the counter med. On a fixed income and paying Medicare A and B and G high deductible since 65. It sure takes a big bite out of monthly income. I am almost 67 , play basketball, ride bike's, walk a lot I do pay for house and car insurance and even added a earthquake rider. Seems all my money goes out to insurance companies. I have not turned on SS or started getting retirement payments yet . Putting it off since the longer i wait seams my IRA grows and SS will pay the most at 70. I have No debts, house paid off. But monthly income sure has been effected by the Medicare A and B and HiD G payments. Why pay for yet another insurance Plan D for drugs when not likely to use it. The 95 $ a month for the average drug plan could be used for smoothies at a local shoo. They take fresh fruit in a blender with ice , almond milk etc . This costs 4.50 $ each. Have 4 utilities to pay and more importantly look forward to pay my small tithing, fast offerings, and humanitarian donations. This i make monthly. I also have Property taxes due in November. etc. Is there a cheaper D Plan ?
I knew somebody like you who said I'm healthy and don't need meds, so I'm not going to take Part D. I told her we are getting older and at some point we will all be taking meds, and maybe very expensive drugs. She declined Part D. Then months later, came down with a conditon that required her to get an expensive med filled regularly, for hundreds each time. Then she joined a Part D plan and now will pay the higher premium for life. Choices have consequences. By the way, when is the movie coming out? I heard they are talking about having George Clooney play you?
$2,000 drug limit is just cost shifting by the government to insurance companies on to us the users. Result is higher monthly premiums, and/or reduced benefits - drop free gym membership, no dental, no eye care, no hearing aid coverage, no more incentives to get vaccinations or annual wellness visits or shopping, travel incentives. After several years into retirement now can you really switch back to traditional Medicare with a G or N Medi-gap plan plus a Part D drug plan and not pay significantly more out of pocket each month?
No thanks.I'll stick to my Kaiser Senior Advantage, not just because it has saved me thousands of dollars, but because I think it gives me better, more reliable healthcare. As an integrated system, things don't fall through the cracks which, when I was a practising physician in fee for service medicine, I saw quite often.
I so have a Kaiser Senior Advantage plan but for years they have denied me help for my spinal problems. At one point they were going to do surgery and I was approved for it. At the preop physical they found a cardiac arrhythmia that they had not treated me, though I had complained of it for years also. So, they canceled the operation and finally scheduled me for a cardiac ablation. Then when I recovered from that they denied the surgery because of my age and the ablation, though I nolonger have an arrhythmia. Kaiser will delay service for serious problems until there is nolonger a possibility to address the problem. Both the arrhythmia and the back pain are very longstanding problems. I have had to live with serious back pain without help for more than 20 years. My life is seriously impacted. I am currently doing physical therapy exercises but that does not correct the issues and pain I deal with daily. I work hard on flexibility and try my best on exercises strengthening core muscles but at 83 years old, It's much harder than it was at 63 years old. Kaiser Senior Advantage is o.k. for people with minor problems but they are much less proactive on anything that is serious and costs a lot of money and effort. I would happily go on regular Medicare without Kaiser as a private problem, but my Medicaid requires either Kaiser which has all lab and x-ray services in one place or another HMO that requires me to travel all over the county for various services. That's not possible at my age and with my pain. So Kaiser it is. W3 need universal health care! We deserve it! We pay too much for inferior health care. In my case, Medicaid pays too much for my health care. Promptly addressing my health care in my 60s would have saved all the pain, disability and ongoing physical therapy which does not help much.
So my question is with the Part D .. if I just turned 65 July 2024 so last month and I immediately went onto an advantage plan which I regret so I’m calling today to switch over to a supplement plan because I believe I’m allowed to correct? Do I have 63 days from when I turned 65 in July or do I have 63 days from when I get a supplement plan? I would have them start the supplement plan October 1st or is it the 3 month period that was mentioned in the video? 3 months prior the 1 month of the birthday and 3 months post birthday?
I would recommend starting your Part D coverage the same time as your Supplemental plan, assuming you'll be able to switch with no issues. We can help you set up both! 1-800-864-8890
My parents thought if they just took supplements, they would stay healthy forever. They didn't sign up for Part D for many years. Now my Dad has passed away and Mom is paying a penalty for the rest of her life, on a very limited income.
Immediately get the $0 premium wellcare plan when you start medicare as a placeholder. You can change your plan annually every year during the enrollment period without penalty if you need a better plan.
My husband was already on Medicare when we met and I haven't paid much attention to his. He is retired through a transportation workers union (city bus driver) The union pays his insurance which I think I just figured out must be a Medicare Advantage Plan through Humana. He buys his meds at the local Kroger Pharmacy. Can he or should he have a Part D Plan in addition? He only takes a BP pill and Cholesterol med at this time. He is 76.
I can’t afford to pay any premium. I have a free Humana gold membership but it’s horrible. I only make 800.00 a month on social security. They take out almost 200.00 a month for plan B . I had to take SS early because of severe asthma and now I have emphysema. I can’t get hardly any medication. Thinking about trying to get on disability 😢
Insurance companies don't care except to take every dollar from you. I think Bernie Sanders tried telling everyone this but mainstream beliefs said democratic socialism was evil. Only brainwashed capitalists will tell you this.
For these specialized meds, the manufacturer has patient assistance programs. There are eligibility requirements. This is not COPAY assistance. I have worked for manufacturers for 13 years and have helped 1000s of patients obtain free medication from them. For low income patients on Medicare there is extra help for part D which lowers the cost to free or up to $10 a month.
It gets better in 2025, except for the fact than your part D plan will skyrocket in cost because the Ins. co's won't eat that cost, they will pass it on to us seniors in the form of high cost of coverage........
In other words, those of us on Tier1 and Tier2 medications where our out of pocket copays were either $0 or less than $5 and exempt from the deductible, will now pay 25% and most likely those Tiers will be now be subject to the deductible. It will only shift the burden of pay those of us on Preferred Generic and Generic medications. Thanks Medicare.........
@@MedicareSchool ok thank you. I wasn’t aware Part D cost was not covered. This is good to know. I don’t turn 65 until January 2026 but doing my due diligence now. So my cost could be the Part B deductible, and premium, Plan G premium, Plan D premium and my out of pocket cost capping at $2,000 starting in 2025. Does that about sum it up?
So aren't the companies that offer Medicare Part D plans going to jack the 2025 premiums way up as a result of the 2025 Medicare Part D changes? Will the premiums be included in the 2025 out of pocket maximum or are they in addition?
We do not have any information on what the changes for premiums will look like just yet. We won't get that information until closer to AEP, once we do receive it we will update everyone as soon as possible.
So are you saying that all Medicare advantage plans have part d coverage and we don't have to worry about a penalty, or do we still have to worry about a penalty if we're on certain Medicare advantage plans?
@@MedicareSchool I think you all are deleting my replies but honestly, you didn't even read my question. I'm kind of sad I used you all if this is the best response u have. I totally respected you till now.
How does it work if you’re on a Medicare advantage plan and you switch to a Medicare supplement plan? You’ve had a drug plan with the advantage plan. Will they still issue you a drug plan with a supplement plan without a penalty?
U do great work it helped me a lot but the whole system is riged for the advantage plans and insurance company hell they write most of the bill before Congress? I love to here how many companies total and what they take in and ceo s make total it got to a trillion dollars
So here's the problem with that. These people do not have a prescription drug plan already and there's going to be an enormous penalty that they will have to pay to be on that part. D. Drug plan
Part D is awful. The plans are basically all the same and they are all terrible. The plans differ in premiums, but not really in formularies. If your drugs are not available as cheap generics forget about getting help from any part D plan. In my experience, the only benefit to having a part D plan is to avoid penalties. I get by with Wellcare (which covers only cheap generics), cost plus, goodrx, and pharmacy coupons. Thank goodness congress created yearly out of pocket maximums ($3350).
whether younger , middle raising family and getting older life sucks . All these drugs pharmaceutical are the ones getting rich, but these people are going to die too? there monies won’t be in the hearse to their grave .
Not confusing at all the govt again over the years has looked for more and more places where they can squeeze the social security that they took from us for 50 years, from us. Keeping people poor and dependent on the govt
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Please Check your link. Getting 404 page.
Thank you. We are going to fix it now.
People can choose not to take many of the drugs that doctors prescribe.
I have turned down meds that doctors told me that I had to have or I would die.
I'm still here.
It seems like the Dr idea of healthcare is pharmaceuticals instead of more holistic treatments.
@@dennistyler9852 ...in the pocket of big pharma....to end up a "continuing customer".....not one being "cured".
Exactly just stay off the prescriptions that doctors make kick backs on.
One thing I have discovered with Part D plans is that the one sure thing is that no matter which plan you choose, you will be prescribed something that it doesn't cover, or only partially covers!
That's the truth! I bought the most expensive option plan from my carrier, and I regularly had to pay extra on some not-so-rare drugs.
Getting older for me is frightening, not because I'm aging, but because I don't know how I am going to survive off SSI and SSDI with no job pension. Single no children and no husband. 😢
I’ll be working until I drop dead. 😕
@@edwardprisby7603Hopefully only PT, that’s why we retired from FT. All the best.
I am in Florida, not getting an advantage plan,also not getting standard G or N. Going to be G high deductible. About $60 to $70.a month. Worse case on a bad year 2,800 out of pocket. I will stash that much away. I get Medicare in less than a year
@loulu8404 plan G in NY is over $400 a month. I'm stuck with MA
@@vince8436- Medicare is another $174.50, and Probably going up..
Nobody explains this stuff better than Marvin
He makes this look overly confusing.
Yes, and be sure to see if you qualify for the "Extra Help" plan. Many people do and don't realize it. If your income from two years ago exceeds their limit they'll notify you by mail and you have 60 days to enroll in a plan D. Specialty doctors like cardiologists usually have a storage room full of medications provided by their pharmaceutical reps. If you have a heart valve replaced and need a blood thinner like Eloquis they be happy to provide it for a few months. Hope this helps, thanks!
Thank you for sharing that!
Unfortunately my husband's cardiologist office told him they could only give him 2wks and told him not to become dependent on them for this med. (Eliquis)
I have found that the days of free meds from the doctor are largely over.
Be sure you apply for EPIC Plan and MEDICARE SAVINGS PROGRAM MSP to qualify for EXTRA HELP Part D Program easier.
I’m glad you recommended “compare”as an option. I’m on a statin and a couple of other RXs. I find between Optum Perks and Good RX apps and Costco pharmacy pricing, I’m not hitting my Part D deductible at all. If you are on lower cost drugs, you get more savings by shopping than by your Part D plan choice. I’m on the cheapest part D plan available without concern of the benefits.
Thank you. Many more people need to be aware of the "compare options". Cuban's Cost Plus Drugs and the Canadian Pharmacies are also worth exploring. My understanding also that you do not need to be a Costco member to utilize the pharmacy.
True about Costco but members get discounts on some RXs
Drop the statin. It’s a farce. Research
Excellent info. Clear and concise. Thank you!
Glad it was helpful!
I have a Walgreen’s drug plan, which started out at about $35 a month, now I pay $81 a month. It’s outrageous.
what is a walgreens drug plan? I get my prescriptions at walgreens but have the wellcare plan at $0 a month
@@mazy03 it’s thru United Health care.
@@mazy03 I have Wellcare also and am puzzled how it has gone to zero per month? You know why it went to zero? I'd call and ask, but I'd get somebody in the Phillipines who knows nothing.
@@jeffro221 each year plans change and this coming year I'm sure they'll be a cost, but many will still stay on the same plan without checking others.
We pay 113. 40 each because we needed coverage through the donut hole. I can't imagine premium increase, increased deductable and then a 2000. Out of pocket cap. So these new plans make you pay the 2000 out of pocket up front.. On top of that. We take expensive meds. I got sick after covid vaxx.
Two years ago I had part D for 5 years then two years ago I wanted to change insurance companies and I was out of the plan for ONLY 2 weeks then new plan charged a penalty. They are a bunch of THIEVES!
You didn't change during open enrollment?
Just like car insurance if you drop it without a new one in place at same time you are penslized..you should know what the rules are before you start making changes. That's on you to know what you are doing.
Agreed. Make SURE the plan will cover meds you take OR meds you think might be in your future. Get the best you can afford.
Just stay off prescription medications! Loose weight, get up and move, stop the junk food!
That will work for some, but not all conditions. Cancer, Parkinson's Disease, Multiple Sclerosis are a few examples of diseases that medications are necessary.
I always learn so much by watching your videos!
I'm so glad!
Thanks I really learned a lot bcz next yr of Feb I will be on Medicare
Glad that we can help, if you have any questions you can always call our office at 1-800-864-8890.
I just started September 1st i do have Wellcare STAND ALONE DRUG PLAN AND ONLY ORIGINAL MEDICARE A AND B PERIOD ❤ BECAUSE I DO NOT NEED TO PAY MONEY BEFORE I AM SICK. I CANNOT AFORD A MEDIGAP PLAN BUT I HAVE A TON THAT WILL COVER MY BILLS IF I HAVE TO BE IN HOSPITAL. THANK YOU MR MARVIN FANTASTIC VIDEO ❤
I have regular Medicare and a supplement plan but no part D. I get most of my medical care from the Indian health service including prescriptions from the pharmacy. If I should ever need an expensive drug that they don’t carry I can get a letter of creditable coverage and sign up for a part D plan with no penalties. If the timing is bad I guess I can sign into the Indian hospital and let them take care of it.
What is a Indian hospital
@@dignacorniel6514 On the res.
Do you mean a hospital in India or a Native American hospital? I assume you are in the U.S. because you mention Kaiser Senior Advantage.
I am an enrolled member of a Native American tribe. The Indian health service runs clinics and hospitals all over the country for tribal members. Right now I use a large clinic near my home for primary care, lab work, pharmacy, dental and vision.
Great presentation and thank you very much for clarifying so many tricky situations.
Glad you enjoyed it!
Hi Marvin, I have a question. If you need an expensive medication not on the formulary of your drug part D plan and you pass the 2k out of pocket spent, is your part D plan required to.pay for the medication ?
Medicare will not cover any medication not on your formulary regardless of the out-of-pocket max but you can get a letter from a doctor explaining the necessity of the medication to get it added to your formulary, however.
@@MedicareSchool Thank you for this answer.
One thing I am doing and will do is if I have a covered drug, but I use a non-insurance way of buying it, such as GoodRX, Cost Plus drugs, or Walmart’s low-cost Prescription Program, I will save the receipts and submit them to my insurance drug plan. The idea is to get it credited against my deductible and my $2000 cap. My insurance company company, Aetna, seems to be ok with it. As are most companies. It certainly pays to ask them if they will take such receipts and apply them.
Another great way to get cheaper prescriptions.
I enjoyed my zero dollar WellCare plan. Actually paid better than my United 128 dollar plan other than not covering Trulocity
Try contacting the drug manufacturer and ask if they have any assistance programs. Don't worry about it if you think your income is too high. Let them be the judge of that. Most manufacturers have 3 types of assistance: finds set aside for people on Medicaid, funds set aside for people on Medicare, and funds set aside for people with regular insurance.
Some manufacturers also work with special pharmacies that lower the price, but you have to get the medication by mail-order only. Best of luck!
I have Wellcare and pleased with them
Their customer service isgood,especially with renewal reminders with either texts or phone calls
I have to .50 Wellcare. Have you heard how much it is increasing yet.
Wellcare is awful. I can’t wait to change back to someone else
@@OFLHLGZ28 Why is it awful?
WHY are the insurance and pharmaceutical companies holding us hostage and make this soooo complicated we can’t even understand it???
Greed in my opinion.
It's the government that runs Medicare. They control the rules
Govt controls medicare, not big pharma
The govt runs medicare and sets the rules.
It's disheartening
Marsha Smithfield NC love your videos
Thank you, glad that we can help!
Plan D sounds about as confusing as anything! LOL, One thing that isn't entirely clear to me (I'm still 4+ yrs away from Medicare) is that there are different premium prices for different Part D companies, and I completely get the part about your formulary and seeing that any meds you take are in that... But if someone is relatively healthy and maybe even taking NO meds, or just one or two common generic meds, and they go for the cheaper plan because their meds are in the formulary, but, unbeknownst / unexpectedly they need a new med that is very expensive a couple of months down the road, and that med or equivalent is NOT in the formulary, that means what, they are stuck paying full cash price until the Oct 15-Dev 7 window? Yikes? I'm thinking like a chemo drug or something exotic, but necessary.
Some chemo medication is covered under Part B if administered by a doctor.
Marvin also mentioned something about having your doctor fill out some kind of form to get a non-formulary med placed into your formulary. Without going back and watching again, I can't recall the details but he did mention it. He said it "usually gets approved".
Is the Wellcare Medicare RX Value Plus Plan PDP still going to be around for 2025?
You are right don't go without a ( Creatable) drug plan for more than 63 days. Plan Premium $3.70 Penalty $8.70. I had to appeal their penalty (2) times and I won. Excellent Video.
Thank you, glad that you were able to get that penalty removed!
Medicare should charge same style penalty when Medicare Advantage Plans fail!!! 40% of American retirees will be re-entering Medicare Supplemental Plans. Only fair way to deal with issue.
GREAT INFO. thank you 👍
Glad it was helpful!
EXCELLENT PRESENTATION!
Thanks for watching
Excellent video. Thank you.
Glad it was helpful!
The change in 2025 is gonna drive up Part D premiums significantly!
Give thanks to the Government and their incompetence.
Actually the medication costs are going to be capped at $2000. The base premium will go up $2.08. Yes 2 dollars and 8 cents. There will be NO prescription "donut hole" which was a gap Before the cap you could have to pay $5000 in copays THEN be in a gap and pay at least 25% of the medication costs until a set amount is paid, then the gap closes.for an example- if you pay $5 a copay for your $100 medication- and you get into the gap, you will have to pay 25% ( $25) in the "hole" of the donut. You will be in the donut until you and your plan spends $8000. IN 2025 THERE WILL BE NO GAP AND YOUR COSTS ARE CAPPED AT $2000 A YEARS THANKS TO OUR GOVERNMENT.
@@collinsfriend1 Just wait. What do you mean by "the base premium"?
I heard that when the Biden administration found out the insurance companies were going to raise the monthly premiums way up they said hold on a minute we'll give you billions of dollars to keep quiet for a little while.Thats because they were going to be increased just before the election.
@@collinsfriend1To pay for the cap the plans will remove drugs from their formularies or change their tiers. This is not a good thing.
How much are the monthly
premiums going to go up I don't think the insurance companies are going to like it.
What's going on with Wellcare? I hear they are dropping out next year???
I have not heard that, but have been curious why the promium went to zero. Maybe that is why.
@@jeffro221 My premium was zero THIS year....but I thought there were rumors they were leaving the market??
@@az8theist977 If I find out anything about them leaving I'll update here.
Marvin always does a great job explaining Medicare supplements!! Thank you.
Our pleasure!
Thank you for sharing this information. Any further information would be greatly appreciated.
Sure thing!
Thank you
You're welcome
Thank you so much for the detailed explanation of the 2025 setup..👍
Happy to help!
good stuff
I purchased Medicare A And B and G high deductible at 65..From 58 to 65 had no insurance and paid the Obama care fine several times. 20 to 58 had employer insurance and mostly never used it i did keep teeth cleaned regularly and so this seems to be the only ongoing medical exspense since i also had braces as a kid. I dont use tobacco products, alcohol, coffee or tea. Dont use recreational drugs and seldom take a over the counter med. On a fixed income and paying Medicare A and B and G high deductible since 65. It sure takes a big bite out of monthly income. I am almost 67 , play basketball, ride bike's, walk a lot I do pay for house and car insurance and even added a earthquake rider. Seems all my money goes out to insurance companies. I have not turned on SS or started getting retirement payments yet . Putting it off since the longer i wait seams my IRA grows and SS will pay the most at 70. I have No debts, house paid off. But monthly income sure has been effected by the Medicare A and B and HiD G payments. Why pay for yet another insurance Plan D for drugs when not likely to use it. The 95 $ a month for the average drug plan could be used for smoothies at a local shoo. They take fresh fruit in a blender with ice , almond milk etc . This costs 4.50 $ each. Have 4 utilities to pay and more importantly look forward to pay my small tithing, fast offerings, and humanitarian donations. This i make monthly. I also have Property taxes due in November. etc. Is there a cheaper D Plan ?
I knew somebody like you who said I'm healthy and don't need meds, so I'm not going to take Part D. I told her we are getting older and at some point we will all be taking meds, and maybe very expensive drugs. She declined Part D. Then months later, came down with a conditon that required her to get an expensive med filled regularly, for hundreds each time. Then she joined a Part D plan and now will pay the higher premium for life. Choices have consequences.
By the way, when is the movie coming out? I heard they are talking about having George Clooney play you?
@@jeffro221?
$2,000 drug limit is just cost shifting by the government to insurance companies on to us the users. Result is higher monthly premiums, and/or reduced benefits - drop free gym membership, no dental, no eye care, no hearing aid coverage, no more incentives to get vaccinations or annual wellness visits or shopping, travel incentives. After several years into retirement now can you really switch back to traditional Medicare with a G or N Medi-gap plan plus a Part D drug plan and not pay significantly more out of pocket each month?
No thanks.I'll stick to my Kaiser Senior Advantage, not just because it has saved me thousands of dollars, but because I think it gives me better, more reliable healthcare. As an integrated system, things don't fall through the cracks which, when I was a practising physician in fee for service medicine, I saw quite often.
I so have a Kaiser Senior Advantage plan but for years they have denied me help for my spinal problems. At one point they were going to do surgery and I was approved for it. At the preop physical they found a cardiac arrhythmia that they had not treated me, though I had complained of it for years also. So, they canceled the operation and finally scheduled me for a cardiac ablation. Then when I recovered from that they denied the surgery because of my age and the ablation, though I nolonger have an arrhythmia.
Kaiser will delay service for serious problems until there is nolonger a possibility to address the problem. Both the arrhythmia and the back pain are very longstanding problems. I have had to live with serious back pain without help for more than 20 years. My life is seriously impacted. I am currently doing physical therapy exercises but that does not correct the issues and pain I deal with daily. I work hard on flexibility and try my best on exercises strengthening core muscles but at 83 years old, It's much harder than it was at 63 years old.
Kaiser Senior Advantage is o.k. for people with minor problems but they are much less proactive on anything that is serious and costs a lot of money and effort. I would happily go on regular Medicare without Kaiser as a private problem, but my Medicaid requires either Kaiser which has all lab and x-ray services in one place or another HMO that requires me to travel all over the county for various services. That's not possible at my age and with my pain. So Kaiser it is.
W3 need universal health care! We deserve it! We pay too much for inferior health care. In my case, Medicaid pays too much for my health care. Promptly addressing my health care in my 60s would have saved all the pain, disability and ongoing physical therapy which does not help much.
So my question is with the Part D .. if I just turned 65 July 2024 so last month and I immediately went onto an advantage plan which I regret so I’m calling today to switch over to a supplement plan because I believe I’m allowed to correct? Do I have 63 days from when I turned 65 in July or do I have 63 days from when I get a supplement plan? I would have them start the supplement plan October 1st or is it the 3 month period that was mentioned in the video? 3 months prior the 1 month of the birthday and 3 months post birthday?
I would recommend starting your Part D coverage the same time as your Supplemental plan, assuming you'll be able to switch with no issues. We can help you set up both! 1-800-864-8890
My parents thought if they just took supplements, they would stay healthy forever. They didn't sign up for Part D for many years. Now my
Dad has passed away and Mom is paying a penalty for the rest of her life, on a very limited income.
The penalties are ridiculous. The Government is ridiculous. All the best.
@@bookmagicroe9553 they are a bunch of thieves
there are no cost or low cost plans and you don't have to use them, but at least your signed up and won't have to pay a penalty
@@mazy03 And the penalty is for life. Penalized for life is so unfair but that’s the government.
Immediately get the $0 premium wellcare plan when you start medicare as a placeholder. You can change your plan annually every year during the enrollment period without penalty if you need a better plan.
My husband has had an advantage plan through his company for many years. Can he get plan D?
He can get Part D, his advantage plan doesn't include drug coverage already?
Its a shame America is the only country that charges exorbitant prices for services and medications! Should be a crime!
Quick question. what about a person on ssdi age 54 do they have to pay the outrageous premium until 65 or risk a penalty?
Under the age of 65, penalties are not applied. Once you turn 65 they completely reset your Medicare as if you are a new recipient.
My husband was already on Medicare when we met and I haven't paid much attention to his. He is retired through a transportation workers union (city bus driver) The union pays his insurance which I think I just figured out must be a Medicare Advantage Plan through Humana. He buys his meds at the local Kroger Pharmacy. Can he or should he have a Part D Plan in addition? He only takes a BP pill and Cholesterol med at this time. He is 76.
You'll need to check with his carrier. Some Advantage plans won't allow you to have a Part D plan if they are already covering your medications.
I can’t afford to pay any premium. I have a free Humana gold membership but it’s horrible. I only make 800.00 a month on social security. They take out almost 200.00 a month for plan B . I had to take SS early because of severe asthma and now I have emphysema. I can’t get hardly any medication. Thinking about trying to get on disability 😢
What about the recent changes to part d premiums caused by the so called inflation reduction act? Premiums could double.
What kind of country are we when someone "needs" a $13,000/mo med....to LIVE...and can't afford it?
Insurance companies don't care except to take every dollar from you. I think Bernie Sanders tried telling everyone this but mainstream beliefs said democratic socialism was evil. Only brainwashed capitalists will tell you this.
That is why you get a plan d plan so you don’t pay $13000 you pay a small monthly I pay $9. My sister pays fifty cents per month
For these specialized meds, the manufacturer has patient assistance programs. There are eligibility requirements. This is not COPAY assistance. I have worked for manufacturers for 13 years and have helped 1000s of patients obtain free medication from them. For low income patients on Medicare there is extra help for part D which lowers the cost to free or up to $10 a month.
It gets better in 2025, except for the fact than your part D plan will skyrocket in cost because the Ins. co's won't eat that cost, they will pass it on to us seniors in the form of high cost of coverage........
I realize your services are a necessary evil. What I don't like is the normalization of this chaotic BS system.
In other words, those of us on Tier1 and Tier2 medications where our out of pocket copays were either $0 or less than $5 and exempt from the deductible, will now pay 25% and most likely those Tiers will be now be subject to the deductible.
It will only shift the burden of pay those of us on Preferred Generic and Generic medications.
Thanks Medicare.........
Does the $2000.00 max out of pocket drug plan apply toward Advantage plans also.
Yes, all part D whether part of an advantage or Stand Alone plans.
Yes it does
Does a supplement plan, like Plan G, cover the patient cost?
This video is referring to Part D, so Plan G does not cover anything for prescription medicine.
@@MedicareSchool ok thank you. I wasn’t aware Part D cost was not covered. This is good to know. I don’t turn 65 until January 2026 but doing my due diligence now. So my cost could be the Part B deductible, and premium, Plan G premium, Plan D premium and my out of pocket cost capping at $2,000 starting in 2025. Does that about sum it up?
retirement appears to be :
quit full time work and then work part time just making sense of paying for life
Look at trelgry it over 800 inhalers others 550 basic over 100
please send me the link for master class
Here is the link to the Workshop! medicareschool.com/master-medicare/?
So aren't the companies that offer Medicare Part D plans going to jack the 2025 premiums way up as a result of the 2025 Medicare Part D changes? Will the premiums be included in the 2025 out of pocket maximum or are they in addition?
We do not have any information on what the changes for premiums will look like just yet. We won't get that information until closer to AEP, once we do receive it we will update everyone as soon as possible.
I have part "C".
Many Part C plans have drug coverage built in so you may not have to worry about this.
He is wrong on one point. The maximum allowed Part D drug deductible will rise to $590.00 for 2025.
So are you saying that all Medicare advantage plans have part d coverage and we don't have to worry about a penalty, or do we still have to worry about a penalty if we're on certain Medicare advantage plans?
If you have an Advantage plan with drug coverage, you don't need to worry about the Part D Penalty, it would be considered creditable coverage.
@@MedicareSchool YOU TOTALLY IGNORED MY QUESTION. I'M NOT A FREAKING IDIOT. UGHHHHHHH
@@MedicareSchool DO YOU EVEN READ THE QUESTIONS? CAN YOU UNDERSTAND ENGLISH? UGHHHHHH
@@MedicareSchool I think you all are deleting my replies but honestly, you didn't even read my question. I'm kind of sad I used you all if this is the best response u have. I totally respected you till now.
The for profit health care system turned out to be the definition of extortion
How does it work if you’re on a Medicare advantage plan and you switch to a Medicare supplement plan? You’ve had a drug plan with the advantage plan. Will they still issue you a drug plan with a supplement plan without a penalty?
Yes, when you make that switch you won't have any penalties because you've had drug coverage through the advantage plan!
The 2025 Part D deductible is $590 not $540
Thought I read somewhere that 2025 deductible is going to be $590. Do I have that wrong?
That is correct, we made an error in this video. We do apologize of any confusion!
Thank you @@MedicareSchool
Basically you have to be rich to get coverage that pays more. Rich get richer the poorer get poorer. Isn't that a shame/sham.
U do great work it helped me a lot but the whole system is riged for the advantage plans and insurance company hell they write most of the bill before Congress? I love to here how many companies total and what they take in and ceo s make total it got to a trillion dollars
The plans I saw were mega expensive.
Plan pricing will depend on where you live.
This seems confusing. So many different coverages. So many different tax laws. I might have to pay someone to help me with strategies.
Give us a call we are happy to help through this process, you can contact our office at 1-800-864-8890.
Tri-Care for life cover my drugs.
So here's the problem with that. These people do not have a prescription drug plan already and there's going to be an enormous penalty that they will have to pay to be on that part. D. Drug plan
This is all a foreign language to me
If you have any questions we're mor than happy to help. You can contact our office at 1-800-864-8890.
@@MedicareSchool
I set up an appointment this morning for next week.
I hope they are patient, lol.
❤
That penalty is bull shit. That should be against the law. It’s a moneymaking racket.
Part D is awful. The plans are basically all the same and they are all terrible. The plans differ in premiums, but not really in formularies. If your drugs are not available as cheap generics forget about getting help from any part D plan. In my experience, the only benefit to having a part D plan is to avoid penalties. I get by with Wellcare (which covers only cheap generics), cost plus, goodrx, and pharmacy coupons. Thank goodness congress created yearly out of pocket maximums ($3350).
The out of pocket max congress created is causing part D premiums to skyrocket.
whether younger , middle raising family and getting older life sucks . All these drugs pharmaceutical are the ones getting rich, but these people are going to die too? there monies won’t be in the hearse to their grave .
Isn’t the 2025 Part D deductible $590?
That's the highest drug companies can set them at but some carriers might charge a lower deductible.
This is unbelievably confusing
We understand that it can be confusing, that is what we are here for. If you need any assistance give us a call at 1-800-864-8890.
why are part D heavily subsidized in 2025, the monthly premium is going up but uncle sam is paying a big part
Not confusing at all the govt again over the years has looked for more and more places where they can squeeze the social security that they took from us for 50 years, from us. Keeping people poor and dependent on the govt