You are one of the two Medicare reps on TH-cam that explains in understandable terms how all this works. I’m 63 and I hope you’re still around and I am too when I’m 65 Lol
Stephanie knows her stuff, and more importantly she has the gift to be able to clearly communicate. What you do not kind in one video she most certainly has in another within her Y.T. channel... Not only Medicare beneficiaries are tuning in for information... but she is teaching & inspiring new Agents & Brokers are as well. Great job Stephanie!
Wow! Just turning 65 in an next couple of months -- I was mystified where to start to see if Medicare D is a fit for me. You have provided exactly what I need. Thank you so much!
I get the pleasure of going on Medicare later this year when I turn 65. Since I take a biologic drug for psoriasis that costs a little over $6000 a month, my annual cost is going to be about $550/month annualized with the first month over $2000 and the second month over $1000. Add to that my medicare policy with a Irmaa surcharge, I'm going to be paying over a $1200 a month for healthcare. I thought things were bad under the ACA, but this takes it to another level.
After stumbling into your video I am so glad I did and watching your video from the beginning to the end , I can’t say enough thank you ! 🙏your video sure let me see light in the tunnel, my plan D just raise from $22 and change to over sixty dollars, I did not use any kind of prescription drugs,now I am Definitely ! going to change my plan ,your explanation very clear and very informative, Thank you!
Stephanie, your clear and concise explanations of the whole medicare enrollment process is a godsend and a breath of fresh air. You are now my go to website if I have any questions or issues about this process. Thank you for all you do.
Found your TH-cam channel the other day and have watched about 4 of the videos, thank you for this service as I am a nurse in the Managed Care World and lack of understanding is a big problem. Your videos are very educational and you make them simple to understand. I have 4 1/2 years till I enroll in Medicare but will be reaching out to your business when my time comes. Thank you
Just became Medicare eligible after winning my disability case. Looks like I’ll be losing Medicaid. Navigation of all the various parts is frustrating as heck. These videos are helpful, trying to figure out the coverage I need while keeping the costs lower.
Stephanie you are the best! Your help and knowledge is so helpful to us. We save significant dollars annually by letting you help us select plans. Thank You 🙏
Hi Stephanie, I will be 65 in April and have been doing my research. The plan you show in this video (SilverScript SmartRX from Aetna) includes Tier 2 drugs in the deductible. Most plans do not include that tier. Your video alluded that it was Tier 3 and above. Also from what I saw in the video, Medicare’s website did not provide that information. I have found your videos to be very informative.
I learned not to just enter your current pharmacy to get rates, but enter a mixture of those in your town. Those could be preferred in-network for other plans your current pharmacy doesn’t participate in. Just entering your current pharmacy does not give a complete picture.
Just looked at this search engine for the first time today. Glad I watched your video because I learned something new about the deductible! (I'll need one month of 2021 and then 2022 Part D coverage). Anyway, I noted two things when entering my 90-day mail-order drugs. The order of plans may show SilverScripts as lowest premium and monthly cost, but another plan actually had lowest premium+mail-order prices. Also, the "monthly costs" at the end of the drug details for 90-day allotments was listed as "monthly" but really a 90-day total.
Just remember that the USPS has now changed their delivery times and they are taking far longer! You can expect to be without meds for several days at a time waiting for the mail to come.
@@davenone7312 Not likely. I've used mail order for many years and they only time I'm without drugs is when pharmacy failed to send it out in time. Next 90-day supply is usually there before I finish the prior shipment. And short-term bridge supply can be arranged from a retail store if needed.
If we are purchasing prescription drugs out of pocket from less expensive pharmacies such as Good RX or Cost Plus Drugs, do we still include those drugs on the Plan D cost calculations?
Newbie here! When you change drug plans do you need new prescriptions? Even if they are CVS in 2021 and CVS in 2022? Thank you so much for the hints and tips! 👏🏼👏🏼👏🏼👏🏼👏🏼
Can you purchase a part D plan only. I'm healthy with no prescriptions so I'm thinking of just taking the mandatory A and B but get the lowest cost D plan.
Stephanie, do you have to select a drug? What if a person is not on prescription drugs yet? Just curious. I'm two years away from Medicare, but I'm trying to learn as much as I can. Thanks.
Thanks for your video. I have a question. You indicated that if you are taking tier 1 or 2 meds, you don't have to worry about the deductible. What about if you are taking a name brand med like Xarelto or Eliquis which I think are tier 3 meds? Should I shop for a low or $0 deductible plan even though the premium is higher?
Thank you so much for the great information. Also, can you please, provide me information with special enrollment, how much time I have to switch a plan to avoid medical underwriting? Thanks.
My employer offers us a "Medical Retiree" plan whereby employees who retire can obtain vision/dental/prescription drug coverage through their insurance provider, (the same provider who provides their insurance to employees still working). If I were to enroll in this plan and decided a year or two into it to switch to a regular Plan D plan, would I be subject to a penalty?
As long as this plan is considered creditable for Part D, you would not be penalized. Generally the plan has to let you know if they are NOT considered creditable by Medicare.
@@AbtInsuranceAgency Thank you! After I posted my question, I looked again at the chapter on Medicare Part D in the government's MEDICARE & YOU 2022, and it refers to this in the first paragraph. I decided last night to contact our HR Dept. today to ask if their plan is creditable.
A newbie here. Can you have say humana for one part of coverage and a different one for plan D? I will be contacting your group as enrollment draws closer.
Thank you for this video! Our WellCare Value Script plan monthly premium is going down in 2022, so I have to figure out what we will be losing if we stay with it. Your tutorial will really help!
Interesting. Our WellCare plan premium is going up more than double. The new premium is ridiculously higher than the cost for any other plan. I sure don't understand that, since our medications are just tier 1 generics. So, you are wise to try to figure out if you will be losing something with them in 2022.
Excellent Videos and I will be contacting you next year to get ready for this Medicare enrollment. Question: I sometimes use GoodRX which can be quite low sometimes. Do you know how these prices compare with the GoodRX card?? Thanks again for these great informative videos, Stephanie!
It depends on the medication. Some will be cheaper with GoodRx, some cheaper with your Part D drug plan. We can help you review this. Call us at you approach your Medicare eligibility! 888-465-9728.
Stephanie can you explain why the Medicare star ratings for MA-PDs are rated so much higher than original Medicare. You can access the original Medicare ratings by selecting a MA-PD in planfinder, go to plan details then go to health plan star ratings. The quality ratings appear to indicate that MA-PDs provide much higher quality than original Medicare. Thoughts?
While I do appreciate what you did, I don't think you considered the bigger picture. The main mistake that I find people making is to focus on the overall premium and drug costs. If everyone's health stays somewhat stable, you are right. However, if things change where expensive drugs become needed, there could be a big problem. For example, if you need an expensive cancer drug in the future, your plan may not even cover it. Frankly, I would suggest that the best drug plan is the one with the biggest formulary and/or one that has a reputation for allowing coverage for needed drugs they are not on the formulary. Sadly, I don't know any way to find all this out. If you could cover how to easily compare formulary, that would be very beneficial. NOTE: To my knowledge, the plan with the largest formulary is the AARP Medicare RX preferred plan. Sadly, it also is the most expensive since it includes items such as insulin.
The one good thing about Part D drug plans is that you can always change your plan from each year. And the plans themselves change quite a bit from year to year. Because of this, we recommend choosing a plan based on your immediate needs, or expected needs for that year. And then you want to actively reassess your plan choice from year to year as your needs change. If your doctor prescribes you a medication that isn’t covered by your Part D plan, you can also file a formulary exception in order to get that drug covered by your plan for that year, if your doctor seems it medically necessary.
Thank you so much for this step-by-step explanation. I have one question regarding when do I enroll in plan D. I am still covered by my wife's employer plan until the end of 2021. I already have plan B and a supplement plan G. Can I enroll now for 2022 plan D or do I wait till say the first week of December or does it make a difference. The reason I am asking is that I don't want my enrollment in plan D right now to interfere with the existing health plan which includes my drugs from my wife's employer. Thank you again.
Hello, I have a quick question about that medicare website. I tried to find out what my monthly costs for a tier 5 drug would cost, but they only show the monthly costs from august through december. Is there a way to check the monthly costs from january through december? I am finding it very difficult to see a general price I will have to try to come up with each month when I turn 65. Thank You
Stephanie, how can I find a plan that gives the best service? My initial plan has off shore customer service which is lacking. Had it for 3 months and have not gotten my prescription setup on a mail order successfully after about 6 calls.
Stephanie, you are very informative. However, i wish just once all the youtubers discussing medicare part D drug coverage would use more tier 5 drug examples. There are many people out there who take cancer drugs which are extremely expensive and the payments for these drugs are very confusing.
Yes I totally agree! She cherry picked each of her drugs in order for her video to seem so rosy! It truly was a disservice what she has done here just to get more likes and subscriptions!!
We have other videos that go into more depth about Part D, as well as the donut hole and how it works and how to avoid it. This video was simply meant to provide a brief example on how to do a Part D search. Please check out the “videos” tab on our channel to see more examples on how part D works when it comes to higher tier medications! 🙂
Hi Stephanie, my husband has neuroendocrine cancer, he gets a monthly shot at MD Anderson called Sandostatin. Is this covered under part B? Also is getting part D the same as getting a supplement insurance?
@@mariachapman5213 I would suggest calling our office, we can thoroughly review all of the best options for his situation. We work with many folks who are working with MD Anderson on treatments. 888-465-9728 or email stephanie@abtinsuranceagency.com
I agree with all the wonderful comments below. You make navigating Medicare much easier for me. A little more research and I'll be ready to contact your agency. Hope you offer plans in Arizona. My enrollment period started this month. (Jan 2022) I do have a question about how any new scripts needed during the year are handled? Are they covered? I'm guessing they are but will raise the plan price at some point. I read the comment below about selecting a plan with the largest formulary. Based on your response, since I don't expect having to take something not included in the plan (I'm sure no one does until they do) I would have to wait until the next year to select a plan that would cover it. Since I haven't heard new scripts being discussed I'm thinking they are not an issue. Is that correct?
Good questions! The Annual Election Period is for Part D and Medicare Advantage. The Medicare Supplement Open Enrollment Period is for Medicare Supplement/Medigap Plans and is generally a one time window for each Medicare beneficiary. Then there is also a Medicare Advantage Open Enrollment Period for people on Medicare Advantage Plans that want to make a change. We cover each below: th-cam.com/video/MUuHhRzIx6Y/w-d-xo.html th-cam.com/video/UbNv1kIn9GI/w-d-xo.html th-cam.com/video/ONmvrFP9kzI/w-d-xo.html They don't make it simple! 😃
Is the medicare supplement open enrollment period; is it also the initial enrollment period with the initial 7 month period to choose the medigap policy with guaranteed issue? Thank u
Stupid question, perhaps, but is there any reason one would choose any plan except the one that has the lowest cost? I'm puzzled as to why so many plans exist if cost is the only factor one should consider...?
We recommend choosing a plan that has the “total annual lowest cost” when adding up premiums, copays and coinsurance for your specific medications, which can vary from one plan to another.
Thanks for your informative video. I am currently on my employer coverage with Medicare as my primary. My plan includes my prescriptions . However, if I decide to change to part D, should I include my Prolia drug that I take twice a year in the doctor’s office on the enrollment form for part D? I’m confused about this drug. Thanks.
In most cases Prolia is covered by Part B of Medicare if you receive it in a provider setting (not Part D), but I would double check with your provide to see how they code/bill it.
Hi Stephanie - A belated question: Are there any Medicare-based drug plans that offer negotiated drug prices? If so, how does that work? Particularly if you cannot use a Medicare Advantage plan. For example, my 22 year old daughter has a prescription for Bupropion. I questioned the cost of $25 for a 90 day supply, but googling the cost was eye-opening. List price for a 30-day supply of the brand-name Wellbutrin would be $2,367 and a 30-day supply of the generic Bupropion is $79 (or $237 for 90 days). Since my daughter still has to satisfy her deductible, her $25 cost is a non-subsidized price, but that price was clearly negotiated down by the insurance company. So, what if this drug was prescribed to a retiree on Medicare? Would they pay the full, non-subsidized, non-negotiated price? Clearly, there is a lot to be gained by a group drug plan that negotiates prices. Or are we stuck with Congress's prohibition that Medicare shall not negotiate drug prices?
I think you might find this article interesting- “Under the Medicare Part D program, which covers retail prescription drugs, Medicare contracts with private plan sponsors to provide a prescription drug benefit and gives plan sponsors authority to negotiate drug prices with pharmaceutical companies” www.kff.org/medicare/issue-brief/whats-the-latest-on-medicare-drug-price-negotiations/
Do you know of any information already have Medicare coverage under 65 due to disability and have supplemental plan. However recently employed large employer so employer health insurance understand primary. Do you know how the Medicare supplemental plan kicks in?
I have a drug plan and I find it a struggle communicating with customer service. I try to word my questions in the simplest way, and they don’t understand. I think they are overseas.
Very weird to see you do a search for Travis County, TX -- it's like you are making videos tailored for me, LOL! I have been learning a lot from your videos -- thank you. I shared your channel on Facebook.
Your videos are soooo helpful! How do you factor in 90 day Rx costs for mail order maintenance drugs? Are you licensed to work in GA? Is there any advantage to working with a local vs out of state ins broker? Thanks!
You have the option of entering in 90 day supply when you do the search on Medicare.gov, and yes we are licensed to work in GA. Please give us a call at 888-465-9728! 😃
Hi Stefanie. Please can you give me an advice which health care i will get.right now i HEALTHNET but i spent around $1000 out of my pocket. I am a diabetic and taking a lantus pen and ozempic . I am planning to try SCAN CLASSIC OR SCAN BALANCE.I dont care about my others medicine.I am very concern about my lantus and ozempic because i always reach the donut hole of $4120. I live in los angeles and iam 70 year old.i hope you can help me which health care i will get this coming enrollment.thank you very very much and very appreciate your advice .. GOD BLESS YOU AND YOUR FAMILY,
I was told that I can’t receive medicare until I’m 65, only Medicare advantage plans. I am on SSDI since April of 2019. Is this true, do I have to wait?
Hello, my plan total monthly premium is $24.00 and my Total Yearly Drug Cost is $85.60. In the section "Estimated Total Drug + Premium Cost" why does it say that my total yearly drug + premium cost is $133.60. I'm just a bit confused on this section of the plan. Thank you!
Hai Stephanie Please help me out with my prescription medications, it's a big list, which insurance is the best 👍 to make it affordable to me. 1)Janumet- 50/1000 my - two tablets a day 2) Atorvastatin-40mg - 1 / day 3)Metoprolol-ER-50 my-1/day 4)Losartan -59mg-1/day 5)Isosorb Mono- ER-30mg-1/day Thanks
For a serious illness what are we looking at out of pocket for cancer on the best part D plan you know of. Something from the pharmacy. Must be a MEDIAN
I've believe that success in business is a direct correlation to how much value you can provide to people, and this mentality has worked for us thus far 🙂
You only added high use generics! You have done us all a disservice! Please redo this video and be true to what drugs old people need. Lots of elderly need respiratory meds like Breztri, Treligy etc. Why no cancer drugs selected? There are many drugs that can put one in the catastrophic range in a heartbeat! You made this part D seem so wonderful by carefully selecting only tier 1 generics! Please let the people know that a wrongly selected drug plan can cost them Thousands every year! Selecting a part D can be far far more costly than you demonstrate in this video! You only picked the best case scenario, thats very very misleading
I picked some of the most common medications, since 90% of Medicare beneficiaries will not fall into the donut hole or reach catastrophic coverage. I do have other videos that go into much more depth about the donut hole and more expensive medications and how part D works with those, as well as videos specifically about Medicare coverage for cancer drugs and treatment. Please feel free to check them out on our channel! 🙂
You are one of the two Medicare reps on TH-cam that explains in understandable terms how all this works. I’m 63 and I hope you’re still around and I am too when I’m 65 Lol
I’ll be here! 😉
Stephanie knows her stuff, and more importantly she has the gift to be able to clearly communicate. What you do not kind in one video she most certainly has in another within her Y.T. channel... Not only Medicare beneficiaries are tuning in for information... but she is teaching & inspiring new Agents & Brokers are as well. Great job Stephanie!
What a compliment Jordan, thank you!
I Can't wait to talk to this Wonderfull young lady, today is Sunday. She deserve great rest from her busy job helping older people. Thank you.
Thanks Steph. I just retired and you made navigating the treacherous and convoluted waters of Medicare easier. You've been a TREMENDOUS help.
Wow! Just turning 65 in an next couple of months -- I was mystified where to start to see if Medicare D is a fit for me. You have provided exactly what I need. Thank you so much!
I get the pleasure of going on Medicare later this year when I turn 65. Since I take a biologic drug for psoriasis that costs a little over $6000 a month, my annual cost is going to be about $550/month annualized with the first month over $2000 and the second month over $1000. Add to that my medicare policy with a Irmaa surcharge, I'm going to be paying over a $1200 a month for healthcare. I thought things were bad under the ACA, but this takes it to another level.
After stumbling into your video I am so glad I did and watching your video from the beginning to the end , I can’t say enough thank you ! 🙏your video sure let me see light in the tunnel, my plan D just raise from $22 and change to over sixty dollars, I did not use any kind of prescription drugs,now I am Definitely ! going to change my plan ,your explanation very clear and very informative,
Thank you!
I’m so glad to hear that!
Stephanie, your clear and concise explanations of the whole medicare enrollment process is a godsend and a breath of fresh air. You are now my go to website if I have any questions or issues about this process. Thank you for all you do.
You are so welcome! Call us with questions anytime, we are here to help.
Your videos are very informative.
I will be turning 65 in a few years. I will definitely give you a call to help with my Medicare needs. Thanks again.
Found your TH-cam channel the other day and have watched about 4 of the videos, thank you for this service as I am a nurse in the Managed Care World and lack of understanding is a big problem. Your videos are very educational and you make them simple to understand. I have 4 1/2 years till I enroll in Medicare but will be reaching out to your business when my time comes. Thank you
Thank you Mark!
Just became Medicare eligible after winning my disability case. Looks like I’ll be losing Medicaid. Navigation of all the various parts is frustrating as heck. These videos are helpful, trying to figure out the coverage I need while keeping the costs lower.
Stephanie you are the best! Your help and knowledge is so helpful to us. We save significant dollars annually by letting you help us select plans. Thank You 🙏
Thank you Richard!
Thank you so much. I had my Medicare site pulled up and went along with you. Very helpful!!
Hi Stephanie, I will be 65 in April and have been doing my research. The plan you show in this video (SilverScript SmartRX from Aetna) includes Tier 2 drugs in the deductible. Most plans do not include that tier. Your video alluded that it was Tier 3 and above. Also from what I saw in the video, Medicare’s website did not provide that information.
I have found your videos to be very informative.
Many plans have a $0 deductible on tier 1 and 2 drugs but yes certain plans consider tier 2 drugs to be subject to the drug deductible too.
Stephanie, do you have offices that enrolling Medicare patients can go to work out their enrollment plans?
Perfect. This video is exactly what I needed right now.
I learned not to just enter your current pharmacy to get rates, but enter a mixture of those in your town. Those could be preferred in-network for other plans your current pharmacy doesn’t participate in. Just entering your current pharmacy does not give a complete picture.
Good tip! 🙂
Thank you for posting this helpful video
Just looked at this search engine for the first time today. Glad I watched your video because I learned something new about the deductible! (I'll need one month of 2021 and then 2022 Part D coverage). Anyway, I noted two things when entering my 90-day mail-order drugs. The order of plans may show SilverScripts as lowest premium and monthly cost, but another plan actually had lowest premium+mail-order prices. Also, the "monthly costs" at the end of the drug details for 90-day allotments was listed as "monthly" but really a 90-day total.
Just remember that the USPS has now changed their delivery times and they are taking far longer! You can expect to be without meds for several days at a time waiting for the mail to come.
@@davenone7312 Not likely. I've used mail order for many years and they only time I'm without drugs is when pharmacy failed to send it out in time. Next 90-day supply is usually there before I finish the prior shipment. And short-term bridge supply can be arranged from a retail store if needed.
I love the information you provide. When will you post info for 2023? We're enrolling soon for 2023.
I just want to say thank you for your informational videos! Gracias!
Stephanie, thank you so much. I need to check out my mom's drug plan this year as it is getting more and more expensive.
What about insulin needles, syringes, CGM sensors and etc.?
Thats wonderful information you shared stephanie....
If we are purchasing prescription drugs out of pocket from less expensive pharmacies such as Good RX or Cost Plus Drugs, do we still include those drugs on the Plan D cost calculations?
Love your videos. I think I'm addicted to 'em !!!
I love to hear that!
Thank you for this info.
Newbie here! When you change drug plans do you need new prescriptions? Even if they are CVS in 2021 and CVS in 2022?
Thank you so much for the hints and tips! 👏🏼👏🏼👏🏼👏🏼👏🏼
No, you do not need to get a new prescription, just change your plan and continue to refill your current prescriptions 🙂
Thank you Stephanie, this was most informative.
Can you purchase a part D plan only. I'm healthy with no prescriptions so I'm thinking of just taking the mandatory A and B but get the lowest cost D plan.
No response,was this a stupid question? Hope not because my next question is worse.
If you do not take part d Medicare Penalize you later t
you have to pay more for part D
For more info call Medicare
Stephanie, do you have to select a drug? What if a person is not on prescription drugs yet? Just curious. I'm two years away from Medicare, but I'm trying to learn as much as I can. Thanks.
This video talks more about what to do for part D if you are taking no medications! th-cam.com/video/EgTmRW8-ay4/w-d-xo.html
with a new medicare advantage plan in Delaware (freedom blue ppo) do I have to get a separate prescripton plan part d
Well done Stephanie!
Thanks!
U can help people in any state?
We are licensed in 46 states 🙂
is there medical underwriting when you switch plans, thanks.
Not when switching Part D drug plans, only Medigap plans.
thanks
You are gifted.
But how about physical, occupational, speech therapy?
Question. April will be my start date. I think I need to enroll in January. I’ve looked at some of your videos and would like help
Yes! Please call us at 888-465-9728!
Thanks for your video. I have a question. You indicated that if you are taking tier 1 or 2 meds, you don't have to worry about the deductible. What about if you are taking a name brand med like Xarelto or Eliquis which I think are tier 3 meds? Should I shop for a low or $0 deductible plan even though the premium is higher?
Will they do a 90 day supply or only 30 days at a time, generics
Very informative! Thanks!
Thank you so much for the great information. Also, can you please, provide me information with special enrollment, how much time I have to switch a plan to avoid medical underwriting? Thanks.
Please contact us for more information action regarding your specific situation. 888-465-9728
My employer offers us a "Medical Retiree" plan whereby employees who retire can obtain vision/dental/prescription drug coverage through their insurance provider, (the same provider who provides their insurance to employees still working). If I were to enroll in this plan and decided a year or two into it to switch to a regular Plan D plan, would I be subject to a penalty?
As long as this plan is considered creditable for Part D, you would not be penalized. Generally the plan has to let you know if they are NOT considered creditable by Medicare.
@@AbtInsuranceAgency Thank you! After I posted my question, I looked again at the chapter on Medicare Part D in the government's MEDICARE & YOU 2022, and it refers to this in the first paragraph. I decided last night to contact our HR Dept. today to ask if their plan is creditable.
A newbie here. Can you have say humana for one part of coverage and a different one for plan D? I will be contacting your group as enrollment draws closer.
Thank you for this video! Our WellCare Value Script plan monthly premium is going down in 2022, so I have to figure out what we will be losing if we stay with it. Your tutorial will really help!
Interesting. Our WellCare plan premium is going up more than double. The new premium is ridiculously higher than the cost for any other plan. I sure don't understand that, since our medications are just tier 1 generics. So, you are wise to try to figure out if you will be losing something with them in 2022.
I’m looking into Mark Cuban’s Cost Plus Program for my drugs and dropping Part D. Thought’s? Good idea or not.
Could work as long as you are comfortable paying a Part D penalty if you do decide to enroll in Part D in the future.
Are all these costs for Medicare and insurance deductible for tax purposes?
Excellent Videos and I will be contacting you next year to get ready for this Medicare enrollment. Question: I sometimes use GoodRX which can be quite low sometimes. Do you know how these prices compare with the GoodRX card?? Thanks again for these great informative videos, Stephanie!
It depends on the medication. Some will be cheaper with GoodRx, some cheaper with your Part D drug plan. We can help you review this. Call us at you approach your Medicare eligibility! 888-465-9728.
Stephanie can you explain why the Medicare star ratings for MA-PDs are rated so much higher than original Medicare. You can access the original Medicare ratings by selecting a MA-PD in planfinder, go to plan details then go to health plan star ratings. The quality ratings appear to indicate that MA-PDs provide much higher quality than original Medicare. Thoughts?
Original Medicare doesn’t have star ratings. Part D drug plans and Medicare advantage plans do.
While I do appreciate what you did, I don't think you considered the bigger picture. The main mistake that I find people making is to focus on the overall premium and drug costs. If everyone's health stays somewhat stable, you are right. However, if things change where expensive drugs become needed, there could be a big problem. For example, if you need an expensive cancer drug in the future, your plan may not even cover it. Frankly, I would suggest that the best drug plan is the one with the biggest formulary and/or one that has a reputation for allowing coverage for needed drugs they are not on the formulary. Sadly, I don't know any way to find all this out. If you could cover how to easily compare formulary, that would be very beneficial.
NOTE: To my knowledge, the plan with the largest formulary is the AARP Medicare RX preferred plan. Sadly, it also is the most expensive since it includes items such as insulin.
The one good thing about Part D drug plans is that you can always change your plan from each year. And the plans themselves change quite a bit from year to year. Because of this, we recommend choosing a plan based on your immediate needs, or expected needs for that year. And then you want to actively reassess your plan choice from year to year as your needs change.
If your doctor prescribes you a medication that isn’t covered by your Part D plan, you can also file a formulary exception in order to get that drug covered by your plan for that year, if your doctor seems it medically necessary.
Thank you so much for this step-by-step explanation. I have one question regarding when do I enroll in plan D. I am still covered by my wife's employer plan until the end of 2021. I already have plan B and a supplement plan G. Can I enroll now for 2022 plan D or do I wait till say the first week of December or does it make a difference. The reason I am asking is that I don't want my enrollment in plan D right now to interfere with the existing health plan which includes my drugs from my wife's employer. Thank you again.
As long as your enroll between Oct. 15th and Dec. 7th using the AEP election period, your coverage will begin Jan. 1st. I hope this helps!
@@AbtInsuranceAgency Thank you very much.
Hello, I have a quick question about that medicare website. I tried to find out what my monthly costs for a tier 5 drug would cost, but they only show the monthly costs from august through december. Is there a way to check the monthly costs from january through december? I am finding it very difficult to see a general price I will have to try to come up with each month when I turn 65. Thank You
Stephanie, how can I find a plan that gives the best service? My initial plan has off shore customer service which is lacking. Had it for 3 months and have not gotten my prescription setup on a mail order successfully after about 6 calls.
Stephanie, you are very informative. However, i wish just once all the youtubers discussing medicare part D drug coverage would use more tier 5 drug examples. There are many people out there who take cancer drugs which are
extremely expensive and the payments for these drugs are very confusing.
Yes I totally agree! She cherry picked each of her drugs in order for her video to seem so rosy! It truly was a disservice what she has done here just to get more likes and subscriptions!!
We have other videos that go into more depth about Part D, as well as the donut hole and how it works and how to avoid it. This video was simply meant to provide a brief example on how to do a Part D search. Please check out the “videos” tab on our channel to see more examples on how part D works when it comes to higher tier medications! 🙂
Hi Stephanie, my husband has neuroendocrine cancer, he gets a monthly shot at MD Anderson called Sandostatin. Is this covered under part B? Also is getting part D the same as getting a supplement insurance?
Part D is different than a Medicare Supplement insurance policy. These monthly shots should be covered by Part B yes.
@@AbtInsuranceAgency should he do part A and part B and a supplement insurance?
@@mariachapman5213 I would suggest calling our office, we can thoroughly review all of the best options for his situation. We work with many folks who are working with MD Anderson on treatments. 888-465-9728 or email stephanie@abtinsuranceagency.com
Smart. Informative. Helpful. & With all respect, she's pretty too. Thank you.
I agree with all the wonderful comments below. You make navigating Medicare much easier for me. A little more research and I'll be ready to contact your agency. Hope you offer plans in Arizona. My enrollment period started this month. (Jan 2022)
I do have a question about how any new scripts needed during the year are handled? Are they covered? I'm guessing they are but will raise the plan price at some point. I read the comment below about selecting a plan with the largest formulary. Based on your response, since I don't expect having to take something not included in the plan (I'm sure no one does until they do) I would have to wait until the next year to select a plan that would cover it.
Since I haven't heard new scripts being discussed I'm thinking they are not an issue. Is that correct?
Thanks for info!
what is the difference between the annual election period and open enrollment? or is it the same thing? thank you :)
Good questions! The Annual Election Period is for Part D and Medicare Advantage. The Medicare Supplement Open Enrollment Period is for Medicare Supplement/Medigap Plans and is generally a one time window for each Medicare beneficiary. Then there is also a Medicare Advantage Open Enrollment Period for people on Medicare Advantage Plans that want to make a change. We cover each below:
th-cam.com/video/MUuHhRzIx6Y/w-d-xo.html
th-cam.com/video/UbNv1kIn9GI/w-d-xo.html
th-cam.com/video/ONmvrFP9kzI/w-d-xo.html
They don't make it simple! 😃
Is the medicare supplement open enrollment period; is it also the initial enrollment period with the initial 7 month period to choose the medigap policy with guaranteed issue? Thank u
So, are there any obstacles to switching Part D plans during the open enrollment period?
No, you can always change between Oct 15-Dec 7th.
Stupid question, perhaps, but is there any reason one would choose any plan except the one that has the lowest cost? I'm puzzled as to why so many plans exist if cost is the only factor one should consider...?
We recommend choosing a plan that has the “total annual lowest cost” when adding up premiums, copays and coinsurance for your specific medications, which can vary from one plan to another.
It’s important to shop your drug plan every year.
Thanks for your informative video. I am currently on my employer coverage with Medicare as my primary. My plan includes my prescriptions . However, if I decide to change to part D, should I include my Prolia drug that I take twice a year in the doctor’s office on the enrollment form for part D? I’m confused about this drug. Thanks.
In most cases Prolia is covered by Part B of Medicare if you receive it in a provider setting (not Part D), but I would double check with your provide to see how they code/bill it.
Hi Stephanie -
A belated question: Are there any Medicare-based drug plans that offer negotiated drug prices? If so, how does that work? Particularly if you cannot use a Medicare Advantage plan.
For example, my 22 year old daughter has a prescription for Bupropion. I questioned the cost of $25 for a 90 day supply, but googling the cost was eye-opening. List price for a 30-day supply of the brand-name Wellbutrin would be $2,367 and a 30-day supply of the generic Bupropion is $79 (or $237 for 90 days). Since my daughter still has to satisfy her deductible, her $25 cost is a non-subsidized price, but that price was clearly negotiated down by the insurance company.
So, what if this drug was prescribed to a retiree on Medicare? Would they pay the full, non-subsidized, non-negotiated price? Clearly, there is a lot to be gained by a group drug plan that negotiates prices. Or are we stuck with Congress's prohibition that Medicare shall not negotiate drug prices?
I think you might find this article interesting-
“Under the Medicare Part D program, which covers retail prescription drugs, Medicare contracts with private plan sponsors to provide a prescription drug benefit and gives plan sponsors authority to negotiate drug prices with pharmaceutical companies”
www.kff.org/medicare/issue-brief/whats-the-latest-on-medicare-drug-price-negotiations/
Do you know of any information already have Medicare coverage under 65 due to disability and have supplemental plan. However recently employed large employer so employer health insurance understand primary. Do you know how the Medicare supplemental plan kicks in?
How is nyship empire drug plan
Thank you! 🤓
I have a drug plan and I find it a struggle communicating with customer service. I try to word my questions in the simplest way, and they don’t understand. I think they are overseas.
Very weird to see you do a search for Travis County, TX -- it's like you are making videos tailored for me, LOL!
I have been learning a lot from your videos -- thank you. I shared your channel on Facebook.
We are neighbors! 🙂
If I am retiring in March of 2022, can I still use this website to select a PartD plan?
Thank you
Your videos are soooo helpful! How do you factor in 90 day Rx costs for mail order maintenance drugs? Are you licensed to work in GA? Is there any advantage to working with a local vs out of state ins broker? Thanks!
You have the option of entering in 90 day supply when you do the search on Medicare.gov, and yes we are licensed to work in GA. Please give us a call at 888-465-9728! 😃
Hi Stefanie. Please can you give me an advice which health care i will get.right now i HEALTHNET but i spent around $1000 out of my pocket. I am a diabetic and taking a lantus pen and ozempic . I am planning to try SCAN CLASSIC OR SCAN BALANCE.I dont care about my others medicine.I am very concern about my lantus and ozempic because i always reach the donut hole of $4120. I live in los angeles and iam 70 year old.i hope you can help me which health care i will get this coming enrollment.thank you very very much and very appreciate your advice .. GOD BLESS YOU AND YOUR FAMILY,
How do I get my Medicare number? Good job, by the way
Call 1-800-MEDICARE or check your ssa.gov account online. 🙂
Chemo not covered?
It is covered by Medicare Part B
I was told that I can’t receive medicare until I’m 65, only Medicare advantage plans. I am on SSDI since April of 2019. Is this true, do I have to wait?
In some states Medicare Supplement plans are not available to people under 65 on Medicare disability.
No sound
So who is best?
@John Dunn what plan?
It depends on your needs.
Do not be complacent...shop your Part D every year
Hello, my plan total monthly premium is $24.00 and my Total Yearly Drug Cost is $85.60. In the section "Estimated Total Drug + Premium Cost" why does it say that my total yearly drug + premium cost is $133.60. I'm just a bit confused on this section of the plan. Thank you!
Are you looking at 2021 or 2022 plans? $24 is the month premium. The $85.60 is the monthly Rx costs/copays.
Hai Stephanie
Please help me out with my prescription medications, it's a big list, which insurance is the best 👍 to make it affordable to me.
1)Janumet- 50/1000 my - two tablets a day
2) Atorvastatin-40mg - 1 / day
3)Metoprolol-ER-50 my-1/day
4)Losartan -59mg-1/day
5)Isosorb Mono- ER-30mg-1/day
Thanks
For a serious illness what are we looking at out of pocket for cancer on the best part D plan you know of. Something from the pharmacy. Must be a MEDIAN
Medicare is socialized medicine for old people.
Don’t you lose business by telling people how to enroll themselves online as opposed to going through you?
I've believe that success in business is a direct correlation to how much value you can provide to people, and this mentality has worked for us thus far 🙂
You only added high use generics! You have done us all a disservice! Please redo this video and be true to what drugs old people need. Lots of elderly need respiratory meds like Breztri, Treligy etc. Why no cancer drugs selected? There are many drugs that can put one in the catastrophic range in a heartbeat! You made this part D seem so wonderful by carefully selecting only tier 1 generics! Please let the people know that a wrongly selected drug plan can cost them Thousands every year! Selecting a part D can be far far more costly than you demonstrate in this video! You only picked the best case scenario, thats very very misleading
I picked some of the most common medications, since 90% of Medicare beneficiaries will not fall into the donut hole or reach catastrophic coverage. I do have other videos that go into much more depth about the donut hole and more expensive medications and how part D works with those, as well as videos specifically about Medicare coverage for cancer drugs and treatment. Please feel free to check them out on our channel! 🙂
@@AbtInsuranceAgency Will do, thanx for the reply