Episode
AHIP Medicare Exam Prep 25, Current Part D Benefit Phases and Cost Sharing
- Podcast
- Insurance Exam Prep
- Published
- Sep 10, 2026
- Duration seconds
- 248
- Processing state
not_requested- Canonical source
- https://open-exam-prep.com/
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Summary
This podcast is made by Ran Chen, who holds an EA license, Insurance and Securities licenses (Series 6, 63, 65), and the CFP® designation. He is passionate about opening access to high-quality exam preparation resources and helping learners prepare more effectively for professional certification exams. In this episode you will learn: - The current CMS standard Medicare Part D structure features three benefit phases (deductible, initial coverage, catastrophic coverage), completely eliminating the legacy coverage gap or donut hole. - Maximum standard deductible caps are set by CMS at $590 in 2025 and $615 in 2026, after which beneficiaries pay 25% cost-sharing under defined standard benefit design. - Beneficiary out-of-pocket spending is capped at the True Out-of-Pocket (TrOOP) threshold of $2,000 in 2025 ($2,100 in 2026). - Beneficiaries pay $0 cost-sharing in the catastrophic coverage phase, as the former 5% coinsurance requirement has been eliminated. - TrOOP calculations include beneficiary out-of-pocket costs and manufacturer discounts for covered drugs, but strictly exclude plan premiums and non-formulary drug costs. For more free exam prep tools, practice questions, and AI-powered explanations, visit https://open-exam-prep.com/ or YouTube Channel: https://www.youtube.com/@Open-exam-prep