Part D of Medicare - 2023 Changes and Donut Hole Example

Senior Advisors- Bringing Clarity to Medicare

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This brief video outlines how Part D of Medicare works including the different phases - Deductible, Initial Coverage Level, Coverage Gap aka Donut Hole, and Catastrophic Coverage. About 85% of people won't reach the Coverage Gap or Catastrophic Coverage, but if you have expensive medications (~15% of people) you will likely reach the Coverage Gap. This video includes a detailed example for those of you that like to 'geek out' on data, like me :-)
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Опубликовано:

6 авг 2024

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Комментарии : 43

@mikenixon2401 Год назад

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 Год назад

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.

@henwhisperer Год назад

Thank you. Informative video.

@SeniorAdvisorsMedicare Год назад

Thanks for watching !

@kathleenbirkelbach-uy3pl 10 месяцев назад

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

@SeniorAdvisorsMedicare 10 месяцев назад

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 ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-x9ZUf_jwkrE.html

@toktalk9974 Год назад

Thanks. Subscribed and liked !

@SeniorAdvisorsMedicare Год назад

Thank you for the feedback and subscribing!

@Angelstar7774 Год назад

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

@SeniorAdvisorsMedicare Год назад

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 ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-DWE7tQSlw_w.html

@Angelstar7774 Год назад

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

@SeniorAdvisorsMedicare Год назад

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

@Nowinspiredtoday 11 месяцев назад

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

@SeniorAdvisorsMedicare 11 месяцев назад

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.

@kimberlylovellette5117 9 месяцев назад

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

@SeniorAdvisorsMedicare 9 месяцев назад

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

@soniaivette 2 года назад

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

@SeniorAdvisorsMedicare 2 года назад

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 Год назад

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 Год назад

Thank you so much for that explanation!!

@SeniorAdvisorsMedicare Год назад

@@jamesbungert3155 - thank you for your feedback.

@SeniorAdvisorsMedicare Год назад

@@soniaivette - thanks Sonia.

@joycephelps3926 2 года назад

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

@SeniorAdvisorsMedicare 2 года назад

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.

@ronv9189 Год назад

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 Год назад

Hi Ron, the drug prices are specific to the Part D Plans. If you send us an email to info@senior-advisors.com 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.

@johnsedarat143 Год назад

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

@SeniorAdvisorsMedicare Год назад

Thank you for your feedback.

@bytheSEAsoaps Год назад

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 Год назад

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 Год назад

None ..false advertising.

@SeniorAdvisorsMedicare Год назад

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

@johnlutz9275 11 месяцев назад

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 10 месяцев назад

Hi John - thank you for the feedback. You will be happy to see the donut hole going away finally in 2025! ru-vid.com/video/%D0%B2%D0%B8%D0%B4%D0%B5%D0%BE-x9ZUf_jwkrE.htmlsi=iVzP3H36x1rEram0

@johnlupo3919 Год назад

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

@SeniorAdvisorsMedicare Год назад

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

@barrysimmons4546 Год назад

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

@SeniorAdvisorsMedicare Год назад

Hi Joseph - thank you for your perspective.

@mikenixon2401 Год назад

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

@barrysimmons4546 Год назад

@@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.