Will the MAJOR CHANGES to the Medicare Drug Coverage System Impact You in 2024?

[@DianneSano-i1u]

Thank you! Very educational. Glad to have you as a resource!

[@Theretirementnerds]

Appreciate you watching! So glad you found us!

[@ADayInTheLifeofLori]

Your videos are so beneficial! I just subscribed. Thank you!

[@Theretirementnerds]

Thank you so much! So glad to hear they are helpful!

[@jacquelinemartin1886]

After listening to a bunch of your videos ("reference an animal so I know watched") I made my Medicare decision to drop Advantage and go to Supplement G, in large measure because of the clearness of your instruction and education. Now I am trying to pick a Plan D. I watched this video above and the donut portion of coverage is still unclear to me. Do you have any other videos on picking a Plan D? I can be a tad dense. Thank you

[@Theretirementnerds]

Hi Jacqueline, want to send me an email to [e-mail] and I can send you a video we have but it isn't on KZbin.

[@reneeledesma3354]

Always being transparent is the honest thing to do.

[@ZDD760]

Thank you for explaining how it works

[@Theretirementnerds]

Thank you for watching!

[@glasslinger]

Well, I checked with my dealer and he said not a problem! :)

[@artimuscoffee8921]

I'm more confused than ever Pray to God I never have to take a medicine like this one

[@1charlastar886]

I've been dealing with a leukemia for almost 14 years. The brand name medication for it is over $21,000 a month. The generic is over $19,000 a month but doesn't work as well for me after trying it for 2 years. My husband retires in June, 2024.

[@Theretirementnerds]

So sorry to hear about what you've had to fight through for so long!

[@Dumbluck14]

Cut to the chase. How did we get screwed?

[@Theretirementnerds]

Depends on your medications. If you have high medication costs, you have an out of pocket max of sorts. If you don't have high medication costs, your monthly premiums going up will help pay for that new max out of pocket cost.

[@shelteredsparrow2736]

I am so appreciating these as I am getting ready to choose a Medicare plan

[@Theretirementnerds]

So happy they are helpful!

[@markschuebel5710]

Go for plan g issue age

[@eduardooramaeddie4006]

Thank you for the information, it's very important

[@Theretirementnerds]

Thank you for your support Eddie!

[@patjohns1179]

that's where i opped out of medicare and use goodrx or singlecare and don't need to pay up the azz for crap coverage at best

[@tucktucker7439]

Erik, informative, but my cancer drugs all got pushed to Tier 5 (specialty drugs) of my plan D for 2024 and the copay 31% of cost? Tier 4 (non-preferred drugs) is 50% of the cost? Where is this 25% limit supposed to be?

[@Theretirementnerds]

That would be in the coverage gap, if the medications are on formulary. This video shows how to use medicare.gov to see medications covered and how they are covered in each month and each phase during the year: kzbin.info/www/bejne/nIjJmIaZgpd7h5Y Hope that helps!

[@ioanstokowski1647]

Excellent presentation. You made this complicated subject understandable, in short order. Thanks!

[@Theretirementnerds]

Thank you so much for watching!

[@wiifit]

I am takig some generic medicine. Somehow GoodRX coupons make those medicine cheaper than what I can get thru Medicare part D. I am also taking a brand-name medicine which has no generic. It costs several hundreds dollars per month, even with Medicare part D. I applied for the patient assistance program from the biopharmaceutical company, and it becomes free due to my low income. So the Medicare part D insurance does not seem useful to me. But of course I am still enrolled to avoid the late enrollment penalty.

[@paulherring8959]

Now I understand why my part D plan monthly premium is going up from $32 and change to $68 and change. But at least there's now a maximum limit to what I'll have to pay if I need it.

[@Theretirementnerds]

You are correct! These changes are a major reason why Part D premiums, in general, have increased quite a bit. Thank you for watching!

[@tinalippincott9823]

Thank you, Erik, for keeping us all up to date with the most current information. I am grateful I am not on any prescription meds but am not naive enough to think that may always be the case. Excellent, well organized presentation, as always.

[@Theretirementnerds]

Thank you fornyour support Tina!

[@joannekearney5329]

Question... do you know what the difference is between Silverscripts choice and Silverscripts smart saver Part D plans?... Choice premium is about $53/m with a $545 deductible..while smartyaver is $15/m with only a $280 deductible. Seems too good to be true. The only obvious difference I can find is that one of my pharmacies is not in the network..but two others are. I called the company but got someone whose accent I had trouble with and his explanation was even more confusing. I can't help but think that I am missing something. Do they have different formularies? Thanks

[@Theretirementnerds]

Hi Joanne, Medicare has super strict rules about agents sharing plan specifics in a public forum like this, meaning specific companies and those plan benefits. So, a little tied on what we can say to those plans specifically. However, different part D plans cover different medications (formularies as you mentioned). Some part D plans include higher cost meds on their formulary and others don't. So, if you don't take the expensive meds, and don't need the bigger formulary, the higher cost doesn't make sense. If you do have higher-cost meds and need the formulary, may be worth paying a higher premium. The big filter to use is "Lowest estimated cost" Don't look at lowest premium or lowest deductible or lowest drug cost. Lowest estimated cost is the combination of premium + drug costs and that's the important number. Hope that helps!

[@davidfolts5893]

Thanks 90 Days From Retirement! It will be nice to have a MOOP of $2,000 in 2025 for Medicare drug costs; that's a big deal!

[@Theretirementnerds]

Agreed! Still waiting to see the other effects of that change. Hopefully they won't be too dramatic

[@davidfolts5893]

@@Theretirementnerds Formularies get smaller?

[@Theretirementnerds]

@davidfolts5893 maybe. More likely is higher premiums. Average in 2023 was $31.50. Projections for the average in 2024 are sitting around $55.50 😬 Benefits may change, meaning potentially higher copays and coinsurance amounts in initial coverage where more are approaching that 25% mark rather than the 6.6% example in this video. Tiering of medications may shift. Bumping some to higher tiers. Carriers will offer first looks at 2024 plans here soon and we'll have a better view into what's coming.

[@davidfolts5893]

@@Theretirementnerds Thank you, I will factor that into our 2024 spending.🙏

[@pattyeverett2826]

The big thing that could be done to lower drug costs is to change the patent laws. Right now, big Pharma companies abuse these laws by slightly changing their formulas to extend their patents. They tried this in India and were told to go to legal you know where, your patent has expired. The biggest abusers are the makers of insulin(the original developer of insulin gave the patent away to save lives). With the $35 cap now, seniors may not feel the pain anymore, but people on private insurance and people that have no insurance sure do. There are other abusers of the patent laws also, Abbvie comes to mind.

[@Theretirementnerds]

Such a convoluted system. A lot of things that work together to make things harder on those who use it. We don't have the answers, but we hope our seniors are protected. Thank you for watching and sharing!

[@pattyeverett2826]

@@Theretirementnerds The answers are there, other countries use them!

[@goaski474]

As if the Manufacturer isn't going to factor their insurance payout into the original cost of the drug, making their contribution effectively ZERO. This is asinine. My wife and I have two high cost drugs apiece. We get 2 months 'free', oh thank you so much! We also just received a letter that our medigap in NY is increasing 15%. Yep, 15%, inflation is currently ~4%. PS -you also left out the monthly cost of part D. Truly, thanks for the explanation. Maybe the Administration should forgive drug costs instead of student loans, something they signed up for? I certainly did not sign up for this BS - it was forced down my throat.

[@Theretirementnerds]

Thank you for watching. Lots of moving parts, and yes, the monthly cost of Part D is likely to increase this coming year. As soon as we get actual data, we'll be sure to make some updates.

[@HRHolm-bi6zu]

And what about the drug coverage under Medicare Advantage/Part C plans?

[@Theretirementnerds]

Works the same way and follows the same phases. Minor difference in deductibles in favor of many Advantage plans. Here's a video on the differences: kzbin.info/www/bejne/iKCqfmSfe51lldU

[@andreah6379]

I am so glad I don't need any major drugs at all. So damn complicated. And expensive. So much cheaper in other countries. We are being screwed by big pharma, fellow Americans!!💥

[@dmansfieldlife]

and now for... the rest of the story. So where do you think the money is going to come from to pay for these expanded benefits for those with high drug costs? That's right, you guessed it. It will come from the plan costs going up for those with low drug use. So everyone is going to pay more for all RX plans to pay for these improved benefits for those that take lots of drugs. Many of these people in this situation are already getting their drugs mostly paid for through Medicaid. So this will be a windfall for the drug companies. This will save Medicaid programs money. So who gets stuck paying for the drugs? The majority of the people that don't currently have high drug costs. In addition; There will be less incentive for people to take less medication. There will be less incentive to use generic medication. Drug companies will be releasing new medications at higher costs as fast as they can that Medicare will have to cover. As usual this all sounds great but the devil is in the details.

[@eddiea3782]

I can see a lot of folks just cancelling their prescriptions meds. When money gets tight. Including myself.

[@dmjh932]

In the coming year we plan a change with my wife's Medicare supplement and part D coverage. She's had a supplement for 9 years. I have had an advantage plan for 10. I have literally saved thousands of dollars. In 2024 we've decided to drop her Mutual of Omaha supplement and go with a UHC advantage plan. We'll save more than two thousand dollars in premiums which will be applied to her many maintenance drugs. She can then within that year return to her supplement G without any underwriting. It's that one time zero risk opportunity we're going to use.

[@Theretirementnerds]

Correct. You have the trial right if you need it for this year. Monthly premiums are an important consideration, including the Part D premiums. Thank you for watching and sharing your perspective!

[@Revelation21NINE]

And what if you don't take ANY drugs, you still have to pay this exorbitant $545???

[@Theretirementnerds]

No, if you don't take any medications, you do not have to pay the deductible.

[@douglasbriel6103]

I've never had to pay over a couple bucks per medicine before. There was some note about Medi-Cal no longer covering medicine, but I don't really understand.

[@Theretirementnerds]

Not familiar with that update either. Possibly moving drug coverage to Medicare for those eligible for both Medi-cal and Medicare?

[@rgr3427]

The “Donut from hell”, what a crazy government scam. Don’t forget, you have to get a new donut each year and it’s starts all over again and the amounts and rules of eating the donut can change, wow…

[@Theretirementnerds]

It can be a mess, for sure. 2025 gets rid of the donut hole (finally), but we'll have to see what the consequences of that decision will be as we get closer. Thank you for watching!

[@tomrobertson3236]

You can thank Bush and the Republicans of that time

[@rgr3427]

Both parties are culpable, tax us and then tax the money we receive after paying into a tax funded program plus increases in fee’s to offset any cost of living increase. Worse than the great Ponzi scheme, 401k.

[@horrifiedheartlander]

The thing that gets me about Plan D is how much more expensive it is if you become seriously ill in November than January. In just a month's time, you ha ve to pay a high deductible as if you had gotten sick all over again. 😠

[@sweetie2219]

I still don t understand something. I take low cost generic drugs and will not meet the 545 deductible in 2024. I am turning in Jan 2024. So what happens then. Do I pay the premium and the price of the drugs?

[@Theretirementnerds]

That will depend on your plan. Many plans cover tier 1 or Tiers 1 & 2 before the deductible. You would pay the premium and either nothing (depending on your plan) or the deductible and a small copay.

[@oldmanjimh3165]

Once I meet $8000 I'm broke. I'm just on S.S. and no way can I afford $8000 each year.

[@Theretirementnerds]

The good news is you don't need to meet $8,000. It comes out to about $3,300 out of pocket if you have very high medications. $3,300 is still a lot, but it's not 8,000 :)

[@188jan]

With all this expensive medications. Seem it’s better not to retire 😂

[@Theretirementnerds]

I get the sentiment! Drug plan changes are limiting the exposure, albeit at higher premiums costs. Unfortunate that drug coverage is so pricey for seniors. Thank you for watching!

[@Shortie5-1]

I watched a video of yours about having a year to change to a new Medicare plan without underwriting when your a new member to Medicare. Is that true?

[@Theretirementnerds]

Hi there! If we're talking about Supplement plans, yes. The state you're in may impact this. Some states are more flexible. But for most states, if you take an Advantage plan when you are new to Medicare during your initial enrollment period, you have that 12 month "trial right." There is another trial right for those who initially took a supplement plan and switched to an Advantage plan. They also get this trial right to switch back to original Medicare and a Supplement plan within those 12 months of the first switch to an Advantage plan. So, they can go: Supplement to Advantage to Supplement (within that 12 month window). They CANNOT go... Supplement to Advantage to Supplement to Advantage (2nd time now) and then back to Supplement. It's just that first switch. Does that make sense or make it more confusing?

[@masterlee4370]

I believe most of us never ever thought about any of this in our 20's, 30's, 40's. and 50's. I know I sure didn't. I have trouble understanding why a drug like this one used for preventing blood clots is so expensive. I remember my first job in high school at age 16 working at National Food Store, a grocery chain. Tuesday's was senior discount day. I think 62 and over got 5% off their grocery bill. We would get a lot elderly people on that day. I didn't think much of it back then, but I would think many of them were living off their social security and maybe a few had a pension too. This was in 1975 so there was no 401-k plans that I know of. I know my company didn't start the 401-k until 1980. So all these years many seniors have had to deal with this issue. I am glad the government is finally stepping up to help make it better for seniors. I know one of your videos has 2025 being even better than 2024. I have mixed feelings about technology in general, but this is one area I am grateful for as your videos help keep us informed, and help guide us in the right direction on taking the best steps going forward when we start medicare or are already on medicare. Great Video!

[@Theretirementnerds]

It's so true. Our brains, for the most part, put away information we don't need in the immediate future, so planning for these things in our 30s, 40s, and 50s isn't something most people think about. It'll be interesting to see the shifts in the market with the 2024 changes and the 2025 changes. Hopefully it doesn't cause negative consequences for Medicare beneficiaries. Appreciate you!

[@paulherring8959]

Now consider voting for Joe Biden next year. Legislation and changes he has made are helping seniors out far more than Trump ever would. We never even saw page 1 of Trumps "glorious" health care plan.

[@felixgarcia9063]

I'm screwed! I'm thinking of getting a supplemental plan because of my hardship health which I can barely afford. Now this BOMB for 2024 will throw me over. Pension and SS = $45k without taxes. Holy Crap! I wonder if anyone will refuse my meds and healthcare if I don't have the money since I need a roof over my head. Not to mention food, car and car maintenance, utilities...

[@Theretirementnerds]

Sorry to hear about the hardships. 2024 medication updates are positive in general. The premium changes on that are yet to be seen. We hope it will all work out for you! Let us know if we can help in any way.

[@newliferadio3918]

Time to trust God for your life