Medicare Part D Explained (Part 2 - Avoid the donut hole)
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- Опубликовано: 25 авг 2024
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Welcome to Part two of Medicare Part D Explained. This is a continuation of the Medicare Part D Explained first video. While the first video included information about Part D for everyone researching their Medicare options, this video includes more advanced concepts that are important to those who are paying hundreds of dollars a month for their prescriptions. I will assume in this video that you have already seen Part 1 of Medicare Part D Explained.
In this video we are going to talk about the four stages of the Medicare Part D prescription drug coverage. This includes the deductible, your initial coverage, the coverage gap (formerly referred to as the donut hole) and catastrophic coverage. We will discuss these stages are impact by your TROOP (True Out-Of-Pocket Expense). Then last, but not least I will touch on Low Income Subsidy options that can be used to help relieve the financial burden of prescription drugs and Part D premiums for those who qualify. If you are having difficulty paying for your prescriptions, this will be very important for you.
If you are spending a lot of money on prescriptions it is important to understand each of these four stages and how the right Part D plan can help you manage your out-of-pocket costs. My objective is to help you understand what you need to know about Medicare Part D plans so that you do not spend more than you have to for your prescriptions.
Four stages…
The first stage is the deductible. A deductible is the amount of money you pay before your insurance will pay any benefit. Each year Medicare sets a maximum deductible that a Medicare Part D plan can charge. They can charge the maximum. They can charge less than the maximum or have no deductible at all. For 2021 the maximum Medicare Part D deductible is $445. I would suspect the amount of the deductible will continue to increase a little each year.
The second stage of your Part D coverage is your Initial Coverage.
After you meet your deductible, for those prescriptions that are not exempt, your Medicare part D Plan will help pay your prescription costs. The Initial Coverage is where you would pay a copay or coinsurance for part of the prescription costs, and the insurance company will pay the rest.
For Stage Three, I need you to understand a new term. You may want to write this down. The term I need you to understand is your True Out-of-Pocket cost, often abbreviated as your TROOP.
TROOP is your total out-of-pocket costs on the prescriptions in your Medicare Part D plan formulary.
Your TROOP includes the money you spend on Part D prescriptions. It also includes money spent on your prescriptions on your behalf. For example, the pharmaceutical manufacturer contribution or discount, or an HSA plan or Medicare Saving Account (MSA) or Flexible Spending Account (FSA). It can also include the Extra Help from a Low-Income Subsidy.
Your TROOP does not include your Part D monthly premium. It does not include drug you pick up over the counter or by using Good Rx.
During Stage Three, or the Coverage Gap, you pay 25% of your dug costs. Your costs go up during this stage. The Part D Plan
You pay 25% of the cost of the prescription. The Pharmaceutical Industry will pay 70% of the prescription and Medicare will pay the remaining 5%.
Catastrophic Coverage is Medicare is simple.
In this stage Medicare will typically pay the greater of 95% of your prescription drug costs or $3.70 for a generic prescription or $9.20 for a brand name prescription.
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Do not sell yourself short, you are the best personality for what you do. You explain everything very well, the customer does not feel any high pressure, you are thorough and have such a calm demeanor. Thank you!
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Thank you for explaining Medicare Plan D. Why would the government make things so complex. You make it easier to understand.
you are welcome Peter
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Thank you for this excellent video.
Matthew is great. Husband started looking for help to figure out the Medicare enrollment situation. He called the toll free number and was astonished to discover that Matthew's office is, literally, three miles from our home. We went and visited with him and got husbands coverage all set up. He is a great asset to anyone trying to figure out this enrollment. I, too, now am watching these videos as I need to sign up for part D now. Thank you, Matthew, for your help.
Thank you Alice
Great video and in depth info.
Avi Deshmukh, MD, FACS, MBA, MS
Wonderful way to stay current with Medicare part D Thank you!
Your videos are so robust and comprehensive. Thank you so much for all the information.
Thank you, Very helpful 20:50
Your the best our stage 3 is Killin me and my wife. That dought hole can't keep taking everything so yes I will be calling asap. God bless. John
Thank you for sharing your knowlege
This whole series has the best information, and it’s presented in the clearest way anywhere on RUclips. I trust this guy.
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I listen to all his utubes...very very clear to understand.
Your videos are very informative. You explain the topic clearly and I can feel your sincerity in what you do.
You are amazing Matthew! More power to you!
Thanks for the detailed update. It really clears up a lot of the fog of medicare.
Thanks for the wonderful video!
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I never really knew how my Part D plan worked. I'm sure going to change this year. Thank you Matthew so much for these videos.
Excellent & informative as usual.
Wonderful video, so much information
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I am an agent myself, and learn a lot from your videos.
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Matt, you are the most honest person I’ve ever known. As I always said, your videos are very invaluable , straightforward and very caring💞 keep up your good work! You are awesome!
Thank you, Matthew. I have been trying to gather information about Medicare for over a year now, and just 3 months ago, I happened upon your Medigap Seminars. I am so impressed on how you present the material, but more telling is the genuine care and concern you express while doing it. I hope you keep doing this for people who come after me looking for logical, concise, and clear explanations on all of the Medicare information you present.
Thank you Teresa. When you are ready for more personalized advice I do hope you will call my office. I would love to compete for your business. 800-847-9680
Very informative, worth watching
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I’ve had Medicare for 10 years and never knew some of this info. Thank you so much!
I gave subscribed. Medicare is a Ness so thank you for clarifying e everything.
Excellent learning on part d
Thank you for this well thought out information.
i got hand cramp from taking notes , stopping an restarting video. but it was worth it to get a better understanding of my rights AND my responsibilities.
Medicare just might cover that hand cramp too! ;-)
The best videos on Medicare I have seen. Clear, detailed, and extremely helpful in making the right decisions. Bless you, Matt.
Thank you Gx B. I hope you give us the opportunity to compete for your business when the time comes.
Absolutely the best
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These videos are invaluable. I wish they were available when I first started researching Medicare five years ago. Matthew presents the information in a succinct and understandable format.
Finally I understand. Thank you!!
Hi. Watching in Chicago. Thanks for the information.
I am new to Medicare sales and you are an excellent teacher. I love how you take your time and break things down into bite-size morsels.
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Thank you Gina. I try!
Very clear and thorough.
Very well done as per the other 10 or so videos I have watched. Your "4 Stages of Part D" handout (see above link) which you explained in the video (6:50 - 15:50) was very helpful. I also think your written summaries under the "Show More" link are very helpful. I print them off and read through them to review and reinforce your video presentation. Finally, your story at the 2:20 mark as to why you make these videos was very touching. For me, they were a confirmation of the type of person you genuinely are and that you truly have the best interests of your clients at heart. Thank you again and God Bless.
I really learnt a lot from this video. It gave me the knowledge to shop for my own drug plan. Thanks Mr Matthew's
Nov 2023
you are welcome. Have you seen the new videos on Part D here?: partdshopper.com/
@@MedigapSeminars yes I did
Thank you so much. This is the most comprehensive video on Part D. I appreciate all your time and work.
Thank you for your kind words Barbara. I appreciate it.
Video is very good. I will contact them and talk.
Love your videos. I am new to Medicare this year and you have helped so much.
Excellent
Very detailed explanations.
Matthew. My wife and I can't wait till next week here in OCT-21. YOUR A GOD SEND TO ALOT OF PEOPLE.!!! THANK YOU FROM OUR HEARTS. IT IS VERY IMPORTANT INFORMATION FOR US ALL. GOD BLESS YOU.!!! JOHN AND MARY. MINNESOTA
Thank you for taking the time to write such a nice comment.
Great information. I've been binge watching catching up on all your Medicare videos. This helps us tremendously in navigating through the maze of medicare. Thank you so much.
Best Breakdown Ever!!!!
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Thank you for explaining this
Thank you for all the help.
wonderful! video
Excellent.. hope to be as good as an agent as you!
Excellent demo, handy to stop and rewind if you don't understand a concept. This was lifesaver-thank you very, very much!
Doing a great job explaining this confusing topic
Good presentation.
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I will turn 65 in 2022,your video helps a lot for me to understand,thanks.
You have been very helpful. Thank you.
thanks for the informations..
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Very informative
Glad it was helpful!
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Wish I’d found you before. Thank you
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Great explanations.
3:23 pm Thank you for all your hard work and time to help us make the right decisions with our part D plan.
Clear and helpful
clearly explained
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Thanks for sharing.. much help in understanding how MC-PlanD works. Lots of work for you guys to bone up, but much appreciated. God bless you.
You are welcome. Please consider us when getting your Medicare, I would enjoy competing for your business. You can also use this site for your Part D partdshopper.com/
followed pretty well with videos on part A & B, PART D gets a bit confusing. but you do well in explaining. thanks
Thank you
This is the most thorough presentation of Medicare Part D. I have seen during my research.
Thank you.. clearly explained.
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Thank you for your honesty. Glad you clarified. I often wondered how money "RUclipsrs" like you make from signing somebody up for the different parts of Medicare. Your information was clear and understandable and I'm going to highly recommend them to everyone I know that's in my age group and getting ready to sign up for Medicare.
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Thank you for helping me to understand all about part D plans.
Thank you for a clear and understandable explication of the complex Part D!
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Thanks for all the videos. You Matthew C are Amazing with all the information Medicare's information you provided to all of us reaching the retirement age. Thanks so much.
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Thanks again Matthew for your thorough explanation of this confusing Part D coverage
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Thank you so much this all is a lot to take in. Your video is very good explained everything so well.
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I want to thank you for the clarity you brought to a really difficult thing to sort through. Your videos gave me the information I needed, in a way I could understand, to make an informed choice. Good job and Thank you again!
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Hi, your incredibly informative videos and my talks with your agent, Marcene, has helped me to navigate the sign up processes for my supplement plan and part d plan without stress and headaches. Thanks so much for the valuable help you provide! Keep up the good work! William
Thank you for the kind words William. I will pass this on to Marcene
He starts giving info at 7 and a half half minutes, but you may want to lear more about him watching the first 7 minutes.. He give a lots of good info.
Not sure if that's a compliment or not, ;-) But thank you
Hi Matthew, thanks for the part two as always when I am watching your other videos. I will be on Medicare next year and definitely I will call you for all my Medicare needs. Thanks you again and wish you well.
well done
On Oct 10 partdshopper.com was still under construction. I'll keep checking back until it is up. Super helpful as I will be signing up for medicare when I retire in January 2021.
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Thank you. Your series is the best I’ve seen on Medicare. Unfortunately 5% of the truly expensive drugs is still a lot of money.
Yes, it is. The average person on Medicare who survives cancer still has about $30,000 out-of-pocket. That's why we encourage Cancer Protection insurance that provides you a lump sum tax free check when first diagnosed with cancer.
Thank you. For your help :)
Best I have seen. Will return again and again.
Thank you Enoch. Please reach out to us if you would like my recommendations on your Medicare. My services are free to you, the consumer.
Great job thanks 🙏
Thanks so much for helping me to understand this important benefit.
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Your honest and knowledgeable presentations are better than a professional polished actor.
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