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2020 Medicare Part D

August 22, 2019

 

There are some changes coming to Part D starting in 2020-it's hard to believe, but it's not that far away!  We've broken it down a little, to make the all-consuming information seem a little less daunting.

 

The following are the new changes, or increases effective January 1, 2020:

 

Initial Deductible: 

Will go up $20 to $435

Initial Coverage Limit (ICL): 

Increases $200 to $4020

Out-of-Pocket Threshold (TrOOP): 
Increases from $5,100 in 2019 to $6,350 in 2020.

 

Coverage Gap (Donut Hole):

This begins once you reach your Medicare Part D plan’s initial coverage limit ($4,020 in 2020) and ends when you spend a total of $6,350 out-of-pocket.

 

2020 Donut Hole Discount: 

Part D enrollees will receive a 75% Donut Hole discount on the total cost of their brand-name drugs purchased while in the Donut Hole.

 

The discount includes, a 70% discount paid by the brand-name drug manufacturer and a 5% discount paid by your Medicare Part D plan.

 

The 70% paid by the drug manufacturer combined with the 25% you pay, count toward your TrOOP or Donut Hole exit point.


For example: If you reach the Donut Hole and purchase a brand-name medication with a retail cost of $100, you will pay $25 for the medication, and receive $95 credit toward meeting your 2020 total out-of-pocket spending limit. 

Medicare Part D beneficiaries who reach the Donut Hole will also pay a maximum of 25% co-pay on generic drugs purchased while in the Coverage Gap (receiving a 75% discount). 


For example: If you reach the 2020 Donut Hole, and your generic medication has a retail cost of $100, you will pay $25. The $25 that you spend will count toward your TrOOP or Donut Hole exit point.

 

Minimum Cost-sharing in the Catastrophic Coverage Portion of the Benefit:

 

Beneficiaries will be charged:

 

     For generic or preferred multi-source 

     drugs:

     $3.60 for drugs with a retail price under $72         and 5% for those with a retail price greater           than $72.

 

     For brand-name drugs:

     $8.95 for drugs with a retail price under $179       and 5% for those with a retail price over $179.

 

Maximum Co payments below the Out-of-Pocket Threshold for certain Low Income Full- Subsidy Eligible Enrollees:

$3.60 for generic or preferred drug that is a multi-source drug & $8.95 for all other drugs.

 

 

Again, these prices will not take effect until January 1, 2020.

 

As always, if you have any questions, please give us a call.

 

 

Try to do something nice for someone today, just because.

 

 

 

All the best,

 

 

Randall J. Lawson

Owner/Agent

The HgO Group

803-851.0219 office

803-521-5581 cell

randy@thehgogroup.com

thehgogroup.com

National Producer Number #9276045

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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