Part D, 2000 cap

[yeager]

Am I missing something? For the PDP's, if client is hitting the $2000 cap, then it makes no difference what plan they are on since the premium is included in that 2000 cap?

 

[Midlevel]

Am I missing something? For the PDP's, if client is hitting the $2000 cap, then it makes no difference what plan they are on since the premium is included in that 2000 cap?

You are missing an awful lot but I will just start by saying the premium is not included in the $2000 max. There are a bunch of other details you are probably missing but I don't want to get into trying to explain it at the moment. Did you not attend all the carrier meetings/seminars that explained all the new Inflation Reduction Act provisions and how the $2000 max is being figured?

 

[Yagents]

Are we in August still?

 

[annon123]

As was said the premium isn't included and this applies to both D and MAP's. Basic and enhanced plans work differently with respect to how they figure the MOOP. In a basic plan the MOOP is actually 2K. In an enhanced plan the patient will likely pay less than 2K due to how they count what is paid even if the patient didn't pay out of their pocket. There was another thread here that posted some videos that explained it with examples.

 

[ValeRosso]

You are missing an awful lot but I will just start by saying the premium is not included in the $2000 max. There are a bunch of other details you are probably missing but I don't want to get into trying to explain it at the moment. Did you not attend all the carrier meetings/seminars that explained all the new Inflation Reduction Act provisions and how the $2000 max is being figured?

What $2000k max? Gonna need you to explain, I would have definitely heard something about this if it were true.

 

[somarco]

$2000k = $2,000,000

Looks like a fat finger calculation to me. No wonder seniors can't afford their meds.

 

[somarco]

Are we in August still?

It is spring forward, not spring back

 

[GoPokes]

Am I missing something? For the PDP's, if client is hitting the $2000 cap, then it makes no difference what plan they are on since the premium is included in that 2000 cap?

Nope. Not missing a thing. You should get the highest premium PDP so you can hit that 2,000 as quickly as possible. Dont let these other agents fool you, they dont want you to steal their clients.

 

[Midlevel]

I had a new winner yesterday. $235000.00/year prescriptions and client will pay around $300.00 for the year. God I wish I could give them to WellCare PDP but aren’t 65 so can’t buy Med Sup. Could write them a WellCare MAPD but swore I would never give them business again. I have til Friday to change my mind though.

 

[Chazm]

It’s crazy to see some people have ozempic and other brand name drugs, and hitting their cap at $60. MAPD of course.