Part D of Medicare - 2023 Changes and Donut Hole Example

[@mikenixon2401]

Thank you for your research and explainations. I have an advantage plan with my Medicare so I am not burdened with many of the hidden costs like deductables.

[@SeniorAdvisorsMedicare]

Thanks for watching, Mike. The Part D coverage in a Medicare Advantage plan actually works the same way. It is possible your advantage plan has a $0 deductible for Part D, but the other Part D steps (Initial Coverage, Coverage Gap, and Catastrophic Coverage) still apply.

[@Angelstar7774]

thanks for the concise explanation, didn’t congress pass the law that medicare recipients only have to pay $2K OOP total per year?

[@SeniorAdvisorsMedicare]

Hello. Yes, but the $2,000 max doesn’t take effect until 2025. Here is a link to a video that explains those changes - Inflation Reduction Act - Medicare Part D Impacts kzbin.info/www/bejne/eoioaKeHiNGqldk

[@Angelstar7774]

@@SeniorAdvisorsMedicare tysm! I made a chart based off yours to figure out my own OOP costs and it was really helpful 😊

[@SeniorAdvisorsMedicare]

@@Angelstar7774 - Your welcome. I am glad it worked out for you!

[@kathleenbirkelbach-uy3pl]

Thank you explaining the Framework is helpful wondering about 2024 any changes i’m helping my aunt navigate .

[@SeniorAdvisorsMedicare]

Hello Kathleen - here is a link to the video showing 2024 Part D changes. The 2024 Part B premiums haven’t been released yet. We will create a video when they are released. If you subscribe to our channel, you will be notified. 2024 Part D Plan Changes kzbin.info/www/bejne/rmq9hpmVn9yeqKc

[@Nowinspiredtoday]

Really wish broilers would explain this to people before they tell them all there media cations covered

[@SeniorAdvisorsMedicare]

Hello Mark- yes we certainly do explain this to our clients and review their specific drug costs when the first enroll and every year during the annual enrollment period as well.

[@henwhisperer]

Thank you. Informative video.

[@SeniorAdvisorsMedicare]

Thanks for watching !

[@toktalk9974]

Thanks. Subscribed and liked !

[@SeniorAdvisorsMedicare]

Thank you for the feedback and subscribing!

[@kimberlylovellette5117]

Does your $ amount allowed before coverage gap reset every year?

[@SeniorAdvisorsMedicare]

Hello Kimberly, yes, all of these figures reset each year on Jan 1.

[@ronv9189]

I am trying to use your model to calculate my costs for a very expensive Tier 4 drug (Retail: $2,093, 45% CoPay). I have replicated your calculations in a spreadsheet I built, but I can't find how these values are derived: April Pharma Discount $89 April Member Pays $106 November Actual Costs $97 Can you please provide the formulas, or the verbal explanation? Is the spreadsheet available for purchase? Thank you for any assistance. Ron V

[@SeniorAdvisorsMedicare]

Hi Ron, the drug prices are specific to the Part D Plans. If you send us an email to [e-mail] with your list of medications with dosage/frequency, and your zip code, we can send you a precise cost estimate and report that includes each drug.

[@joycephelps3926]

We can’t read the slides. Can you do a screen grab w voice over for part of the vid in the future?

[@SeniorAdvisorsMedicare]

Hi Joyce - I am sorry you can't read the charts. We tried a different format this year and we will go back to the old format going forward.

[@johnsedarat143]

Thanks for trying But show the illustration FULL SCREEN so we can read it

[@SeniorAdvisorsMedicare]

Thank you for your feedback.

[@soniaivette]

In the hybrid months that you mention are weighted months, how is that calculated? Thank you!

[@SeniorAdvisorsMedicare]

Hello - thank you for the question. For the month of April in the example, it is a 'partial' month of the Donut Hole so it is just a weighted calculation. I don't recommend people get too caught up in the partial/weighted months of the calculation. Just know that it will reach the full donut hole (25%) the month after reaching the Initial Coverage level limit.

[@jamesbungert3155]

I won't get too deep, but the blended month is made up of the part of the $1200 still in the initial coverage level ($1,060), and the part that's into the Coverage Gap ($140). The blend comes when you take the proportion of the $1200 that each of these amounts makes up. $1,060 is 88.3% of the $1200 and the $140 is 11.67%. From there it gets tricky, given that the copy is a flat amount and so forth. The main way to check if the calc is at least on the right track is if it's between the 1st and 2nd month's amount. Here, it's between, for both blended months. I'm a Medicare actuary and I still get confused.

[@soniaivette]

Thank you so much for that explanation!!

[@SeniorAdvisorsMedicare]

@@jamesbungert3155 - thank you for your feedback.

[@SeniorAdvisorsMedicare]

@@soniaivette - thanks Sonia.

[@johnlutz9275]

THE donut hole is a complete joke. Theres No reason for this deductible, many of us seniors have a hard time with this donut hole. All i can say is its a worthless step.!!!

[@SeniorAdvisorsMedicare]

Hi John - thank you for the feedback. You will be happy to see the donut hole going away finally in 2025! kzbin.info/www/bejne/rmq9hpmVn9yeqKcsi=iVzP3H36x1rEram0

[@bytheSEAsoaps]

I'm sorry call me feeble, but f why is medicare so damn complicated? Does it really need to be so complicated? Single HealthCare now!

[@SeniorAdvisorsMedicare]

Hello - Medicare is almost 60 years old. Most government systems become very complicated and convoluted over time due to years and years of layered legislation and regulations. We do our best to try to help simplify these complexities.

[@christinamariehicks1078]

None ..false advertising.

[@SeniorAdvisorsMedicare]

Hi Christina. Could you please clarify your comment? What is false advertising? This is just an educational video explaining Part D of Medicare.

[@johnlupo3919]

STOP SAYING "ALL RIGHT"!!!!!!!!!!!!!!!!!

[@SeniorAdvisorsMedicare]

Thank you for your feedback John. Hope you have a great day!

[@barrysimmons4546]

Medicare premiums should be tripled. The program will soon be insolvent. Seniors are so greedy

[@SeniorAdvisorsMedicare]

Hi Joseph - thank you for your perspective.

[@mikenixon2401]

You will be a senior some day. Be careful what you wish for as you may get it.

[@barrysimmons4546]

@@mikenixon2401 I am a senior. My premiums are $587.00 per month. Much too low for an old person. Young people should not be spending money for old people's healthcare. We had many years to save for our healthcare.