Part D of Medicare - 2022 Changes and Donut Hole Example

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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[auricgoldfinger]

The complexity of this is ridiculous. I’m a retired physician. Now I see why there are increasing numbers of American expats. The system is broken

[dholmes]

This is the best and most understandable explanation of these steps. Other people think they are explaining it clearly but they are not.

[laurice]

I wonder who dreams these confusing drug plans up? I think they dump them on Seniors, some of our most vulnerable people on purpose. Because they’re hoping that they will not be able to understand it! It’s mind boggling even if you’re Not a senior yet!😵‍💫

[mks]

The BEST & Simplest video on Donut hole i came across. Thanks a lot.

[baruchbenyaakov]

Thanks for explaining “out of pocket” before the catastrophic coverage kicks in. Not the usual definition in health insurance. Good job!

[sandywolf]

Much clearer now about the donut hole. Thank you.

[paulineron]

Thanks, this was very helpful. But I wish they had made a simple plan rather than such a complicated scheme.

[lcarliner]

In Florida, the included Part D plans with most Medicare Advantage plans are almost superior to any separately purchased Part D plans, especially that annual initial yearly deductible is usually zero!

[lourdesgrijaldo]

I'm not on Medicare yet but soon will be. I'm on Humera and I think it costs around d $6k retail per prescription per month. I just want to check how much it will cost me when I get to Medicare. Thank you so much.

[aprilpugh]

We are looking at which is our best options when you have a very high cost drug. Currently it is $7, 658.00 per month retail and with our current insurance it is costing us $35.00 a month. The manufacture has a discount card for us right now, but as soon as we go on Part D they do not offer any type of discount card program. What would you suggest?

[jamesyoung]

so, what happens when the next year comes along, like say January 2022. Does the limits reset to zero?

[kjunkocox]

Thank you, This was very helpful. I couldn't understand May part.
My understanding "Actual Drug Costs for Consumer become $126.25".
which part of my thinking is wrong? Thank you very much.
Running Total retail Cost $4, 775- Dounut $4, 430= $345, $345x Member pay 25%=$86.25,
Copey$40+ $86.25=$126.25

[katelynboel]

Does the retail cost of insulin under the Part D Senior Savings Model count toward initial coverage phase?

[youngheekim]

Please share the formula for actual drug costs for consumers for the month of May.

[maryrenaud]

Donut hole was supposed to go away by now. What happened to that?

[johnlupo]

OK / ALRIGHT (sounds like a Peggy Lee

[johnlupo]

MUST YOU START SENTENCES WITH THE WORD