If your stand-alone Medicare Part D prescription drug plan (PDP) - or Medicare Advantage plan that includes drug coverage (MAPD) - has an initial deductible, you will usually pay 100% of your prescription drug costs
until you have met the deductible.
For example, if your Medicare plan has a $435 deductible, you will pay the retail price for your medications until you have spent $435 and then your plan coverage will begin (and you will only pay a portion of the retail cost, such as a $30 co-pay or 25% co-insurance on your medications).
Reminder: Low-costing formulary tiers may be excluded from your deductible.
Many 2020 Medicare Part D plans have certain drug tiers excluded from the initial deductible. For example, you may find that your 2020 Medicare Part D plan has a $435 initial deductible, but the deductible only applies to medications on formulary Tier 3, Tier 4, and Tier 5 - and your lower-costing Tier 1 and Tier 2 drugs are covered before meeting the $435 deductible.
About 9 million people will only see a $20 increase in their initial deductible.
For example, if your Medicare plan has a $435 deductible, you will pay the retail price for your medications until you have spent $435 and then your plan coverage will begin (and you will only pay a portion of the retail cost, such as a $30 co-pay or 25% co-insurance on your medications).
Reminder: Low-costing formulary tiers may be excluded from your deductible.
Many 2020 Medicare Part D plans have certain drug tiers excluded from the initial deductible. For example, you may find that your 2020 Medicare Part D plan has a $435 initial deductible, but the deductible only applies to medications on formulary Tier 3, Tier 4, and Tier 5 - and your lower-costing Tier 1 and Tier 2 drugs are covered before meeting the $435 deductible.
About 9 million people will only see a $20 increase in their initial deductible.
The 2020 standard Medicare Part D prescription drug plan initial
deductible will increase to $435 from the $415 standard
deductible in 2019 and this $20 increase in deductibles will impact about 9,400,000 people currently enrolled in a 2019 stand-alone Medicare Part D plan.
However, over 6.7 million people will see an increase in their 2020 initial deductible of $25 or more.
In fact, over 2,800,000 stand-alone Medicare Part D beneficiaries are enrolled in PDP that will have an initial deductible increase from $25 to $260. An additional 3,800,00+ beneficiaries will see their $0 deductible increase to anywhere from $50 to the standard deductible of $435.
The chart below highlights some of the increases in 2019 / 2020 Medicare Part D plan deductibles.
In fact, over 2,800,000 stand-alone Medicare Part D beneficiaries are enrolled in PDP that will have an initial deductible increase from $25 to $260. An additional 3,800,00+ beneficiaries will see their $0 deductible increase to anywhere from $50 to the standard deductible of $435.
The chart below highlights some of the increases in 2019 / 2020 Medicare Part D plan deductibles.
|
Medicare Prescription Drug Plan Deductible Increases |
||||||
|
2020 Plan Name |
Deductible |
States |
Members Affected |
|||
2020 |
2019 |
Incr. |
% Incr. | |||
| SilverScript Choice (PDP) | $360 | $100 | $260 | 260% | TX | 247,300 |
| WellCare Medicare Rx Saver (PDP) was the 2019 Aetna Medicare Rx Saver (PDP) |
$435 | $310 | $125 | 40% |
CA | 138,528 |
| BlueCross Rx Value (PDP) | $195 | $95 | $100 | 105% | SC | 15,082 |
| EnvisionRxPlus (PDP) | $435 | $325 | $110 | 34% | PA | 102,060 |
| SilverScript Choice (PDP) | $320 | $100 | $220 | 220% | GA | 163,774 |
The good news: about 254,000 people will see a decrease in their current initial deductible.
As in past years, some stand-alone Medicare Part D plans (PDPs)
have chosen to reduce their initial deductible for the 2020 plan year.
Members of the Alaska SilverScript Choice (PDP) will have a
$230 deductible in 2020 down from $415 in 2019. About 254,0370 members
across various Medicare Part D plans will see a decrease of between $5
to $185.
How to see the changes in your 2020 initial deductible.
Our PDP-Compare and MA-Compare tools show the coverage changes for each stand-alone Medicare Part D prescription drug (PDP) and Medicare Advantage (MA or MAPD) plan across the country and include 2019 / 2020 changes in plan features such as premium, deductible, cost-sharing and formulary size changes. Our compare tools also highlight plans that will be merged or discontinued and plans that will be added in 2020.
Not sure whether you want an initial deductible?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about Medicare plan coverage and their 2020 Medicare Part D and Medicare Advantage plan options.
How to see the changes in your 2020 initial deductible.
Our PDP-Compare and MA-Compare tools show the coverage changes for each stand-alone Medicare Part D prescription drug (PDP) and Medicare Advantage (MA or MAPD) plan across the country and include 2019 / 2020 changes in plan features such as premium, deductible, cost-sharing and formulary size changes. Our compare tools also highlight plans that will be merged or discontinued and plans that will be added in 2020.
Not sure whether you want an initial deductible?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about Medicare plan coverage and their 2020 Medicare Part D and Medicare Advantage plan options.