If you have Medicare prescription drug coverage, often referred to as Part D, your plan should have notified you about any changes in costs for 2020. Part D plans can change the drugs they cover, their pharmacy networks, and their costs (such as copayments, coinsurance charges, and deductibles) from year to year. Remember, there are two main ways that you can get your Medicare prescription drug coverage:
- A Medicare Advantage Plan that covers both health and drug coverage, or
- A stand-alone Part D plan that works with Original Medicare.
Your Part D plan should have sent you an ANOC or EOC notice informing you of your plan’s benefits, costs, and covered drugs for 2020. If you have a Medicare Advantage Plan with prescription drug coverage, you should have received one EOC that describes both your health and prescription drug coverage for 2020.
Part D plans must include the minimum coverage that is set by law, but each plan may offer varying types of coverage. For example, in 2020 Part D plans can set a maximum deductible (amount you pay out-of-pocket before your insurance begins to pay) of $435. However, some plans may not require you to pay any deductible. The following chart shows costs last year compared to this year. Be sure to review your plan materials for specific cost changes.
|Medicare Part D Costs: 2019 vs. 2020|
|Part D maximum deductible||Up to|
|Part D coverage gap threshold|
You reach the coverage gap, or donut hole, when you and your plan together have spent this much on covered drugs since the start of the year.
|Part D catastrophic coverage limit|
You get out of the donut hole and reach catastrophic coverage when you have spent this much out of pocket* since the start of the year.
*Note the out-of-pocket costs that help you get out of the donut hole include what you’ve spent on covered drugs since the start of the year (deductible, copays); most of the discount for brandname drugs while you’re in the donut hole; and any drug costs paid by family members, most charities, State Pharmaceutical Assistance Programs (SPAPs), AIDS Drug Assistance Programs (ADAPs), and/or the Indian Health Service.
Read Next: When can I Make Changes to My Coverage in 2020?
Find Out: Are Changes Coming in 2020 to Medicare Advantage Plans?
Return to: Medicare 2020
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