Shocking Changes to Medicare Drug Plans - Medicare Part D

[@michaelcampbell9127]

I watched Keith's videos, filled out the information sheet on his website, and Keith called me within hours. Keith walked me through the process and we found the plan that best suited my needs. It was a pleasure working with Keith. Keep up the good work guys.

[@MedicareonVideo]

Thanks Michael!

[@beachrobyn]

I've been watching Keith's videos for a long time. When it came time for my husband to sigh up for Medicare I knew who to reach out to. Henri called and helped me thru the whole process. I am so grateful for both Keith and Henri!

[@MedicareonVideo]

Happy Henri was able to help! He is great!

[@jonscrivner9087]

It's a full time job to keep up. It's also extremely important to.

[@nixxkids]

My wife and I are in our mid to upper 50’s. I appreciate your advice and figure you can’t start too early trying to educate yourself.

[@MedicareonVideo]

Always best to start the Medicare information maze early!

[@bennasir6793]

Thank you Keith, I will definitely call you soon.

[@MedicareonVideo]

Looking forward to it!

[@MOstix13]

Excellent information, explained clearly. Thanks so much.

[@MedicareonVideo]

You're welcome!

[@bighornbasin]

Really like the easy-to-understand explanations of confusing requirements in Medicare.

[@fredk9999]

Agree

[@MedicareonVideo]

Happy to help!

[@lori2516]

I am so grateful for the help with choosing a plan and navigating the process. Henri was super helpful, pleasant, and knowledgeable! Thank you, Keith and Henri!

[@MedicareonVideo]

You are welcome! Glad Henri was such a big help!

[@johnczech7074]

Time spent watching your channel is always worthwhile.

[@MedicareonVideo]

Thanks John!

[@maribelgonzalez4555]

the issue with Medicare supplement plans is that not every Medicare member can afford the part B and supplement plan and vision cost and dental so it’s not affordable for everyone that’s why so many members go with MAPD. I do see the value as an agent but some mbrs don’t. Great video

[@carolinebeck807]

I was just reading the notice from Wellcare and the fifty cent a month policy went to Zero next year. I also noticed they did away with the $35 a month insulin coverage.

[@deniseearly4318]

They still cover insulin for $35. That is the law. Wellcare has the lowest premium and are keeping it low.

[@carolinebeck807]

@deniseearly4318 Perhaps I'm reading it wrong.But the information mailed to us says insulin products are not covered on this tier, which is specialty tier five.

[@kevinw.weiser9820]

The quote link appears to be broken. Didn't work for me.

[@MedicareonVideo]

For our website? You can also give us a call at 877-885-3484!

[@michaeltorrey3603]

My part D premium stayed zero dollars but tier 2 drugs increased to $5 from $2. They haven’t published their formulary yet so waiting for that.

[@MedicareonVideo]

Today is the day to check!

[@bills1779]

Who is that with? Wellcare ?

[@michaeltorrey3603]

@@bills1779 WellCare value script.

[@NYCisland]

@@bills1779 I too have Wellcare and it's still $0 for 2025 in WA state. They have increased premiums in other areas. I am switching out from Wellcare for 2025 since the total drug cost / year is more $$ for me. I will switch to one with $22/mon premium because one of my meds will be less than half the cost compared to Wellcare ($1945 vs. $760). It's the total cost that counts, not just the premium.

[@jeebs98-br549]

My Part D drugs are so inexpensive that I usually never get out of the deductible phase until around September. My wife, however, takes expensive migraine medication, along with the 'normal' things that I take, so she can easily reach Catastrophic phase by September. In the past, folks like her paid more than I did, because the deductible and the premium stayed the same, but the drug costs were very different. With these changes, everyone's premiums will likely increase in order for the drug companies to afford the restrictions the government has placed on them - even folks like me. Fair or not, this seems like a socialistic approach to me.

[@commonsense6967]

I'm in an MA with drug plan included, and my premium didn't change at all in 2025.

[@joycethreattto2115]

Great information

[@MedicareonVideo]

Glad it was helpful!

[@user-nm5yv6ij8w]

My BCBS Part D drug plan is going DOWN by $7.00 per month for 2025. I just got the ANOC last week.

[@MedicareonVideo]

Good news!

[@bills1779]

What exact plan is this? I may need to look into this ❤

[@commonsense6967]

I'm happy that for the past 8 years I've been with my 4.5 star-rated HMO MA. Yes, I wish they also had a PPO version, but I've saved thousands of $$$ over the last 8 years not choosing original Medicare +vision+meds (none of which I'm on) etc. And there are many added benefits. Co-pays got lower for 2025, though annual MOOP will be higher ($5500.) Premiums stayed the same.

[@ladonnasimpson2954]

Thank you 🙏🏽

[@MedicareonVideo]

You're welcome!

[@fredk9999]

Not just changes-shocking changes

[@MedicareonVideo]

2025 will be a big year!

[@deniseearly4318]

The changes are not shocking and anybody who takes a brand drug will benefit.

[@appydaysquilts]

Thank you for explaining the deductible! I'm blessed to be healthy enough that I don't take any medications, but I buy a Part D plan because I'm required to. This was my first year on Medicare, and I actually thought I'd have to have pay $280 before the plan paid a dime if I had to have a common medication like a blood pressure med. As you said, this new change makes it considerably more expensive for people in my situation, but I feel better knowing the new $580 deductible won't be in play if I get a cold and need a Z-pak or something.

[@MedicareonVideo]

Yes, it is interesting how the deductible is different than in many other insurance plans!

[@RussellSSmith]

This week the San Angelo, Texas City Council learned that the United Healthcare Medicare Supplement premiums for their retirees were going to increase 62% for 2025 because of the Inflation Reduction Act.

[@deniseearly4318]

The Inflation Reduction Act has nothing to do with Medicare supplement.... so somebody lied.

[@mikeflair6800]

Interesting. Especially those 'premium and out of pocket caps' beginning in 2026...that will squeeze the insurance companies. For my 2025 Plan D premium, I am looking at a 350% increase in premium from $10 to $45, and out of pocket up 100%, from $280 to $590. It seems the insurance guys are squeezing the consumers this year in 2025, before they get squeezed by the government in 2026. All of this seems driven by that $2000 yearly maximum, that must be having a bigger impact than expected. I don't like it!

[@MedicareonVideo]

@@mikeflair6800 sounds about right!

[@IsaiahLove777]

Mutual of Omaha doesn't even do Part D anymore.

[@stubrown]

Kind of impossible to know what you like and what you don’t like before the numbers are even out for the public (Oct 1)… I guess clairvoyance is more prevalent in election years…

[@AndiS-dz4pq]

Another great video. Thank you.

[@MedicareonVideo]

You're welcome!

[@deniseearly4318]

I was on a call by Cigna that went through calculating when people will hit the catastrophic stage where they will pay $0. The Cigna guy said it makes no sense to get a high premium drug plan because of the $2000 cap. Even with the deductible, people with expensive meds will pay less overall. The key will be to be sure your expensive med is on the plan formulary.

[@thelakeman5207]

If most people never get to $2,000, why are they raising rates?

[@MedicareonVideo]

@@thelakeman5207 the ones that do can go much higher

[@billlock77]

The insuranse company pays everything after the $2000. If they dont raise rates they would go broke.

[@jeebs98-br549]

It's a socialistic approach. Spread out the costs of a few among everyone. Not saying it's unfair - no one choses to need expensive drugs. Just answering your question with my point of view.

[@deniseearly4318]

@@jeebs98-br549 Hmmmm. You have defined "insurance".

[@RetardedSissy]

​@@jeebs98-br549for the most part, that's what insurance is. It's a "what if" something really bad happens".

[@conniernordan]

By the time you pay a monthly part b premium, a deductible, and 20 percent and live on SS you are at a disadvantage. So if you add a supplement such as Aflac you now are paying more. If you wait to sign up they penalize you. How does this benefit us unless you are sick most of the time, yet, if you are sick then you pay the 20 percent and enough 20 percents can cause financial hardship, plus the monthly premium which just increased as well btw. Insurance companies are worse.

[@WhittyPics]

My 50 cent a month drug plan will be free next year. I take cheap generic drugs and that cheap plan is the cheapest for me. I will double check when the enrollment opens and I can check on the medicare site. It seems I read something about the government taking the risks on the added costs.

[@MedicareonVideo]

It is nice when the plans have a $0 premium, especially when you aren't utilizing it much.

[@jlocke78759]

I hit the donut hole recently when I refilled my prescription for Xarelto. The last 2 refills (90-day supply) showed a drug cost of $1615.79 and my cost of $141.00. This time, the 90-day supply showed a drug cost of $1422.02 and my cost was $454.56. Yikes! Nasty surprise at the pharmacy!

[@MedicareonVideo]

Crazy that prescription costs can rival car payments!

[@deniseearly4318]

Medicare can now negotiate the price of drugs and Xarelto is a the top of the list. The current cost for Xarelto is over $600. Medicare negotiated that down to $197 - starting in 2026. So, you will save money if you have to pay 25% of the cost beccause 25% of $197 is a lots less than 15% of $600. ($50 vs $150).

[@jlocke78759]

@@deniseearly4318 Yes, and the "donut hole" has been eliminated.

[@Findingariel]

During this open enrollment period, can you do a video regarding difference between "basic" and "enhanced" Part D plans? It is my understanding (from another Medicare You Tuber) that "enhanced" plans will have less TROOP (true out-of-pocket) costs because the TROOP is based on the "standard benefit cost calculation" and with an "enhanced" Part D plan you will have lower ACTUAL out of pocket copays/coinsurance/and 0 deductibles and reach the $2000 cap without actually having incurred the full $2000 cap since it is based on "standard benefit cost". Confusing, isn't it? Need you to explain all the differences between the two different types of Part D plans.

[@deborahlauman8441]

So, you will need to pay your deductible then if you have 2k of drug expenses you may be spending around 2500 for your drug cost. Is the deductible the same on all drug plans.

[@nancymiller5413]

My understanding is the $2000 max out of pocket includes the (up to) $590 deductible.

[@kenpoulin6672]

Your deductible counts towards the 2000

[@deniseearly4318]

No. The $590 deductible is part of the $2,000. I was just calculating the cost for a person who takes Eliquis and his total cost will be $900 when he stops having to pay for his meds in October. He reaches the $2000 cap even though he will have spent only $900.

[@jplolding]

We’re do I find an insurance carrier near me

[@MedicareonVideo]

@@jplolding give us a call. That’s what we do! 877-885-3484

[@km-bo3zx]

Medicare.gov

[@stubrown]

Maybe just get the info directly from CMS (released today, 09/27/2024): Today, the Centers for Medicare & Medicaid Services (CMS) announced that average premiums, benefits, and plan choices for Medicare Advantage (MA) and the Medicare Part D prescription drug program will remain stable in 2025. Average premiums are projected to decline in both the MA and Part D programs from 2024 to 2025. Enhancements adopted in the 2025 MA and Part D Final Rule, as well as payment policy updates in the 2025 MA and Part D Rate Announcement, support this stability and increase enrollee protections and access to care for people with Medicare. In addition, the Inflation Reduction Act is reducing prescription drug costs and delivering more comprehensive benefits than ever before, including an annual $2,000 cap on out-of-pocket drug costs. CMS is committed to ensuring these programs work for people with Medicare, that they have access to strong and stable choices, and that they have the information they need to make informed choices about what is best for them.

[@jeebs98-br549]

I understand that Mutual of Omaha is dropping its Part D drug coverage for next year.

[@kurtg9684]

I know people who have regular medicare and their supplemental is $600-$700/month

[@user-TM59]

😮😮😮geez!!

[@MedicareonVideo]

Those are pretty high premiums. I would imagine they are older and on some more high cost plans, like Plan F. If they are in good health, it would benefit them to shop their plans through medical underwriting.

[@thomascunningham111]

I have a large premium increase in my 2025 PDP, so I will search for another plan.

[@MedicareonVideo]

It is a good idea to assess every year during AEP.

[@KimberlyGriffin-v4l]

When can I change?

[@MedicareonVideo]

If you are going from Medigap to Medigap, you can switch any month of the year. Most states require medical underwriting, but there is no timeline. If you are switching from Medicare Advantage to Medigap, you can apply (also with underwriting) during the Annual Election Period, which is Oct 15- Dec 7

[@DollyMutchler]

I have AETNA - A SilverScript prescription drug plan. I have 3 Prescription Drugs maintenance. It is free the 2 medicine the potassium 10meq only $9. For 3 months. I like this insurance that I’ve got. I have paid only $13.00. Do we have to call them to continue my insurance or it is automatically renewed. Thanks

[@sunnyvaleria889]

I have same as you. Today Aetna sent me the changes they are making on their prescription plan raising their premium to $45 a month. I only take a hypothyroidism 25 mg medication and do not use other medications.

[@DollyMutchler]

@@sunnyvaleria889 I didn’t receive yet their letters.

[@MedicareonVideo]

You should have received an Annual Notice of Change (ANOC). This letter will tell you if your plan is still available and if it has any changes going into the new year.

[@deniseearly4318]

You need to change plans if Aetna is raising the premium to $49. Look at Wellcare for $0 premium.

[@MK-ft3qt]

No one would have a problem with prescriptions if they ate a proper human diet...

[@willtwain1383]

Keith, why are you so negative about the great policies the government does for us?

[@MedicareonVideo]

I don't try to be too negative, just a little skeptical.

[@willtwain1383]

@@MedicareonVideo The government is our best friend. Democrats are doing what they can against Republicans and the marriage to corporations most Republicans are in.

[@lelocle4262]

Starts at 2:15.

[@MedicareonVideo]

but then you'll miss my intro!