front view of multiple pill bottle obscuring view of older womanCheck out some of the changes that are being made to standard Medicare Part D plans moving forward from 2019 to 2020

Initial Deductible:

Will be increased by $20 to $435 in 2020.

Initial Coverage Limit (ICL):

Will increase from $3,820 in 2019 to $4,020 in 2020.

Out-of-Pocket Threshold

Will increase from $5,100 in 2019 to $6,350 in 2020 (OUCH!)

Coverage Gap (Donut Hole):

Will 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 in 2020.

2020 Donut Hole Discount:

Individuals enrolled in Part D will receive 75% during the coverage gap, 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).

Another 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 $3.60 for those generic or preferred multisource drugs with a retail price under $72 and 5% for those with a retail price greater than $72. For brand-name drugs, beneficiaries would pay $8.95 for those 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:

Will increase to $3.60 for generic or preferred drug that is a multi-source drug and $8.95 for all other drugs in 2020.

If you would like to learn more about what prescription drug plans are available, call an expert at Medigaptoday LLC at (786) 231-0844 today!

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