Medicare plans and health insurance coverage can be confusing. Below, we’ll provide you with a simple breakdown of what Medicare Part D is and what changes are in store for 2020 to help keep you updated.
What Does Medicare Part D Cover?
Medicare Part D is Medicare’s prescription drug coverage. It has its own list of drugs that are covered, which is called a formulary. Drugs are then placed in different tiers, which have different costs and coverages.
Medicare Part D Deductible Changes for 2020
In 2020, the Medicare Part D deductible will vary. In some plans, the deductible will go from $415 to $435. This means that you must pay $435 before Medicare begins to pay its share of the prescription cost.
Medicare Part D Initial Coverage Limit Changes for 2020
The Medicare Part D initial coverage went from $3,820 to $4,020 as of January 1, 2020. Once you and your prescription plan have hit $4,020 in 2020 for covered drugs, you’ve reached the Medicare “donut hole.” In the donut hole coverage gap, your prescription coverage is temporarily limited until you reach your out-of-pocket threshold.
Medicare “Donut Hole” Changes for 2020
In 2020, if your plan has a deductible, you’ll pay 25% of your drug costs (both generic and brand-name) while in the donut hole. If your plan is designed with a copay after the deductible but before the donut hole, what you’ll pay for prescriptions will change when you reach the donut hole.
Medicare Part D Out-of-Pocket Threshold Changes for 202o
In 2020, the out-of-pocket threshold will increase from $5,100 to $6,350. This is the amount of money you must pay to exit the Medicare “donut hole.” In other words, once you’ve paid $6,350 for prescriptions through your plan, you begin your catastrophic coverage benefit.
Medicare Part D Catastrophic Coverage Benefit Changes for 2020
In 2020, the minimum cost-sharing once you’ve met your out-of-pocket threshold of $6,350 Medicare will cover at least 95% of your prescription costs for the remainder of the year.
How Can Simplefill Help Those Who Can’t Afford Their Prescriptions?
Simplefill prescription assistance can often help people in the “donut hole” coverage gap, those who are uninsured, those whose copay is unaffordable, or people whose medication isn’t covered. If you’re having trouble affording your prescriptions for any reason at all, start an application online or call us at 1(877)386-0206. A Simplefill advocate will respond within 24 hours.