BREAKING: Medicare Part D Premium Costs Confirmed For 2025

The Medicare program was greatly impacted by the passing of the Inflationary Reduction Act, and the greatest impact would be upon Medicare prescription drug coverage. In 2023, we saw insulin being capped at $35. We saw more immunizations having to be covered at a zero copay. In 2024, we saw the catastrophic copay go to zero, max out-of-pocket at $33.50. But in 2025, the greatest impact is going to be this, a $2,000 spending cap, Medicare taking some of its liability and passing that to the Part D plans. And in this video, I'm going to show you the coverage for 2025, what it's going to cost to be on plans, how to compare those plans, and to change those plans if you need to. Now, as we get into the details of prescription drug coverage, I just want to do a quick reminder for you to make sure you're clear that we actually have two different ways in which we can get Part D plans. And let me explain those real quick. Number one, you have the opportunity when you go on Medicare to enroll in original Medicare A and B. And of course, A and B doesn't pay for all expenses 100%. So the majority of people that stay in original or traditional Medicare A and B will actually add some type of a supplemental plan. This is a metagap policy to cover the financial gaps that Medicare did not cover. And so most people, they are getting supplemental plans G or a plan N. So when we have a supplemental plan, what we have to do then is we have to actually add what we refer to as a standalone prescription drug plan. So this would be for self-administered medications, because A and B and supplemental plans cover professionally administered meds, those we take in an inpatient or an outpatient type of a setting. But self-administered meds we've taken home, we have to have a separate drug plan. So that's one way we can get our drugs covered. The second way would be to enroll in Medicare A and B, but we allow a private health insurance company to replace A and B, and we call those advantage plans. And so an advantage plan can come then with a prescription drug plan that's going to be embedded. And all I'm trying to teach you is regardless of how you decide to use your Medicare, you're going to have a prescription drug plan. Either it's separate, standalone, one that you chose, or advantage plan is actually one that the company chose. So everything I'm teaching you is going to apply to both ways that you have as options for having your prescriptions covered. Okay, now with that being said, what I'm going to do next is I'm going to go to my computer. I'm going to show you how to compare the different plans that will be available in your market. All right, so now that we're clear that we can have standalone drug plans or we can have embedded drug plans within the advantage, I'm going to show you exactly how to compare the plans for 2025 and look at really some of the details that I would be looking at in selecting a plan. So what I've done, just so you know, I've used a Dallas, Texas zip code just to select one. So that's really what we're looking at are the plans that are in Dallas. Now, what you will see regardless of where you're in the country this year, most areas are going to have about 15 different drug plans. Aetna has usually one, United Healthcare, AARP has two plans, and then Cigna, Blue Cross Blue Shield, Anthem, Humana, and WellCare are each are going to have about three plans. Okay, so again, it's going to vary market to market, but primarily we're seeing about 15 different plans. So we're going to look now at standalone drug plans and we'll look at Medicare Advantage drug coverage as well. Let's start with standalone drug plans. So what I've selected, again, a Dallas, Texas zip code, 75019. Now, what I did is I went through and I took the top 10 prescriptions that are generic, so very low cost medications, the top 10 that people are taking that are actually on Medicare, because I want to have, you know, kind of a broad scope here. So you're going to see the list. We're looking at amlodipine, of course, a high blood pressure medication, torvastatin is cholesterol, clopidogrel, I think is the way you pronounce that one. That's for people that have the possibility of blood clots. So it's a kind of a heart medication, glipizide, metformin, type two diabetes, the water pill there is hydrochlorothoracide, levothyroxine, of course, for the thyroid, lisinopril, high blood pressure, metoprolol, again, high blood pressure, omeprazole, of course, you know, acid reflux, and vestatin, another form of cholesterol. And I know no one's taking all these meds, but what I was trying to show you is if we did take a bunch of generic meds, which 90% of all prescriptions are, what kind of a drug plan are we going to have what's going to be our out of pocket expense? All right, so we have 10 drugs that we're looking at. And so we're going to tell this system we are done adding drugs. And now I've already chosen the pharmacy in advance. And again, I just usually look at CVS, you can see here Walgreens, I picked a grocery store there in that particular zip code, Kroger, there were others, Walmart, and then mail order. Now again, you can have Costco, there's a variety of grocery stores, but this system will look at five of them and make a comparison. All right, so once we've selected our pharmacies that we would like to look at, then we're going to say done. And by the way, you're going to see in a few minutes, this matters because what we're looking for is the best possible price. And that's why we want to shop among different pharmacies. Okay, so we're done with that. This system has our meds, the system has our pharmacy. And now what it has done, it went out to that market, the plans that are in that particular zip code, 75019. And it took these plans and it actually has put them in order of cost and coverage. So it's looking at are my meds covered, number one, and what is going to be my total cost, which would include premium as well as my out-of-pocket spending. Now we already know that we're capped at $2,000, but we want to see will we get to that number. And so I filtered this by lowest overall premium costs as well as lowest drug costs. So number one, the list is a plan that is WellCare. WellCare is actually a company that's owned by Centeen. So let's look at the details of this plan. And again, I'm not going to look at the details of every single 15 of the plans, but let's look at a couple of them. So number one, you can see WellCare value script plan. Its ID number has a zero premium. Remember, you can be on this plan for zero. Now people say, how's that happen? Well, because the government actually gives these plans a certain amount of money every month anyways, about $160 to $180 a month. And so this plan is saying based upon the meds we cover and the preferred pharmacies that we're selecting, we don't have to have any additional premium. So truly is a zero premium plan. Now that doesn't mean this plan zero everywhere in the country, just happens to be zero in the zip code. Then you're going to notice the next line, total drug and premium cost. Our meds, all 10 of them are zero at a preferred pharmacy, as well as mail order. So there's no cost for the plan. There's no cost for the medication. Now, if we had a medication that was subject to the deductible, we see on this plan, it's $590. Now, none of the meds that are in this list of 10 are subject to deductible. They're actually deductible exempt, very common on tier one and sometimes tier two medications. But here, all of these, we don't have to meet the deductible. So that's WellCare value number one. Second one on the list is called, and by the way, I'm going to check the add to compare so we can lay these side by side in just a minute. Next one on the list is Cigna. Now Cigna is not a zero premium plan. It's low cost is $20. But notice the retail pharmacy and drug cost is 240, which means what? There's still no cost for medications, but because we have a $20 a month premium times 12, it's going to cost us $240 to be on that again, zero for the meds. If I had a deductible med that was subject to deductible, I'd have to meet that. But here you can clearly see all 10 of those meds, zero deductible, zero out of pocket. Okay. And this takes us to number three plan, and that's going to be a humana plan. Again, you can see the premium 4330. And so that's probably, again, the 519.60 is total for the premium for 12 months. That'd be 12 months times 4330. And so again, we're going to get all of our meds zero there. Now, if we had a medication that was subject to deductible, notice they lowered it a little bit. I don't know why they did. It's only $17, but if it's a $573 deductible that we would have to pay with medications that would be subject to that, which are typically again, tier three, tier four and tier five meds. All right. So I'm just going to stop there as far as making a comparison, but this is real quickly shift down. Remember, there's 15 plans. So there's another well care plan has the premium 330. Again, higher cost meds, a Blue Cross Medicare choice plan, again, $60.60 deductible 590 service group choice. This is an Aetna plan. Again, same deductible. We see a premium 4480 higher costs for the meds. Now you wouldn't select these plans based upon the meds that we chose. Okay. You would not enroll in these plans, but these are the 15 plans. Okay. So you can just see the premiums go up. The out-of-pocket expenses going up, of course, as well. Humana basic. So I'm just going to kind of scroll through. So you kind of got a feel for these plans. Okay. And then there's another Cigna plan. Remember I told you most, most areas, Cigna has three plans. And then we had five more plans. There's a Humana plan, 124 premium, zero deductible on that one. Of course you have very high cost. And by the way, let me just stop here and say that, that this Humana Premier RX plan may be a good plan for people that are taking different meds, just not on these meds for sure. Okay. And then another Blue Cross plan, same deductible premium. You can kind of see as we go through here. All right. Another zero deductible there, our preferred plan. Okay. So the whole point is we have 15 different plans. So it's put them in order of cost and coverage. So we know for sure that we're not, we wouldn't select one of the plans that are going to be down here at the bottom. We wouldn't select just really the top three plans. So we're going to go back and now let's compare. What am I looking for when I see these plans? And again, I'm only going to compare three, but we can actually by me selecting the compare, compare, compare. See, I did that. I compared those. Now we actually can open up the details of those plans. Okay. And that's what I'm going to do. And I'll lay these plans side by side. So we have compare, compare, compare. And then the bottom right-hand corner down here is compare. Okay. Now we got them side by side. As you can tell, enrollment starts the 15th of October. I'm shooting this video today is actually the 10th of October. So a couple of days before enrollment begins. So we can see our three plans. We see the different premiums. All right, now let's go and actually look at the premiums. We see the deductible there all the same, except Humana was a little cheaper, $5.73. All of our medications are covered. That's a big deal. 10 of 10, they're all covered by them. Now when it talks about restrictions, they're talking about quantity limits. Sometimes they're going to be 30 pills in the bottle, sometimes 90. There could be some different restrictions. They're called prior authorization, step therapy, different components that the drug companies actually can use. Okay. So let's go through here and you're going to notice that on these plans with well care, CVS is a preferred pharmacy, but notice CVS with the Cigna plan or the Humana plan is a network, but it's not preferred. So you can kind of see the annual costs, why they vary. So obviously, if I'm on the well care plan, I'm not going to go to Cigna. I'm not going to go to CVS. If I'm on the Cigna plan, it would cost too much money. It's not preferred. You can see if I was on the Cigna plan, well, who would I use? I would use Walmart. Why? Because that's going to be my lowest cost for my medications. See that? But CVS would be a wonderful option for this well care value script plan would be zero. If I was on the well care plan, would I go to Walmart? No way. These same meds would cost me $997. That's why I'm saying the pharmacy is going to matter. So you can kind of see the difference there. So every pharmacy that we put in CVS, Walmart, Kroger, Walgreens, they're all preferred pharmacies on that well care plan, right? With the Cigna plan, notice Kroger, you can see here on the screen, Kroger is out of network. It says 12,000. Well, who would do that? No one would do that. CVS is high on this plan, but Walgreens and Walmart are your preferred pharmacies or mail order would be preferred as well. And so again, your meds on that plan would all be zero. You just have to pay your monthly premium of $20. And then let's look real quickly at this Humana plan over here. Again, I would enroll it with that kind of a premium, but you can see my best prices would be at Walmart, the $519.60 or the mail order. Both of those would be preferred pharmacy. Everyone else would be in network, but not preferred. All right. So that's why I'm saying the pharmacy that you choose is going to matter. All right. So you can kind of tell there with those plans, well care would be the one I'd enroll in for sure, just because it's going to give us a zero premium as well as a zero out-of-pocket on our medications. Okay. Now what I want to do is this. I want to show you what would happen. Let's say if we added some meds. Okay. Right now we have zero out-of-pocket on all the plans for our medication, zero. But what happens if I were to add something to that? So I'm going to go over here and I want to go back and just add a couple of meds just so you can kind of see what's happening. So we saw wellcare was number one, that Cigna plan number two, and Humana number three. Hey, if you found this video helpful and you want to see more Medicare information just like it, then go below, right below the video, and you can give us the thumbs up as well as subscribe to our channel. And every time I put a new video, which is about two every week, you'll be notified of that video and others just like you who need this vital information will get it as well. So let's go back and let's just add a couple of medications. So we see, add another drug. And so what I'm going to do here is I'm going to add, I've written a couple down here, but I thought would be, these are also going to be low cost meds, but they're, they're different. There was a medication called alprazolam, alprazolam. And that medication is actually the generic of Xanax. And this, so this would be for anxiety. And so we're going to add that medication. Now, what I do, I'm just using the normal dosage and frequency, but you can see here, however, the medication is prescribed actually will come up as an option. But again, just for comparison's sake, I'm just going to use what is most commonly prescribed. So I want to add alprazolam to our list. Now it's on there. Let's add another drug. Let's add, let's add gabapentin. A lot of people have nerve pain, and so they're need to take gabapentin. And so again, I'm going to add this drug and we're going to use normal dosage frequency, which is looks to be 300 milligram tablets. We'll add that to our list. Let's add a couple more in here. Let's say you need a sleep aid. A very common one is a medication called zopidem, zopidem. It's a generic for, it's ambient generic, zopidem. And you can kind of see it comes up there. And again, we're going to add it. We're going to do normal dosage frequency, one a day, 10 milligram tablets. And then I'm going to put just one more in here. There's an antibiotic that's pretty common that people take called azithromycin. We see that a lot with folks. So let's, let's look at that antibiotic tablet and we'll add it and that. So we just added four medications to our list. You know what I think? Let me add one more. Let's, let's put another pain medication. Let's add hydrocodone. We'll do one with acetaminophen in it. Hydrocodone right here. Let's add this to it. That's a very common one. And again, we'll go 10, 3, 25. Okay. Very good. So we've added five medications. All right. So we're going to tell the system we're done. Now, remember all of our meds were zero on all those plans. We just had a premium on two of them, but the meds were zero. So we're done adding drugs. We're going to stick with our same five pharmacy options, CVS, Walgreens, Kroger, Walmart, and mail order. So we're going to say done with that. Okay. So now it's out looking at the plans, but now we have a different list of medications. So let's see what happens when we do that. Okay. Now things changed. Wellcare is no longer in the first place. It's Humana is going to be in the first place. And you can see that counting our premium, the 4330. Now we have some out-of-pocket expense for medications, total of right at $750. Mail order is more expensive. A lot of times people think mail order is cheaper and not always. Okay. Our retail option is actually a little bit better. All right. So this had a reduced deductible. Then that deductible would have been included in that total out-of-pocket, that 749. So now we have Walmart is number one. And now Cigna, that one earlier that was number two is now the second spot. You can see a total was 825. So what they're about another $75 for the year higher. And then let's go to number three and see what happens. Now we pick up that wellcare value script plan. Now it's because we've added these meds, 925. So 925 versus Humana, which was 750. So we're talking about what another $175 more. So let's keep the comparison the same. Okay. So we're going to compare those three plans. But again, now that order has actually switched. And so we're going to look at those plans and now let's go down to the drugs. We see 15 of 15, see that? They're still covered. All their pharmacies are the same. And again, on that Cigna plan, wouldn't go to CVS, but it'd be fine to go to CVS if I was on the wellcare plan. And so you can kind of see what we have here. It looks like if I was on the wellcare plan, I would, I'm going to, I'm going to go to either a mail order. I'm going to go to Walgreens, Kroger, or CVS. Walmart's high. Why not prefer it? Now notice if I'm on the Cigna plan, remember it was the lowest cost on this one. The mail order or Walmart actually be wonderful on that plan. See how less expensive that is. So it's a little bit better than the wellcare plan. And the Humana was the best of all, as long as I went to what Walmart or mail order, but Walmart would be the best. So if I were saying I'm going to select the plan, that's going to give me the best price with that list of medications. Now my Humana value RX plan is the best. So the point is folks, it's not just the premium that matters. Let this system shop everything because this is total annual costs for all your medications, as well as the premiums you have to pay. So sometimes zero is not best. And you can tell that here. Zero was actually the third best plan. It'd been better to pay a higher premium because then you're going to get lower copays. All right. All right. So that's the way you would make this comparison. Now I just want to real quickly go back over and I want to look at this same medication list when it comes to a Medicare Advantage plan, because remember, remember the Medicare Advantage plan has that embedded drug plan. So we're going to go over to a plan type. And now I'm going to tell them, I'm going to look at Medicare Advantage plans. And again, I'm going to say, I want an HMO or PPO plan. A private fee for service is pretty rare, frankly. So you'd do HMO PPO. And so let's apply that filter to this. And now it's going to go out and it's going to look at all the Advantage plans. And I think in this market, there's over 50 different Advantage plans. And again, I'm not going to look at all of them, but I would like to look at a couple of them. So you can kind of see what, what, what to be paying attention to here. So again, see what it says, showing 10 of 52 Advantage plans, 10 of 52. And again, we're just gonna look at the top three. And so we see the Blue Cross has this plan that has a zero premium. And then the medications are going to be our, you can see 1773. And again, there's a lot of other benefits with this Advantage plan, but I just want to focus during this video, just on the part D component. All right. So we have no drug deductible. So we're total out of pocket 17736. Now let's say we want to compare that one. Now we see another Blue Cross plan again, zero premium. I'm going to skip that one. Another Blue Cross plan. Sorry about that. Another Blue Cross plan. So clearly Blue Cross is very competitive here when it comes to our list of medications. And again, meds, not all that you're going to look at. Let's keep going. Wow. Blue Cross, Blue Cross. Okay. All right. Now let's go. Okay. Here we go. Now we pick up a plan called WellPoint. WellPoint. And you can see here this WellPoint plan, again, medications, very reasonable, zero deductible. So we're going to put that one in our, in our list. And then now we pick up this Cigna preferred Medicare plan here. I'm going to put that in our list as well. Now, again, we're just looking at drugs. So I do, before I move off the screen, I do want to show you a couple of things. Every plan that we've looked at so far primarily were HMO plans. You're going to notice there's also some PPO plans that will be in this market. And the difference is HMO, you many times have to have a referral to see a specialist. You can't go out of your network unless it's an urgent care emergency situation. So I'm not saying PPLs are bad, but sometimes, I mean, I'm not saying that an HMO is bad, but you have to be aware of some of the restrictions. Not as many doctors take HMOs as PPOs. So here we go. We just picked up a Humana, what's called an Honor Giveback. This would be for the veterans and TRICARE PPO plan. There's a Humana Choice PPO plan, but you can kind of see our meds a little bit more expensive there, 636. Here's a WellCare PPO plan, 660 for the meds. So you'll notice that the HMOs normally have a little bit lower cost on their medications. Okay, so let's go back here, and I'm going to go back to where I was, just back to page one, and let's just do a quick comparison. So again, there's 52 plans, so I don't have the time to go through all that. But they are going to give us coverage, so we have to be sure that we're paying attention to these plans. So let me compare them, and we'll lay them side by side. Okay, so there they are, those are the top three plans, again, all HMO plans. But what we're focusing on is our medications, a lot of other details, but the meds is what I care about here for the sake of this video. Okay, here we go, there we go. So again, we've got 15 of 15 meds covered by all the plans, and then we're going to notice here that if I was on this Blue Cross plan, let's see, our Kroger would be preferred, look at that, $177.36, very, very low cost. So that's where you'd want to go to get your medications. Notice on the WellPoint plan, where would we want to go? Let's see, it looks like mail order would be cheaper versus CBS would be a good retail option. And then if I was on the Cigna HMO plan, wouldn't want to go to Kroger for sure, look how high that is. And so it looks like to me, I'd want to use either mail order or Walmart, or that'd be it, one of those two would be the best for that. And that's what I'm trying to teach you. You pay attention to once you put your meds in, let it shop all the plans, show you among those pharmacies, what would be your best option, okay? All right, so hopefully all that is helpful, that's why we shot this today. Now, what I'm going to do next is I'm going to go through, because I've talked about the $2,000 max out-of-pocket, I'm going to show you exactly how that's going to happen and how that for those people that don't have the $2,000 out-of-pocket initially, how we can spread those payments out over the whole year. And that may make it a little bit more feasible for people to meet that $2,000 max. Let's take a look at that next. Now you've heard me say in the video a few times that the most we'll spend in 2025 out-of-pocket for our prescription medications is $2,000, that is the spending cap. And so what I'm going to do with this slide is explain to you exactly how and why that happens. All right, so I want to begin by talking about that in 2025, we're only going to have three phases in all Part D plans. This year, 2024 and prior, we've had four phases. And so now what's happening in 2025, they're eliminating a phase, they're eliminating what we would refer to as the donor hole, the government called actually the coverage gap. And so that is gone moving forward, okay? So that's that part. So before I get into the exact layout of the phases, I just want to draw your attention down here to the bottom real quickly, because I want you to realize that whenever we have a prescription medication, there are four potential payers or different participants to cover the cost of our medications, four of them, all right? And that's going to vary based upon the phase that we're in. And so you, of course, are the patient, you enrolled in the plan. The Part D plan is the plan that you selected, whether that was a standalone drug plan, or it was embedded within the Advantage plan, the Part D plan is also going to participate. And then of course, Medicare pays some of the cost and the manufacturer will discount the medications in some situations as well. All right, so the whole point is when we have a medication, what we're trying to do is get the cost of that medication 100% covered. And that's going to vary depending upon the phase that we're in. So I'm going to teach you how each of these payers contributes in each of these phases. All right, so let's start with the deductible phase. This is the first phase. Now, I just want to clarify something. For those of you that do watch me a lot, you have noticed that I was saying for several months that the deductible for 2025 was actually going to be $540. And the reason I was using that number is because that's exactly what the government put out. And then what happened whenever the bids started coming in from the insurance companies, there was really a disruption and there was some pushback on that low deductible. So the insurance companies convinced Medicare that they should raise the deductible. So they did. So this number here is accurate. The $540 was certainly out there, but it was not accurate. So $590 is a deductible for 2025. All right, and so now you'll notice that there will be some plans, and we saw this as we compared plans, that can reduce the deductible. Some actually went all the way down to zero. All right, now a plan can never have a higher deductible. This would be the max deductible. The majority of the plans, you will have to meet that deductible. It's max, but again, it could be lower or it could be all the way to zero. And so here's what I'm trying to say. If we have a deductible, $590 or anything, then what happens is you as the patient, the one enrolled in the plan, you are 100% responsible for the cost of your medications, whether it's a generic or a brand name. So it's on you, 100% of the cost. Now, the truth is many of you are on very low cost medications, and so you will never even reach the deductible. That's going to happen. I'd say probably roughly 60 to 70% of all people will never even reach the deductible. But if we do, if we reach that deductible, then what's going to happen is then we go to phase two. So you are 100% responsible for the cost of medications. Now, of course, those costs are discounted by Medicare, but nonetheless, it's still on you during that phase. Now, once we reach the deductible, if we do now, we're in the initial coverage phase. This phase has been around for years. And in this phase, what happens is you're the patient, whether it's a generic or brand name, again, we're talking down here, you, you're responsible for 25% of the cost of medication. So if it's $100 retail costs, you pay $25. $500 retail costs, you pay $125. All right. So what happens is if I'm on a generic medication, I pay 25% and the Part D plan participates by covering the other 75% of the cost. If it's a brand name medication, Part D plan pays 65% and the manufacturer has to discount 10%. All right. So again, what are we trying to do? We're just trying to get to a hundred percent of the cost of medication. But the good news is now in this phase, this 25% you're responsible for now has a max of $2,000. Okay. Now that may take you four months, seven months, you know, never, or it could take one month. But the point is we'll never spend more than $2,000. Now, as we move into 2026, that number will be adjusted based upon inflation. That's the only way it's going to go up. But again, there will be a very low spending cap. And so once we've reached that spending cap out of pocket, now we move from phase two to phase three catastrophic. Now in the catastrophic phase this year, I'm doing this video October the 10th of 2024. This actually was zero as well. The spending cap was higher 3350, but it was zero. Now prior to 2024, 23 and before we always had an out-of-pocket responsibility. And that's what many people to spend thousands and thousands of dollars. Obviously that cannot happen any longer. So how do we get our drugs covered in this particular phase? How do we get to a hundred percent? So here's what happens because you're out of pocket zero. What's going on is that drug plan you selected is actually paying 60% of the generic medications. That's what the G stands for generic brand, generic brand. And so the D plan pays 60% and Medicare pays 40%. And that's why the selection of your D plan is so important. You want to make sure you're getting a plan where that medication is in the formulary. Why? Because they cover 60, Medicare covers 40%. Now if it's a brand name medication, what happens? That D plan still has to pay 60% and the manufacturer gives a 20% discount and Medicare pays 20% of the medication. So again, that's how we get to a hundred percent. And I'm teaching you all this because I want to make sure you understand, yes, we're capped at $2,000, but that part D plan is taking on a huge financial responsibility. And we just want to make sure that we have selected the correct part D plan. If you come to a place where you know, you're going to have to make some Medicare decisions pretty soon. The best way to do that is to click up here in this right-hand corner. And you'll have an opportunity to book a call with one of our Medicare guides, all the guides around here, I have personally trained and they truly are professional. They'll answer your questions and they'll show you different Medicare options to make sure that you're confident in the decision that you make. So as we just saw, we know that the max out-of-pocket for our medications for the year, as long as they're in formulary covered by Medicare will be no more than $2,000. That's the max cap. Okay. For spending out-of-pocket. So we have a $2,000 cap. Now the issue is though, sometimes people could owe that the first month that they're on some real expensive medications and some people cannot afford that. In fact, most people could not afford that. So what happens, the government has a way to actually smooth out that $2,000 and take that amount and spread that out throughout the year. So you don't have to be out-of-pocket immediately $2,000. And so the way they're going to smooth it out is right here with this new program in 2025. We've never had this before. So now it's called the Medicare prescription payment plan. And so I'm going to explain exactly how this plan is going to work. Now, keep this in mind when you enroll into your Part D plan. Now remember how you had that Part D coverage, either it's a standalone drug plan, or it's embedded within the advantage. Whoever's going to have you covered, they'll give you the opportunity to be able to enroll in this plan. There will be actually an enrollment online option for you to do that. Now, again, if you're not even going to reach your deductible, it wouldn't enroll in the plan whatsoever. But if you know for sure, there's a likelihood that you're going to meet the $2,000 max sometime through the year, I would enroll in the plan, the sooner the better. All right. And again, if you're not going to get close, don't do this. All right. So when we enroll in the plan, here's what's going to happen. What I'm going to do, I'm going to show you your responsibility in January, February, March, and then April in this example. Okay. And what we're saying in this example, we're going to say that we have $500 of out-of-pocket expenses on medication, that's our responsibility is $500 a month. All right. So here's the way it's going to work. In January, what will happen is you'll get your bill because keep in mind when we enroll in this plan, you have to pay a premium to the company if there's a premium plan for the prescription drug plan. But your prescriptions, you get the pharmacy, you no longer pay at the pharmacy. The actual company is going to bill you for the cost of your medications. Okay. So you pay them a premium and you'll also pay the company for your prescription. So no money is exchanged at the pharmacy any longer once you enroll in the plan. So what I'm saying in this example, our medications are costing us $500 a month. All right. So in January, the plan does not know what you're going to spend throughout the year, but you've enrolled in the plan. And so what they're going to do is they're going to take that $2,000 and they're going to divide that by 12. So this would be your first month's bill. It'd be $166.67. Okay. They'll bill you for that. And so once you're enrolled again at the end of the month of January, then they'll calculate what you actually spent. And we're saying in this example, it would have been $500 that you spent on your medications. You only spent $166.67. So let's take that $500. And so what this means is now you have a balance. You have a balance of $333.33 moving into the month of February. All right. And so again, we're saying that's our balance that carries over into February. And again, we spend another $500 in medications during the month of February. All right. So they're going to take this $500 you actually spent plus the balance. And that's going to give us $833 that we're going to owe. Let me put it over here. Put our balance here. $833.33. And so we have what? 11 months left in the year. So they're going to take that and they're going to divide that by 11. And so let's do that. And that gives us our payment. So February payment is going to be $75.76. All right. So that's the invoice they'll send us. We got to pay that. Now look what's going on. So now I have, I've, I had this balance of 833 and I paid 75.76. So I still have a balance of my and that new balance is going to be 700. Here it is. 757.57 carry over. So again, I had in March, I had another $500 in medications. So I had seven, that number there plus my new $500. And that gives me $1,257.57. And I have 10 months left in the month. So they're going to divide that now. I'm left in the year, pardon me, by 10 to establish my payment. And that gives me $125.76 where I actually made a payment. Okay. And so I have this balance of $1,257.76 and I made a payment of $125.76. So now I have a, I have a carrier over balance of $113,181. And then what happens again? I move into April and I have $500. Okay. That I spent on medications. Okay. Now look, what's happened. Now I've reached my $2,000. Okay. And so that $500 would be added to that $500 add to that. And so this, this puts me at a balance of $1,631.81. And what do I have? I have nine months left in the year. Take that nine divided by, and that gives me now a payment of $181.31 that I would make in April. And now I've maxed out at my $2,000. See that $500 each and every month that gives me to $2,000. So now from April through the end of December that's what my payment is going to be $181.31. So it's a fixed payment thereafter. It changed because my, my balances were changing based upon the payments that I made, but that's exactly where we're going to do it. So the point is the sooner that you enroll in that program, if you think you're going to meet the $2,000, the better off you're going to be. Because again, they just keep carrying the balance until you have spent out of pocket $2,000. And so I think it's a wonderful way to help people transition. Now, if you say that this $2,000 is no problem, that you don't have to enroll into the plan at all. You can just go ahead, you'll pay the first $2,000. And then whenever you've met that, then this would just turn to zero for the rest of the year. All right. So I think a very good idea, a very good way to make this really, really more acceptable to people and more appealing to people. So hopefully you can take advantage of this. If this $2,000 would indeed be an issue. All right, let's close out the video with this just real quickly. If you know that you need to switch your plans and sometimes the plans are still good for you, you're happy with the plan, then it will automatically renew. There's nothing you have to do. Okay. Now, if you need to switch the plan, you have a couple of different options here. Number one, if you're switching the RX plan only, I think the best way to do this would be to go to medicare.gov. Okay. And you can actually go to that site and set up an account and switch your plans there. Now, if you're our client, we have our own website where we facilitate those changes. But again, if you're not our client, then that would be the very easiest way to do it through the medicare.gov site. Okay. Now, secondly, let's suppose that you are on a Medicare Advantage MAPD plan. It includes prescription drug plan, and you want to get off of that plan. Some of you may have an MA only plan. Now, let me tell you who has MA only plans. This is an option for people to get their meds to the VA, or someone who has TRICARE, or someone that enrolled in an MA plan that has federal employee health benefit options. Okay. Those three groups of people can actually get their drugs through credible coverage in those ways. So sometimes people that have this option get an MA only plan to cover them for inpatient, outpatient, and get their scripts through here. And others of you that don't have that option, you will have an MAPD plan. So if you need to switch either one of those, then I would suggest you find someone that you can trust, that's reliable. We'd love to be your broker on that. We can facilitate any of those changes that you need to. And we'll take the time to number one, make sure your providers are in the network, your hospitals, your doctors, make sure that we're comfortable with our co-pays, what it's going to cost to go to the hospital, go to the doctor, the different aspects of those advantage plans. We'll go through that and actually do an analysis with you, but we'd be delighted to help here. And then lastly, those of you that are on supplemental plans, sometimes people want to switch the plans. Now, normally you have to go through underwriting to make that switch, but we can help you to look at your options, to compare companies and premiums and stability of the rates, but all the aspects of making a good switch on supplemental plans, that's something that we'd be happy to facilitate and actually become your broker as well. So reach out to us and we'd be delighted to serve you in any way that we can. Thanks so much.