Medicare Part D can be confusing, but I’m not telling you anything you don’t know. Medicare Part D for 2022 has many coverage phases. I will also hit on the Medicare coverage gap, also known as the Part D coverage gap or donut hole. I am here to help you find your best Medicare Part D. When you are searching for your best Medicare Part D plan you will want to search terms like Medicare in my state and Medicare plans near me. There are usually about 30 different Medicare Part D plans in each state. This makes it extremely important to compare Medicare plans, as the cost for Medicare Part D can differ greatly by company, and not all plans have to cover all prescriptions. You want to make sure you pick a plan that covers all of your prescriptions, if possible.
- There are Many different Companies That Provide Medicare Part D
- How Part D Premium Works?
- The Only Best Medicare Broker You will ever Need
- Why it is Important to Compare Medicare plans and the cost for Medicare Part D
- What Experts Are Saying About Tier Levels
- Initial Coverage Level
- Coverage gap also called as the Donut Hole
- Why Generic Drugs Are Very Popular
- Conclusion — How To Get Your Best Medicare Part D For 2022 | Read On Now!
- About The Author — Christopher Duncan
- Important YouTube Channel Details
What Companies Offer Medicare Part D?
We represent many different plans. They include but are not limited to:
- Unitedhealthcare AARP Part D
- Aetna (SilverScript) Part D
- Anthem Part D
- Cigna Part D
- Humana Part D
- Humana Walmart Part D
- Clear Spring Health Part D
- Elixir RxSecure Part D
- Mutual of Omaha Part D
- Wellcare Part D, and others as well
Being independent agents we are able to represent many different companies to help you find your best Medicare Part D.
How Part D Premium Works?
Let’s get to the specific new average for the Part D premium. The new average Part D premium is going to be a little under $35 a month. This all depends on the plan that you need. In year’s past year I’ve seen Part D premium range from under $10 a month to over $150 a month depending on the Medicare Part D plan. Just because you get a plan with a higher premium doesn’t mean you are getting a so-called better plan. You can pay a higher premium and that doesn’t mean your particular prescription will be covered by that plan.
How Do I Choose a Medicare Broker?
You will want to compare Medicare plans and the cost for Medicare Part D each year as all the plans change. Even the current Medicare Part D plan you have now will change. If you would like to use the best Medicare broker, I don’t know if I am the best but I like to think I am amongst some of the best. There are a lot of great brokers out there, especially my competitors on Youtube, and not only are they my competitors, but I’m also proud to say many are also my friends. Any of us will be able to help you.
Why it is Important to Compare Medicare plans and the Cost for Medicare Part D
After the Part D premium comes the four different phases of Medicare Part D plans. You already know about the different phases if you subscribe to my YouTube channel and follow my Facebook page. The first phase is called the deductible phase. In 2022 the deductible is $480. This is up from $445 dollars. Again if you follow the content I produce, you know that the deductible with many plans doesn’t apply to certain tiers. I’ll review tiers here in a second. Many plans don’t apply the deductible to tier 1 and tier 2 prescriptions.
Most plans have 5 tiers, I see some plans that have 6 tiers inside of Medicare Advantage, but most stand-alone Part D plans have 5 tiers.
- Tier one is for preferred generics
- Next is Tier two for non-preferred generics
- Tier three is for the preferred brand name
- Fourthly, Tier four is for the non-preferred brand name
- Tier five is for specialty drugs
These are usually your injectable drugs. Another reason it is important to compare Medicare plans and the cost for Medicare Part D is different prescriptions with different companies can all be on different tiers. Just because your prescription is on tier one with one company doesn’t mean it will be on tier one with another.
What Experts Are Saying About Tier Levels
If your Medicare Part D coverage, doesn’t have a deductible for tier 1 and tier 2 drugs then these drugs will be covered immediately without the deductible and be covered in the second phase: the Initial Coverage Level or ICL. If your plan doesn’t have a tier 1 or tier 2 deductible then all the prescriptions you take will be subject to the deductible before you move to the second phase, called the ICL. You will need to pay the first $480 of your prescriptions then you will move to the second phase, ICL. Some companies don’t have a deductible, but if they do, the highest amount the deductible can be is $480 in 2022.
What is Initial Coverage Level?
As I mentioned, the second phase is called the Initial Coverage Level or ICL. This is what most of us know as our copays. This is when we usually pay $0 to $15 for tier one and tier two generic prescriptions. About $30 to $95 for tier 3 and 4 prescriptions. The brand name drugs. Most plans have a 33% copay for tier 5 specialty drugs. All of these dollar amounts I am giving are just approximate and vary between all of the companies. Further emphasizing the need to compare medicare plans and the cost for Medicare Part D.
Is Coverage Gap the Same as Donut Hole?
The next phase we will talk about is the coverage gap also known as the donut hole. You enter the coverage gap when you and your insurance company have made combined payments for your prescriptions of $4430 in 2022 during the deductible level and the Initial Coverage Level. Your payments during the deductible level count towards this. Here is an example of how you reach the coverage gap when you are making copays during the Initial Coverage level.
For the sake of ease, we will say you paid the full deductible amount of $480 before your insurance company paid anything. That leaves $3950 for you and the insurance company to pay. If the cost of a prescription is $100 and the insurance company pays $90 and you make a $10 copay the whole $100 comes off the remaining $3950 in this case. So when you and the company pay a total of $4430 for your various prescriptions then you leave the Initial Coverage level and move to the coverage gap or donut hole.
Once you are in the coverage gap phase, you’ll pay no more than 25% of the cost for your plan’s covered brand-name prescription drugs. You’ll pay this discounted rate if you buy your prescriptions at a pharmacy or order them through the mail. Some plans may offer you even lower costs in the coverage gap. The discount will come off of the price that your plan has set with the pharmacy for that specific drug.
Does Medicare Pay for Generic Drugs?
Medicare will pay 75% of the price for generic drugs during the coverage gap. You’ll pay the remaining 25% of the price. The coverage for generic drugs works differently from the discount for brand-name drugs. For generic drugs, only the amount you pay will count toward getting you out of the coverage gap.
Although you’ll pay no more than 25% of the price for the brand-name drug, almost the full price of the drug will count as out-of-pocket costs to help you get out of the coverage gap phase. I’ll explain the importance of out-of-pocket costs with the last phase called Catastrophic Coverage in a moment. But what you pay and what the manufacturer pays for covered brand name drugs (95% of the cost of the drug) will count toward your out-of-pocket spending to get you through the coverage gap phase and into the fourth phase called Catastrophic Coverage.
What happens is when you have paid a total of $7050 out-of-pocket in 2022, you’re out of the coverage gap. Once you get out of the coverage gap you automatically enter “Catastrophic Coverage.” This is when the costs of your prescriptions will reduce dramatically. When you are in the fourth phase called the Catastrophic Coverage phase the cost of your prescriptions will be 5% of the cost of the drug or $3.95 for generics and $9.85 for all other drugs, whichever cost is higher.
Conclusion — How To Get Your Best Medicare Part D For 2022 | Read On Now!
I hope that you enjoyed reading about how to get your best Medicare Part D. It is extremely important to compare the costs of each plan before enrolling, as they can vary greatly by company. Have you found a Medicare Part D plan yet? Let me know how it works for you! What do you think was most interesting or surprising? Leave a comment below so I can hear from you – I love hearing feedback!
About The Author — Christopher Duncan
I’m Chris Duncan, owner of Trusted Benefits Direct. As your Medicare advisor, I want you to know that my business offers superior solutions for everyone. I do not work for insurance companies, which allows me to serve you at a high level without any hidden agendas or conflicts of interest. All resources are provided at no cost. Because people must find peace of mind when looking ahead years down the line.
As an insurance agent, it’s my goal to make your life easier. That includes the process of securing all types of coverage for you and your loved ones, including Medicare Supplements, Medicare Advantage, Medicare Part D, Final Expense life insurance services, and retirement security plans. You can reach me toll-free at 800-910-3382 or get a free quote on MedicareRateQuote.com with just a few clicks! Don’t forget that I also offer contact forms if you would like more information from trustedbenefitsdirect.com – click here now!
Important YouTube Channel Details
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