Understanding Medicare Part D

People new to Medicare are often confused when trying to understand how Medicare Part D works. While an optional pharmacy card seems like it should be fairly simple, it isn't. Watch this video to learn how Medicare Part D Works!

00:00 Introduction
00:18 The Basics
00:37 Deductible
02:44 Initial Coverage
04:12 Coverage Gap
06:08 Catastrophic Coverage
06:46 Future Changes
07:12 Final Thoughts

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[vistamutual]

Well-researched and informative. Good job!

[alexroland]

Thanks so much for explaining Part D! Do you receive any kind of statement during the year that tells you which stage you are in?

[chrisraymond]

I take two decades old generics. Companies play games and don't put them into Tier 1 or even Tier 2. I end up just using GoodRx rather than pay through the nose going through insurance. This is why I got the lowest premium plan.

[linybob]

I am paying a part D premium to Medicare every month.

Do I understand it correctly that all this premium does is give me the right to sign up with a 3rd party insurance company that will actually cover (partially) the price of any drugs I might require? I currently have retiree health insurance through my final employer and, as part of that, Express Scripts which apparently is the part D provider I'd use when I need drugs.

I don't understand what the Medicare part D premium buys for someone, except the privilege of shopping around for an additional monthly premium to cover drug expenses (which is probably a good thing). Am I right?

[sct]

This is so complicated, 😮 so glad I am not taking any medications right now. But, I will buy a cheap plan just in case.

[latashadigby]

My husband Medicare Part B became effective 12/2022. At this time he still had his Employer Health Insurance plan which terminated on 03/31/23. He attempted to apply for the Part D
( drug prescription plan )and was told that he had to wait until the next enrollment period. Is there not a special enrollment period? He has been offered COBRA but is unsure if we will need it or not as a secondary to Medicare . He has met his employer insurance deductible for the year and his coverage will state the same. After looking at the video I’m not sure if we should continue with the COBRA or apply for the Part D prescription plan . He also Has a medical condition that requires expensive medications and treatments.I’m open to suggestions.

[karadouglas]

helpful video but what if i enroll in a part d plan and then later on in the year I start taking a new medication that my plan doesn't cover??

[xbjmocj]

If I go through Cost Plus or Amazon is it possible that I will pay less? I'm not yet 65 so figuring things out but am wondering if I can use those online pharmacies and if Medicare will track those costs. In other words, if I purchase a part D plan, can I still use those online pharmacies if the cost is less?

[raintree]

Once you have reached stage 4 - Catastrophic - will any drug be included in the 95% coverage regardless of the particular Part D plan that you are enrolled in?

[latriciapowell]

Part D is so confusing. I think I’m starting to get it now after watching though so thanks... One question though.. can we use a discount program with our Part D plan to help with our copays or the donut hole?

[kelseymundfrom]

If only the donut hole was as sweet as real donuts if I am on a Medicare Advantage plan, will my Part D be similar to this?

[chrisraymond]

Substitute the word "price" for "cost". When the price of a medication varies by factors of 4 or 5, the issue isn't the COST of the drug. It's the pricing.

[mauinuts]

Hi, I downloaded your HSA flo chart and still don't understan something, however, someone as detailed about Medicare as you have shown can no doubt answer a rather difficult Question regarding HSA contributions during the year I turn 65. Specifically, I am wondering if the $1, 000 catch-up amount can be contributed in full or does it need to be pro-rated by the number of months preceding my effective date? Example: 2023 HSA contribution is $3, 850. My birthday is May 10 and my effective date is May 1st. So is my contribution 3, 850 / 12 months = 320.83 x 4 = 1, 283 plus the $1, 000 for a total of $2280? OR is it 4, 830 / 12 months = 402.50 x 4 = 1, 610?

[wrdr]

When I try to compare plans after entering my prescriptions and pharmacies the total est. cost is $XXX "partial year" I of course want to know what a full year would cost, how do I do that?

[KatieLibby]

Thank goodness the current administration got these changes passed. Prescription costs will continue going up but these policies protect us.

[tommays]

There is no generic drug to treat chronic lymphocytic leukemia so everyone gets hammered with 10, 000 dollars every January

[annamartino]

Insulin should be Free to All and Obesity Treatments should be included with Pre-Diabetes and Weight Management and Dietician advice. We should not be forced to use generics, we should use most effective medicine advised by the doctor. We should not be lead by cost of medicine, as your life quality would be better if using advanced and better medicines. Compare your bloodwork and other tests before becoming a cheapskate on your required medicine. Use YouTube videos to keep yourself healthy without medications.