Medicare Part D ~ 2020
Medicare Part D Changes Annually
Each year, Medicare changes the benefits provided under Medicare Part D. These changes could impact your annual costs for your Prescription Drug Coverage.
Here are some of the key changes for Medicare Part D
Initial Prescription Drug Deductible: will be increased by $20 from $415 in 2019 to $435 in 2020. What does this mean for you? The initial deductible is the ‘first dollar’ spent on your prescriptions. Certain plans will have a $435 deductible, which means that the individual will have to pay their first $435 in drug costs before the benefits start, but this usually only applies to higher tiered medications. Other plans may offer a $0 deductible, which means that the benefits start immediately.
Initial Drug Coverage Limit: will increase $200 from $3,820 in 2019 to $4,020 in 2020. What does this mean for you? The initial coverage limit protects individuals from the dreaded “Donut Hole” (aka Coverage Gap), which results in higher out-of-pocket costs. After the total retail drug cost exceeds the initial coverage limit, the individual will fall into the Donut hole. By increasing the initial coverage limit by $200, this is a minor improvement which lowers the probability of reaching (or delays the timing to reach) the donut hole , which is a good thing.
True Out-of-Pocket (TrOOP) Threshold: will increase from $5,100 in 2019 to $6,350 in 2020. What does this mean for you? In most cases, this won’t have an impact. Less than 5% of people reach this threshold. Catastrophic coverage benefits start when someone exceeds the Out-of-Pocket threshold. In Catastrophic coverage, individuals will pay a much lower fee for their drugs – either 5% of the drug cost or a specific co-pay amount, whichever is greater.
Generic Copay in Catastrophic Coverage– increasing from $3.40 in 2019 to $3.60 in 2020
Brand Name Copay in Catastrophic Coverage – increasing from $8.50 in 2019 to $8.95 in 2020
By increasing the Out-Pocket threshold by $1,250, this could have a significant impact (several hundred dollars) on those individuals that previously reached the Catastrophic Coverage level.
All of these Medicare Part D changes in 2020 will have an impact on selecting the right Part D Prescription Plan for 2020.
Prescription Plan Part D Changes Annually
In addition to the Medicare Part D changes, the insurance companies change their Prescription drug plans each year. These changes could impact the formulary (which drugs are covered), deductibles, premiums, etc.
It is imperative to select the right plan EACH YEAR to avoid the type of mistakes which could result in thousands of dollars of unnecessary costs!
We feel very strongly about ensuring our clients have the correct Part D Prescription coverage and thus, we provide the option for all of our clients to have their Prescription Drug coverage reviewed annually.