What’s new with Medicare Part D in 2020?
Last Updated : 12/12/20193 min read
Summary: If you have Medicare Part D (prescription drug coverage) or plan to enroll in a stand-alone Medicare Part D Prescription Drug Plan, you may be interested in several cost-related trends in 2020.
Medicare Part D premium
Medicare prescription drug plans set their own monthly premium amounts.
Premiums may vary depending on where you live, what plan you select, and whether you qualify for help paying your Part D premium.
Medicare Part D deductible caps at $435 in 2020
Stand-alone Medicare Part D Prescription Drug Plans may charge an annual deductible. The federal government sets a limit on the Medicare Part D deductible each year. For 2020, a Medicare Part D plan cannot set a deductible higher than $435, which is $20 over the maximum Medicare Part D deductible in 2019.
Keep in mind that many stand-alone Medicare Part D Prescription Drug Plans do not charge the maximum allowed deductible. Some plans have a lower deductible. Other plans may have no deductible.
Medicare Part D coverage gap
If the total cost of your prescriptions reaches a certain amount— set each year by the federal government — you pay more for your prescriptions. This is the Medicare Part D coverage gap, also known as the out-of-pocket threshold or “donut hole.” In 2020, once you and your plan have spent $4,020 on your prescription drug costs, you will be in the coverage gap. (That’s $200 more than the 2019 amount.) At that point, you will pay no more than 25% of the costs of covered brand-name prescriptions and generic medications until the total cost of your covered medications reaches $6,350 ($1,250 more than the 2019 amount). If you reach that limit, you will pay a small amount for your covered prescription drug costs for the rest of the year.
What does Medicare Part D cover?
Medicare Part D helps cover outpatient prescription drugs. Each plan has its own formulary, or list of drugs the plan covers, so not every plan will necessarily cover the same medications. A plan’s formulary may change at any time. You will receive notice from your plan when necessary.
Every fall, your Medicare Part D Prescription Drug Plan will send you an Annual Notice of Coverage that tells you about any coverage changes for the next year. You may want to review your plan coverage. If you want to switch to a different plan, the Medicare Annual Election Period is one opportunity to do so.
Medicare Part D also may cover some self-injected medicines, such as insulin for diabetes. But if you go to a doctor’s office or other outpatient facility to receive, for example, chemotherapy, dialysis or other medicines that are injected or given intravenously, Medicare Part B — not Part D —may help pay for those treatments. Medicare Part D does not typically cover over-the-counter medications.
If you have a low income, you might be eligible for Medicare Part D Extra Help.
Do you want to look for a Medicare Part D Prescription Drug Plan in your area that may suit your needs?. You can use the Compare Plans button on this page if you are exploring Medicare coverage options.