Kathleen Emert, Medicare Insurance Broker
Kathleen Emert
Kathleen Emert Agency, LLC
Medicare Broker Licensed in NY, FL and PA
6+ Years of Experience
Contact Details
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Location
Albion, NY
About Me
Kathleen is an Independent Consultant, specializing in Medicare.
Experienced Insurance and Financial Professional with a demonstrated history and a desire to help individuals and consult businesses regarding Medicare Insurance and Voluntary Employee Benefits. Kathleen has many years of management experience in Retirement Services, Client Services, Custody Services, Leadership and Operations.
Q&A with Kathleen Emert
I'm confused about the different tiers in Medicare Part D plans. How do they affect what I pay for my medications?
Answer: Good Afternoon,
There are 5 Tiers for Prescriptions within Medicare Plans. Starting with Tier 1 being the least expensive.
Each Carrier has a different formulary for how they classify a prescription in what Tier and how much your monthly copay would be for that prescription. Additionally if the drug is classified as a Tier 3 - Tier 5 it may also have an annual deductable amount assoicated with it.
If you are required to pay an annual deductible you only pay it once a year regardless of how many T3 - T5 scripts you are on.
Therefore, prescription drug costs vary by Carrier and plans. It is very important to provide all of you prescription drug information to a representative so they can research your best options. Or you can research this information yourself through the CMS website.
Typically the costs in NY for 2025 are something like this:
Tier 1 - Preferred Generic (often no $0 monthly copay)
Tier 2 - Generic (range from $10 to $20 monthly copay)
Tier 3 - Preferred Brand Name Drugs (range from $42 - $47 monthly copay) and an annual deductible may apply
Tier 4 - Non-Preferred Drugs (your copay maybe a flat $ for a % of the drug cost (coinsurance) and an annual deductibe may aply
Tier 5 - Specialty Drugs (your copay will most likely be a % of the drug cost) and an annual deductible may apply.
Keep in mind most of the carriers have direct mail order services which typically offer you the ability to pay two months of copayments for a 90-day supply.
I hope this helps clarify your confusion.
What do you like most about being a Medicare agent?
Answer: The Medicare system is very confusing and overwhelming for most individuals. I enjoy helping people understand the system and finding what plan works best for them and developing long-lasting relationships.
I have heard of some people's providers dropping their Medicare Advantage plans. Should I be worried about this?
Answer: I believe in the upcoming year additional plans will be discontinued. You should continue to reveiw you situation and plan on an annual basis. Make sure to review all correspondence from your Medicar Advantage Carrier. If the plan is being discontinued you will receive a notification.