its not a plus for seniors....shifting the percentages medicare pays to the drug companies...means the insurance will go way up each year..and we probably beg to get the donut hole back....i can see doubling cost o part d insurance...just when Srs get hit by inflation...now this...unreal
@@GiardiniMedicare I just received my updated premium for Part D...my monthly premium went from 6 bucks per month to 50 bucks per month....and no change in my medication over the past several years. Clearly, the insurance companies and drug companies are just passing the new costs to them on to the consumer. Monthly premiums are not considered out of pocket. Cant believe our government did not know this would happen.
If the $2000 cap will increase the cost to the insurance company by 30 to 40 percent for about two million people, then why would it increase premiums 30 to 40 percent for sixty million people? Only a small percent spend over the 2000 anyway.
@@threeftr3349 Yeah, there is little doubt that insurance companies will be raising premiums at this point. Consumers will always lose compared to insurance companies.
They will likely remove some medications, but they can't just remove all of them since Part D plans have to cover at least two drugs in most drug categories.
I hate to be the one to break this to you, but tax dollars are cancelled by the IRS on receipt. Taxes do not fund spending. The US has a fiat currency. That means that Congress funds spending by fiat, or 'on demand.' If you don't understand this basic fact about government spending, you shouldn't offer your opinion. The onus of these changes will fall on Medicare beneficiaries. It NEVER falls on insurance companies. You didn't have to wait until the end of the video to figure that out.
That might have been the case before Medicare recently released the new Part D Premium Stabilization Program. Now, there is no telling what will happen!
So Medicare, our gov is just throwing the elderly deeper and deeper into the for profit insurance companies in retirement., Just like they did by calling Part C Medicare that really are for profit private insurance companies.
2 things, you will have fewer drugs to choose from, such as switching to older, less effective, and more side effects of drugs. 2nd, the healthier patients will be subsidizing the sicker patients, just like ACA of Obama care. In 2025, patients (not the insurance companies who get money from the patients) will be paying more for drugs. than the government.
This seems nuts to me. How can the insurance companies absorb such massive cost shifting to them? The monthly part D premiums are going to have to go way up or just drop the line of business completely.
They will still receive large amounts of federal government subsidies, but you are correct that they will almost certainly have to increase premiums to compensate. Insurance companies practically never "absorb" costs and instead pass them to consumers.
It does seem that the insurance companies are shouldering the majority of burden. Drag manufacturers got off light with just 20% contribution. Seems that drug companies are the root of the problem by charging such high prices for medications. It seems to me the split should be closer to 50/50 for the extra burden the govt is offloading.
I believe that's the plan shift blame to insurance companies, when in reality it's the morons that sit in DC that are the cause of this. Stop printing money, stop sending money to foreign nations at war and stop the insane open borders. That is where the money is going. And those that write these bills they don't have to worry they have their own insurance the Cadillac plan government run, yeah and we pay for that too. This is all BS
Drug manufacturers are the root of the medication costs. They employ dubious business practices to keep prices elevated and ever increasing. Here's an example. My wife just went onto medicare and got a Part D plan that does cover all of her medications. One of the medications, Rasuvo costs about $1,000/Month. Her provider suggested she get the drug in vials and inject herself vs using the expensive "pen delivery" of the brand name drug. We agreed. The pharmacy has been trying to get the methotrexate vials for weeks now and say it might be another month, it's all on backorder. How convenient. There is no shortage of the $1,000 Pens, but low cost vials of what is a longtime generic drug is unobtanium. This is clearly market manipulation. Who can I complain to to get this looked into and resolved?
Thank you for the informative video. I have a question: Can one benefit from the $2,000 out-of-pocket upper limit without enrolling in a Medicare Plan D plan?
I already commented but forgot I had a question. Right now I have WellCare with 0 premium. But they offer a few more Part D plans with different costs. I’m not sure what I’m missing. Can you talk about that in a future Part D session? Thanks!
You likely aren't missing anything. We talk about how to narrow down Part D options in this video: ua-cam.com/video/FyKxOPGGpDg/v-deo.htmlsi=rK6ulF8JV_tT7wCX It just comes down to finding the plan each year that covers your medications for the lowest (or almost lowest) price. We will make a newer version of this video in October for the 2025 plans so you can compare your options for next year to see if Wellcare is still the right option.
@@GiardiniMedicareyour welcome, Matter a fact all retirement accounts are protected from collections. I learned that from an attorney on YT, if I find them again I will send you their channel
If it is only for weight loss, no. However, Wegovy recently changed so that it may be covered for those who also have it prescribed for cardiovascular disease: www.kff.org/medicare/issue-brief/a-new-use-for-wegovy-opens-the-door-to-medicare-coverage-for-millions-of-people-with-obesity/
Ozempic has always been covered by Medicare for diabetes. Under my Part D plan I paid $45 until I hit the donut hole, then my cost jumped to $465 until I entered catastrophic
It's a side effect of the changes we discussed in this video. There are many other Part D options on the market, so make sure they compare their options starting on October 1st.
Shop your plan starting October 1st. Hopefully there will be more cost-effective options, and we will have a video for how to check your Part D options using Medicare.gov
I only take 1 prescription drug. It's only about $60/yr. Even cheaper when I use a PBM like GoodRx. If I don't get a Part D from the start, can I get it later? Would it still cover any new meds required when I signed up for coverage?*********Never mind******Just found your video on "Part D analysis". Thks
Just so others can see, the answer would be yes; you can still get it later to cover your medications at that time... BUT you would have a lifetime penalty once you sign up.
Is the Annual Notice of Change always mailed? I have signed up for electronic delivery of most documents with UHC/AARP. Will I need to go online to obtain this document at the appropriate time?
I'm 76 years old and enrolled in Humana Medicare part D. I pay a monthly premium of $60 for four medications - high blood pressure cholesterol and GERD. Would my premiums be lower with only two medications?
It's possible, but it entirely depends on the medications. One medication can be more expensive than 10 low-cost medications. You can try to see the costs with different combinations using our previous video: ua-cam.com/video/3EKyPZbIxo4/v-deo.htmlsi=OvtV9DJt_72F2En3
For 2025, no, it should not since plans can still use simplified methods to determine Part D creditable coverage. Just pay attention to your coverage, but I won't worry about it now.
@@GiardiniMedicareI'm glad you think so. The complexity of coverage for aging people just ratcheted up another notch. Looks like Medicare found a way to pass financial burden using the insurance companies who most assuredly pass it to mostly retired, and positively aging people who were supposed to be supported. The intricacies of coverage alone for brains slowing down are mind-boggling not to mention for their support system of family & caretakers.
this part i don't understand, the $2000 spending cap. currently the medications i get cost me $0 dollars. they are on my drug plan formulary. does this mean i will have to pay the full cost of the drugs until i reach the $2000 spending cap? plus the monthly fee just to have the drug plan? i only take 2 drugs. levothyroxin and atorvastatin. is this saying that our monthly fee will be higher or is it saying we can opt into a plan where we add on another monthly fee to cover more expensive drugs? very confused
It means your copays and out of pocket costs would count towards the $2,000 cap. If your medications are still a $0 copay then $0 would count towards the cap and it wouldn’t really matter for you unless you need more expensive medications.
Thank you for this great information. So now I’m just mildly concerned with how much my premium will go up. But it sounds like it won’t be crazy high. Whew!
God help Our Real American People and Our Elderly, Disabled and Vets 🙏
A well-produced, informative presentation! Thank you!
I fear the PBMs will more aggressively deny PAs.
😢I got a 50 cent plan.get my drugs cheaper from Amazon than with my insurance
its not a plus for seniors....shifting the percentages medicare pays to the drug companies...means the insurance will go way up each year..and we probably beg to get the donut hole back....i can see doubling cost o part d insurance...just when Srs get hit by inflation...now this...unreal
Only time will tell
@@GiardiniMedicare I just received my updated premium for Part D...my monthly premium went from 6 bucks per month to 50 bucks per month....and no change in my medication over the past several years. Clearly, the insurance companies and drug companies are just passing the new costs to them on to the consumer. Monthly premiums are not considered out of pocket. Cant believe our government did not know this would happen.
If the $2000 cap will increase the cost to the insurance company by 30 to 40 percent for about two million people, then why would it increase premiums 30 to 40 percent for sixty million people? Only a small percent spend over the 2000 anyway.
Those two million people have much higher prescription costs compared to most. At this point, only time will tell.
That makes to much sense, unfortunately insurance companies will raise the rates on everyone, thus insuring their profits in 2025.
@@threeftr3349 Yeah, there is little doubt that insurance companies will be raising premiums at this point. Consumers will always lose compared to insurance companies.
Does the shift in cost from the Medicare to Part D insurers really end up shifting the cost to higher premiums paid by customers?
No one knows for sure yet, but almost certainly, yes.
Of course.
Won't the insurance companies just remove expensive drugs from their formulary ?
They will likely remove some medications, but they can't just remove all of them since Part D plans have to cover at least two drugs in most drug categories.
I hate to be the one to break this to you, but tax dollars are cancelled by the IRS on receipt. Taxes do not fund spending. The US has a fiat currency. That means that Congress funds spending by fiat, or 'on demand.' If you don't understand this basic fact about government spending, you shouldn't offer your opinion. The onus of these changes will fall on Medicare beneficiaries. It NEVER falls on insurance companies. You didn't have to wait until the end of the video to figure that out.
Thanks for the kind and supportive comment☺
the insurance companies will simply double their rates for their Part D plans.
That might have been the case before Medicare recently released the new Part D Premium Stabilization Program. Now, there is no telling what will happen!
So Medicare, our gov is just throwing the elderly deeper and deeper into the for profit insurance companies in retirement., Just like they did by calling Part C Medicare that really are for profit private insurance companies.
2 things, you will have fewer drugs to choose from, such as switching to older, less effective, and more side effects of drugs. 2nd, the healthier patients will be subsidizing the sicker patients, just like ACA of Obama care. In 2025, patients (not the insurance companies who get money from the patients) will be paying more for drugs. than the government.
This seems nuts to me. How can the insurance companies absorb such massive cost shifting to them? The monthly part D premiums are going to have to go way up or just drop the line of business completely.
They will still receive large amounts of federal government subsidies, but you are correct that they will almost certainly have to increase premiums to compensate. Insurance companies practically never "absorb" costs and instead pass them to consumers.
It does seem that the insurance companies are shouldering the majority of burden. Drag manufacturers got off light with just 20% contribution. Seems that drug companies are the root of the problem by charging such high prices for medications. It seems to me the split should be closer to 50/50 for the extra burden the govt is offloading.
I believe that's the plan shift blame to insurance companies, when in reality it's the morons that sit in DC that are the cause of this. Stop printing money, stop sending money to foreign nations at war and stop the insane open borders. That is where the money is going. And those that write these bills they don't have to worry they have their own insurance the Cadillac plan government run, yeah and we pay for that too. This is all BS
Drug manufacturers are the root of the medication costs. They employ dubious business practices to keep prices elevated and ever increasing.
Here's an example.
My wife just went onto medicare and got a Part D plan that does cover all of her medications. One of the medications, Rasuvo costs about $1,000/Month. Her provider suggested she get the drug in vials and inject herself vs using the expensive "pen delivery" of the brand name drug. We agreed. The pharmacy has been trying to get the methotrexate vials for weeks now and say it might be another month, it's all on backorder. How convenient.
There is no shortage of the $1,000 Pens, but low cost vials of what is a longtime generic drug is unobtanium. This is clearly market manipulation. Who can I complain to to get this looked into and resolved?
If the cost falls more on insurers, it will increase premiums. Someone has to pay.
Thank you for the informative video. I have a question: Can one benefit from the $2,000 out-of-pocket upper limit without enrolling in a Medicare Plan D plan?
No. You would have to enroll in standalone Part D or a Medicare Advantage plan with prescription coverage.
Thank you,! your program is always substantive and informative. ❤
The best solution is to change your lifestyle and get off of as many prescription drugs as possible.
Always a good analysis from you. More people should watch your videos.
Thanks! Always trying to make each video better than the last.
This is the best Pard D overview I have seen - mind if I use it on my website for educational purposes?
You can absolutely use it. Thanks for the feedback
I already commented but forgot I had a question. Right now I have WellCare with 0 premium. But they offer a few more Part D plans with different costs. I’m not sure what I’m missing. Can you talk about that in a future Part D session? Thanks!
You likely aren't missing anything. We talk about how to narrow down Part D options in this video: ua-cam.com/video/FyKxOPGGpDg/v-deo.htmlsi=rK6ulF8JV_tT7wCX
It just comes down to finding the plan each year that covers your medications for the lowest (or almost lowest) price. We will make a newer version of this video in October for the 2025 plans so you can compare your options for next year to see if Wellcare is still the right option.
@@GiardiniMedicare Thank you! This video gave me good info about using the site and I’ll watch for the 2025 one later this year.
If an elderly person's only income is Medicare, you cannot sue them in collections. Social security income is protected by law from collections.
Thanks for the added info!
@@GiardiniMedicareyour welcome, Matter a fact all retirement accounts are protected from collections. I learned that from an attorney on YT, if I find them again I will send you their channel
@@threeftr3349 That would be great, thanks!
Will the new weight loss drugs be covered? Wegovy and Ozempic?
If it is only for weight loss, no. However, Wegovy recently changed so that it may be covered for those who also have it prescribed for cardiovascular disease: www.kff.org/medicare/issue-brief/a-new-use-for-wegovy-opens-the-door-to-medicare-coverage-for-millions-of-people-with-obesity/
Ozempic has always been covered by Medicare for diabetes. Under my Part D plan I paid $45 until I hit the donut hole, then my cost jumped to $465 until I entered catastrophic
@@cherylgarrett4455 Exactly. Just comes down to what it is prescribed for.
A relative of mine on Medicare just recieved a notice that her part D was going from $5.00/Month to $40.00/Month for her same coverage, what happened?
It's a side effect of the changes we discussed in this video. There are many other Part D options on the market, so make sure they compare their options starting on October 1st.
Just found out my part D is increasing from $9.90/month to $44.90 per month in 2025! I can't afford such an increase.
Shop your plan starting October 1st. Hopefully there will be more cost-effective options, and we will have a video for how to check your Part D options using Medicare.gov
Incredibly clear presentation!
Great News information! Thank You! ❤Elder, Willie Blackwell and Family!😊😊
Thanks for watching!
A detailed video for Part D changes.
I only take 1 prescription drug. It's only about $60/yr. Even cheaper when I use a PBM like GoodRx. If I don't get a Part D from the start, can I get it later? Would it still cover any new meds required when I signed up for coverage?*********Never mind******Just found your video on "Part D analysis". Thks
Just so others can see, the answer would be yes; you can still get it later to cover your medications at that time... BUT you would have a lifetime penalty once you sign up.
While keeping the same drug plan, can I change pharmacies anytime during the year or only during open enrollment Oct-Dec ?
Thank you
You could change pharmacies at any time
Thank you for the excellent information 👍🏻
Is the Annual Notice of Change always mailed? I have signed up for electronic delivery of most documents with UHC/AARP. Will I need to go online to obtain this document at the appropriate time?
follow up with carrier. If you opted for email, they will email. Typically will be mailed.
we still have hundreds without power here in lincoln ne from 90 mph winds at 5 to 530 yesterday just awful
Sorry to hear that. Hope it gets better soon!
- (= thank you for the advance warning). I'm sure it remains as usual "Forewarned is forearmed."
Thanks for taking the time to watch!
Well-researched, showing the facts and the sources. Thank you so much!
Thanks for watching!
I'm 76 years old and enrolled in Humana Medicare part D.
I pay a monthly premium of $60 for four medications - high blood pressure cholesterol and GERD. Would my premiums be lower with only two medications?
It's possible, but it entirely depends on the medications. One medication can be more expensive than 10 low-cost medications. You can try to see the costs with different combinations using our previous video: ua-cam.com/video/3EKyPZbIxo4/v-deo.htmlsi=OvtV9DJt_72F2En3
Do you consider your medications optional so you could drop any one of them?
Thank you - I need this so bad
Does this change creditable insurance for those of us that are going to continue to work? I
For 2025, no, it should not since plans can still use simplified methods to determine Part D creditable coverage. Just pay attention to your coverage, but I won't worry about it now.
@@GiardiniMedicare Thanks! I thought I had it all under control till I saw the new updates for Part D. Appreciate it!
@@victoriameredith4454 It's definitely confusing! A lot of people are trying to scare people due to the upcoming changes, but it will all work out
@@GiardiniMedicareI'm glad you think so. The complexity of coverage for aging people just ratcheted up another notch. Looks like Medicare found a way to pass financial burden using the insurance companies who most assuredly pass it to mostly retired, and positively aging people who were supposed to be supported. The intricacies of coverage alone for brains slowing down are mind-boggling not to mention for their support system of family & caretakers.
A well-produced, informative presentation! Thank you!
this part i don't understand, the $2000 spending cap. currently the medications i get cost me $0 dollars. they are on my drug plan formulary. does this mean i will have to pay the full cost of the drugs until i reach the $2000 spending cap? plus the monthly fee just to have the drug plan? i only take 2 drugs. levothyroxin and atorvastatin. is this saying that our monthly fee will be higher or is it saying we can opt into a plan where we add on another monthly fee to cover more expensive drugs? very confused
It means your copays and out of pocket costs would count towards the $2,000 cap. If your medications are still a $0 copay then $0 would count towards the cap and it wouldn’t really matter for you unless you need more expensive medications.
Thank you for this great information. So now I’m just mildly concerned with how much my premium will go up. But it sounds like it won’t be crazy high. Whew!
Hopefully not! Either way, just take a moment to compare all of the options in October and you should be good to go
Why does it change year to year ? What do they base it on ? I start in September with mine and i do not have a a monthly premium ❤
Does that mean you have an advantage plan?
Short version, our premiums are going to skyrocket. Thanks Brandon.
If you watch our newest video you'll see why premiums are not going to skyrocket