I wish I saw this yesterday! I have Wellcare but have more expensive drugs like ozempic and it is about 2k but AARP UHC is less - drugs are about 1935 for Wellcare. AARP is much less for drugs but shows total around 1800 but includes premium of about $80 - I thought it would be better to pick low premium and deductoble since that goes toward OOP but not premium. I hit 0 in I think June for WEllcare but much sooner for AARP...Guess it is too late to change?
Yeah, it seems weird that a much higher premium plan will end up with a lower total plan cost (premiums + drug copays)...but it can happen with Ozempic in the mix. Either of those plans can work for you. It sounds like the total expected costs won't be too much different. Either way, it sounds like you'll enjoy no copays for your covered drugs starting around the summer time! :)
What makes these people think all these retirees and other older people can do all this stuff ONLINE????? Most older people I know don't have computers, internet and don't understand what and how to do all this stuff. Some don't even have people that can do this either. NOR do they want to share all the info that could lead to MORE problems for them. They sure don't need to have to pay someone to do all this mess either. Getting help on the phone is just as bad. Either you don't have the info "they" want, they don't answer , and they have problems HEARING the people. Where can you get help. If you go to the local Social Security office it's a nightmare. They have the barriers between the workers and customers and you can't hear what they say. BUT EVERYONE waiting in the office CAN HEAR ALL YOUR INFO! The info that can lead to Identity theft. Why make EVERYONE take that chance?? You can't even set up a private meeting with a person like you used to either. That's so sad.
If someone doesn't have a computer or internet, then they obviously aren't watching our TH-cam tutorials. Our videos are for someone who does have internet access and is searching for answers on how to properly perform this analysis, or get other answers to Medicare questions. A Social Security office is not going to provide any assistance finding the right Part D drug plan or supplemental plan. They have no clue, nor are they even licensed to provide guidance. And this is why Medicare beneficiaries should work with an independent Medicare insurance agency like ours. There is no cost to work with a licensed insurance agent to find the right Medicare plans. Take care! :)
We don't worry too much about star ratings for stand-alone Part D plans. Consider plans with a 2 star rating or higher. Usually 3.5 is the highest you'll see with Part D plans. Enhanced plans are those with no deductible for sure. And then some other plans might be enhanced too, even if it has a deductible. Another way you can tell is if you hit the Catastrophic phase and have no copays for the rest of the year, despite having total drug copays of clearly less than $2,000.
Trying to set up part d for my father in law, we didnt do it originally last year so we will have a penalty seems like. What should a person do if their out of pocket drugs are right at 1000 a year?
Well, definitely get a Part D plan to keep that penalty from getting larger. If he will be just 1yr late getting a plan, then his penalty will be about $4.20/mo (added on to the Part D plan's premium). Find the plan with the lowest expected cost for the year (plan premiums + drug copays).
What do you use to record and edit your videos and be able to keep information private? Like if you’d want to illustrate an application on video but need PI to do so, how do you record without it catching the info? Thanks!
I went back into medicare calculator and ozempic went up from $47 on AARP to about $235....?? And does it matter to get lower drug costs if the premium plus drug cost is same as wellcare with much higher drug cost but total is about the same as as AARP for total premium+drugs?
If the drug is on your plan's formulary, then you can confirm the pricing on Medicare.gov. If it's just a generic, then it's likely covered fine. But if it's a brand name drug, you can verify whether it's covered on your plan's formulary and get the pricing. If it's not covered at all, then ask your doctor for an alternative until you can find one that is covered. Additionally, you can ask your plan to provide a a "formulary exception" to see if they will cover the non-covered drug. But they don't have to allow this.
What if you don't have any prescriptions whatsoever? But, would like to have a backup just in case. I see there are plans that have a zero monthly premium with the $590 deductible. How do these work? I can't imagine a company picking up your prescription payment for nothing.
Despite not taking any meds, you'll at a minimum get the lowest premium Part D plan in your area. This avoids the Part D late enrollment penalty and is at least have a plan in place if you are prescribed meds in the future. The Part D plans get a subsidy from Medicare behind-the-scenes.
If you don’t have a need for prescriptions, pick a part D prescription plan that doesnt cost you anything. Just in case you need a prescription, like being diagnosed with heart disease out of nowhere, you would have coverage. Please please get a plan for drugs, you never know ❤
Usually if there is no deductible, that's a giveaway. Also when you see the total expected drug copays for the year...if the month-to-month total shows you at $0 copays eventually in the year, but it your copays are less than $2,000...it's an enhanced plan. The standard plans would show you at $2,000 in drug copays or close to it...again, assuming the drugs you take are expensive. Some people don't come close to $2,000 and could be fine in a standard plan.
Very good question. There are two things to look for: 1.) If it has a $0 deductible or a deductible only on certain drug tiers 2.) If you see the drug copays go to $0 after a certain amount of months and the total drug copays end up being less than $2,000
Some of the plans have a $590 deductible...mostly the lower premiums plans. But the higher premiums plans usually have a $0 deductible. Sometimes the Medicare website asks a little goofy. If you're getting some strange results, then take a break and come back to it later.
@@MedicareMindset Thanks so much for your response. I wish I can add a print screen here for you to see. Even the Wellcare Value plan has $0 premium have $0 deductible. I hope it just a little goofy from the Medicare website.
I have Wellcare for 2024 and have had no problems. For 2025 I will be changing only because I was recently prescribed a drug that is making them not the best plan for me for the new year. Other than that I woud stay with Wellcare.
There you go! You added Elequis and Ozempic!!! That’s what we need to know! I take very expensive drugs and always get to $2000 out of pocket fast
Great video - I wish I saw it - it is too late to change now - so Enhanced is better for expensive drugs...? And you can tell by no deductible?
The deadline to change a drug plan was 12/7.
And yes, the enhanced drug plans don't have a drug deductible.
I wish I saw this yesterday! I have Wellcare but have more expensive drugs like ozempic and it is about 2k but AARP UHC is less - drugs are about 1935 for Wellcare. AARP is much less for drugs but shows total around 1800 but includes premium of about $80 - I thought it would be better to pick low premium and deductoble since that goes toward OOP but not premium. I hit 0 in I think June for WEllcare but much sooner for AARP...Guess it is too late to change?
Yeah, it seems weird that a much higher premium plan will end up with a lower total plan cost (premiums + drug copays)...but it can happen with Ozempic in the mix.
Either of those plans can work for you. It sounds like the total expected costs won't be too much different. Either way, it sounds like you'll enjoy no copays for your covered drugs starting around the summer time! :)
Thank you so much for this tutorial. I need to help my mom with her enrollment, and this video is so helpful. Thanks again
Great! Love to hear this. And very glad you're helping your mom! :)
What makes these people think all these retirees and other older people can do all this stuff ONLINE????? Most older people I know don't have computers, internet and don't understand what and how to do all this stuff. Some don't even have people that can do this either. NOR do they want to share all the info that could lead to MORE problems for them. They sure don't need to have to pay someone to do all this mess either. Getting help on the phone is just as bad. Either you don't have the info "they" want, they don't answer , and they have problems HEARING the people. Where can you get help. If you go to the local Social Security office it's a nightmare. They have the barriers between the workers and customers and you can't hear what they say. BUT EVERYONE waiting in the office CAN HEAR ALL YOUR INFO! The info that can lead to Identity theft. Why make EVERYONE take that chance?? You can't even set up a private meeting with a person like you used to either. That's so sad.
If someone doesn't have a computer or internet, then they obviously aren't watching our TH-cam tutorials.
Our videos are for someone who does have internet access and is searching for answers on how to properly perform this analysis, or get other answers to Medicare questions.
A Social Security office is not going to provide any assistance finding the right Part D drug plan or supplemental plan. They have no clue, nor are they even licensed to provide guidance.
And this is why Medicare beneficiaries should work with an independent Medicare insurance agency like ours. There is no cost to work with a licensed insurance agent to find the right Medicare plans.
Take care! :)
what about star ratings? How can you identify enhanced vs. standard plans?
We don't worry too much about star ratings for stand-alone Part D plans. Consider plans with a 2 star rating or higher. Usually 3.5 is the highest you'll see with Part D plans.
Enhanced plans are those with no deductible for sure. And then some other plans might be enhanced too, even if it has a deductible.
Another way you can tell is if you hit the Catastrophic phase and have no copays for the rest of the year, despite having total drug copays of clearly less than $2,000.
@@MedicareMindset thank you so much for a great clarifying video. I had seen this so thoroughly explained.
Trying to set up part d for my father in law, we didnt do it originally last year so we will have a penalty seems like. What should a person do if their out of pocket drugs are right at 1000 a year?
Well, definitely get a Part D plan to keep that penalty from getting larger. If he will be just 1yr late getting a plan, then his penalty will be about $4.20/mo (added on to the Part D plan's premium).
Find the plan with the lowest expected cost for the year (plan premiums + drug copays).
He needs a plan because his drug costs could go up depending on his health
What do you use to record and edit your videos and be able to keep information private? Like if you’d want to illustrate an application on video but need PI to do so, how do you record without it catching the info? Thanks!
Really any video editing software gives you the ability to hide/remove certain things from a video. It's just an editing option. :)
@@MedicareMindset does zoom have that option? I find it better than loom for my audio
@@TAZ2693 Not sure, sorry.
I went back into medicare calculator and ozempic went up from $47 on AARP to about $235....?? And does it matter to get lower drug costs if the premium plus drug cost is same as wellcare with much higher drug cost but total is about the same as as AARP for total premium+drugs?
How about if doctor adds a new medication after you select your plan???
If the drug is on your plan's formulary, then you can confirm the pricing on Medicare.gov. If it's just a generic, then it's likely covered fine.
But if it's a brand name drug, you can verify whether it's covered on your plan's formulary and get the pricing. If it's not covered at all, then ask your doctor for an alternative until you can find one that is covered. Additionally, you can ask your plan to provide a a "formulary exception" to see if they will cover the non-covered drug. But they don't have to allow this.
What if you don't have any prescriptions whatsoever? But, would like to have a backup just in case. I see there are plans that have a zero monthly premium with the $590 deductible. How do these work? I can't imagine a company picking up your prescription payment for nothing.
Despite not taking any meds, you'll at a minimum get the lowest premium Part D plan in your area. This avoids the Part D late enrollment penalty and is at least have a plan in place if you are prescribed meds in the future.
The Part D plans get a subsidy from Medicare behind-the-scenes.
If you don’t have a need for prescriptions, pick a part D prescription plan that doesnt cost you anything. Just in case you need a prescription, like being diagnosed with heart disease out of nowhere, you would have coverage. Please please get a plan for drugs, you never know ❤
@@starfishjennie Thank you for caring. I did just that. Thank you!!!
What is the best way to determine if a plan is "standard"? And how come the plans don't have "Enhanced" or Standard" in the name or description?
Usually if there is no deductible, that's a giveaway. Also when you see the total expected drug copays for the year...if the month-to-month total shows you at $0 copays eventually in the year, but it your copays are less than $2,000...it's an enhanced plan.
The standard plans would show you at $2,000 in drug copays or close to it...again, assuming the drugs you take are expensive. Some people don't come close to $2,000 and could be fine in a standard plan.
I’m in scenario 1 no prescription drugs; Where is the button to confirm that WellCare Plan you want for next year?
Wait until tomorrow (10/15) and the ENROLL button will show up when you're viewing the plans.
How can you tell if a plan is enhanced?
Very good question. There are two things to look for:
1.) If it has a $0 deductible or a deductible only on certain drug tiers
2.) If you see the drug copays go to $0 after a certain amount of months and the total drug copays end up being less than $2,000
It is so strange. I see all of the plan for 2025 have a $590 deductible earlier, but all plan show $0 deductible now. What did I do wrong?
Some of the plans have a $590 deductible...mostly the lower premiums plans.
But the higher premiums plans usually have a $0 deductible.
Sometimes the Medicare website asks a little goofy. If you're getting some strange results, then take a break and come back to it later.
@@MedicareMindset Thanks so much for your response. I wish I can add a print screen here for you to see. Even the Wellcare Value plan has $0 premium have $0 deductible. I hope it just a little goofy from the Medicare website.
@@dannydoan3695 Hmmm, that is weird indeed.
I picked WellCare anyone comment on the company as a whole?
My husband and Mom have been very happy with WellCare.
I have Wellcare for 2024 and have had no problems. For 2025 I will be changing only because I was recently prescribed a drug that is making them not the best plan for me for the new year. Other than that I woud stay with Wellcare.
@@mskenny0512what drug changed that for you, please?