Shocking Changes to Medicare Drug Plans - Medicare Part D

There are some pretty significant changes coming to Medicare this year that we need to understand. We need to talk about it so we don't get hit with these surprises. It seems like once we start to figure out this whole Medicare maze then they change things and they make it complicated and they keep us kind of wondering exactly if we're in the right place. I'm gonna go through what's changing primarily this year big time with Medicare Advantage, big time with Medicare drug plans. I'm going to talk right now about the changes that are coming to Medicare drug plans and they're pretty significant so we want to be ahead of this and understand exactly what's going to take place when it changes. So I'm Keith Armbrecht, founder of Medicare on Video. I help people across the country make the right Medicare choices, figure out everything we need to know about Medicare. I can absolutely help you. We get you educated. We get you enrolled. We do everything that's needed to be done and the best part is there's no cost to you to allow us to help you. So I'm an independent insurance broker. I work with just about every major insurance carrier. I do not work for the insurance company. I work on your behalf. We find the best plan at the best price. We enroll into that plan and we just put all your pieces in the right places. So hopefully you'll allow us to help you. You can either give us a call direct or you can just fill out the form on my website and we will email you a quote for the best Medicare supplement plan that's in your zip codes. We make it very easy, no pressure, no push. We just want to make sure that we get it right from the start. So right now let's talk about the changes that are coming to Medicare drug plans. I want to take a quick minute and invite you to join my private Facebook group Talking Medicare. It's a great place to find answers to ask questions without having any pressure from other sales people or insurance agents. It's a bunch of people on Medicare talking about Medicare with their experiences and things that they need to understand. So take just a minute visit TalkingMedicareGroup.com. It's absolutely free. You can join right there. Hope you find it very helpful. Enjoy the video. Now it's not that surprising that there are changes coming because guess what? It's an election year. So things change more dramatically sometimes in election year where they may think it's for the best for people or at least it looks like it's a good thing like the government is actually doing something. So they have initiated this is falling under if you recall what was called the Inflation Reduction Act, a bill that was passed in Congress that really didn't have a whole lot to do with reducing inflations but they put these silly names on them and it has a whole bunch of stuff that's in it. One thing that was in it was some change to Medicare drug plans. So they're trying to give the appearance that they're making things better. They're making things easier. So what's going to come along this year is they're going to put a cap on the maximum out-of-pocket of a Medicare drug plan and that cap is going to be two thousand dollars for the year which sounds fantastic. Number one, most people don't ever get to that stage in a Medicare drug plan of having two thousand dollars of out-of-pocket costs but certainly some do. So it is good for the ones that have a significant usage of medications under Medicare drug plan things for things like cancer and things like that. It can absolutely be a lifesaver for them to have an annual maximum on their out-of-pocket expenses. Now on the flip side of this what it also does is when you put that cap on out-of-pocket expenses what it's going to do it's going to raise premiums. So you're going to see an increase in a lot of drug plans on the premium side. So what we need to do this year for sure is make sure that we do a comparison. If you have a Medicare drug plan you're going to want to do a comparison because your price may go up in premium and we want to make sure that you have the best one. And the way to do that it's very simple to do. I never recommend that you get a Medicare drug plan from an insurance broker like myself because insurance brokers don't have access generally to every single drug plan that's available to you. So you may not get the best plan at the best price simply because whoever you're speaking with that's selling you something doesn't have access to that plan. So Medicare makes it really easy. They have a Medicare drug plan finder and I have a video that walks you right through it. It's really simple you put in your drugs you put in your pharmacy and it's going to show you in your zip code what the best plan is. I'll put the link to that video below this one in the description so you can just walk through that Medicare drug plan finder. I would highly recommend this year you absolutely do a comparison just to make sure you're in the right place with your Medicare drug plan. Now something else that's coming into drug plans and this is on the positive side is they have eliminated what is called or known as the donut hole. You've certainly probably heard of this in the past where we had a Medicare drug plan where you will have a deductible then you'll have some co-payments co-insurance and then you kind of fall off this cliff into what is known as the donut hole. In other words very little to no coverage on your medications while you're in that donut hole until you reach a certain amount and then you go into catastrophic coverage. So they are eliminating the donut hole which will provide better coverage in between tiers as you go along through the Medicare drug plan usage and it's set up to help people that reach the higher levels where their out-of-pocket expenses can certainly be burdensome and we want to make sure that we make it as easy as possible to access medications as you go forward. The donut hole has always been a point of contention confusion within a Medicare drug plan so it's a good thing that the donut hole is going away so we don't have to worry about that anymore after 2025 within our Medicare drug plans. Now something that is on the negative side that's changing in a Medicare drug plan is the deductible. So the maximum deductible is going to go up and this year it's going to be $590 which is a significant deductible. It wasn't long ago like within the last 10 years that there was little deductible on a Medicare drug plan. It started then at $100 and has gone up and gone up and gone up and now it's at $590 but what we need to understand about the deductible on a drug plan is it doesn't apply to everything. So it applies primarily to expensive medications, higher tier drugs that you may come into need if you have again things like cancer or experimental type scenarios, new drugs that come out, very expensive stuff that are in the tier 3, tier 4, tier 5 categories of Medicare drug plans and again they set these things up just to make it complicated for us to figure out where we have a tier 1 medication, 2, 3, 4, 5 but the deductible typically applies to those expensive medications. It doesn't apply if you're in a tier 1 generic medication, tier 2 generic medication. You're probably not going to see that deductible. You'll simply have a co-pay on your Medicare drug plan. So it's something you just need to understand and when you're shopping or comparing look at the deductible. Just because it's a lower one on one plan doesn't mean it's better. We need to understand what it applies to. So understand that when you're shopping or comparing that that deductible isn't kind of a hard deductible. It depends on where it applies when you're going to utilize your Medicare drug plan and that's the good thing about the drug plan finder on Medicare. When you put in your medications it's going to give you the best plan based on total out-of-pocket costs. So the premium of the plan, when the deductible would be used, the co-insurance or co-pays that would fall in based on your current medication. So it works really really well. It's one of the best tools that I've seen that can give you an accurate really thumbnail of your best choice for your Medicare drug plan going forward. So now when we talk about this bigger deductible and this $2,000 out-of-pocket max, if you are in the position where you are facing those out-of-pocket costs. So you're obviously not in a great position medically and you have some expensive medications. We don't want to have a financial burden on top of it but that's generally how things work. But with this new change that's coming to Medicare drug plans is they're going to also include a payment plan. So if you do have those higher out-of-pocket expenses and again it's a cap now on that $2,000 out-of-pocket max where you can spread it out over the year. So you don't have to pay it all. Some people may get it in the first quarter of the year if you're taking really expensive medications. You can now spread that out so it might be a little bit more manageable from a budget standpoint to help with your medication costs as you go throughout the year. Now another change that is coming and again for the positive side or at least the appearance on the positive side is they're going to cap Medicare drug plan premiums at six percent. And this is a little gray at this point. It's not completely understandable on how it's actually going to work going forward but assuming that after 2025 starting in 2026 that whatever premium you currently have cannot go up by more than six percent. And again this may or may not be accurate. A lot of things get passed where when it comes time to implement it isn't always what they've said it's going to be. So just keep that in mind with something like this a premium cap because it's hard to have a premium cap and a cap on out-of-pocket costs because there's going to be cost to somebody somewhere generally the insurance carrier. So either they got to raise premiums or they have to have more out-of-pocket expense on you. But if they're capped on both sides it can be difficult and you may end up losing carriers that offer plans which can be a whole bigger problem when it comes time for having the right selection of things that we need. So those are primarily the changes on Medicare drug plans. Now this is also going to factor into Medicare Advantage plans because Medicare Advantage incorporates Medicare drug plans into their programs. So if they now have higher expenses within their Medicare Advantage plan to the insurance carrier we know that that doesn't just kind of dissipate. It's going to come out somewhere on either higher upfront costs, premium costs for Medicare Advantage or what you're also going to see this year is less of those extra benefits that they promote on TV all the time and they're very you know they're underutilized for one but they generally sound better than they actually are. But you're going to see a pullback on a lot of that because number one Medicare Advantage plans also did not get the funding that they were expecting for this year. So they've got less funding and what you're also going to see on the Medicare Advantage side is a number of them are pulling out of counties. So they have plans if they aren't over-performing in certain counties they're just going to stop and pull that plan out of that county. So a lot of people this year and we're talking millions are going to see a notice from their Medicare Advantage plan that says we're leaving and we're not going to be available to you next year. You need to find other coverage and this will throw a lot of people into really chaos on trying to figure out what the best coverage is for them for the next year. And if you've seen any of my other videos I never recommend Medicare Advantage. There's too many things like that that can happen. You know I mean God forbid the entire plan goes away but certainly your doctor can go away, your hospital can go away. It happens much much too often. They have too much control over everything that revolves around your health coverage and just not something that I would want to have personally. Original Medicare A and B with a Medicare supplement plan gives you all the control, gives the doctor all the control. They don't have these oversights of a private insurance carrier within a Medicare Advantage plan. So original Medicare is fantastic. It's also not unaffordable compared to a Medicare Advantage plan. Something a lot of people don't understand your Medicare Part B premium everybody pays regardless on whether you stay on original Medicare or whether you go into a Medicare Advantage plan you're still going to have that Part B premium. Then you just add a supplement plan and a Medicare drug plan to original Medicare and you've got fantastic health insurance. I mean stuff that you just don't have any worries about as you utilize it down the road and we certainly know we're all going to utilize it more as we get older. So I would always recommend staying with original Medicare whatever you can do. It just makes life so much easier. So I hope you found this helpful and this is what we do. Again I'm an independent insurance broker. We take you by the hand. We make sure you understand everything that's going on. If we're going to stay with original Medicare, we find the right supplement plan that fits into your budget. We enroll you into that plan so you don't have to do anything. It's very easy. We can do it all over the phone. We don't have to meet in person. It makes life easy and we get all your pieces in the right places so when it comes time to go into Medicare you know you got it right. It just makes things the way it should be. So I hope you found this helpful. Have a fantastic day and I'm glad to help wherever we can. Here's another video that I think you'll find very helpful with important information about Medicare that you really need to understand even if you're already in Medicare and then below it there's a playlist that has different videos that cover smaller topics that makes it easier to understand things that you need now and in the future for Medicare. So I hope you find them helpful. Have a fantastic day.