Examples of how 2020 Medicare Part D plans can change prescription cost-sharing designs

As in past years, some 2019 Medicare Part D plans are changing their cost-sharing designs for 2020 prescription drug purchases. For example, the Cigna-HealthSpring Rx Secure (PDP) will add an additional drug tier to its formulary and with the Humana Walmart Rx Plan (PDP) becoming the Humana Premier Rx Plan (PDP) Tier 3 drugs will change from co-insurance of 20% in 2019 to a flat copay of $42 in all states.

In the following example, the 2019 Cigna-HealthSpring Rx Secure plan formulary had five (5) drug tiers. In comparison, the 2020 Cigna-HealthSpring Rx Secure plan formulary has added a new 6th drug tier for Select Care Drugs -- with a $0 copay.

Texas Cigna-HealthSpring Rx Secure 2019 and 2020 Medicare Part D plan Cost-sharing Comparison
2019			2020
Monthly Premium		$22.70			$21.70
Initial Deductible		$415			$435
Gap Coverage		No Gap Coverage			No Gap Coverage
Tier	2019 Cost-Sharing			Drugs on Tier	Tier	2020 Cost-Sharing		Drugs on Tier
1	Preferred Generic		$1	188	1	Preferred Generic	$1	84
2	Generic		$3	725	2	Generic	$2	628
3	Preferred Brand		$30	444	3	Preferred Brand	$26	552
4	Non-Preferred Drug		37%	1,367	4	Non-Preferred Drug	36%	1,301
5	Specialty Tier		25%	549	5	Specialty Tier	31%	447
--	--		--	--	6	Select Care Drugs	$0	95
Total Formulary Drugs	Browse 2019 Formulary			3,273	Browse 2020 Formulary		3,107

In the next example, the 2019 California Humana Walmart Rx Plan (PDP) plan formulary covers 687 medications as Tier Three "Preferred Brand" medications (with a 20% co-insurance) as it becomes the 2020 Humana Premier Rx Plan (PDP) Tier Three "Preferred Brand" will have a $42 copay -- and a much higher premium.

California Humana Walmart Rx Plan (PDP) 2019 and 2020 Medicare Part D plan Cost-sharing Comparison
2019			2020
Plan Name		Humana Walmart Rx Plan (PDP)			Humana Premier Rx Plan (PDP)
Monthly Premium		$29.90			$64.50
Initial Deductible		$415			$435
Gap Coverage		No Gap Coverage			No Gap Coverage
Tier	2019 Cost-Sharing			Drugs on Tier	Tier	2020 Cost-Sharing		Drugs on Tier
1	Preferred Generic		$1	192	1	Preferred Generic	$1	217
2	Generic		$4	620	2	Generic	$4	622
3	Preferred Brand		20%	687	3	Preferred Brand	$42	721
4	Non-Preferred Drug		35%	1,095	4	Non-Preferred Drug	44%	1,073
5	Specialty Tier		25%	587	5	Specialty Tier	25%	564
Total Formulary Drugs	Browse 2019 Formulary			3,015	Browse 2020 Formulary		3,197

There are approximately 2 million members in the 2019 Humana Walmart Rx Plan (PDP) who will see this change, if they do not select a new plan during AEP. The 215,000 members of the Express Scripts Medicare - Saver (PDP) will see their cost-sharing Tier 3 Preferred Brands change from a $30 copay to an 18% co-insurance.

In total, 2.7 million members of various stand-alone Medicare Part D plans will see one or more of the drug tiers change cost-sharing from either coinsurance to copay or copay to coinsurance.

To compare annual changes in Medicare plans, our PDP-Compare and MA-Compare tools show the 2020 stand-alone Medicare Part D prescription drug plans (PDPs) and Medicare Advantage plans (MAs or MAPDs) across the country and include 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 new plans being added in 2020.

Not sure where to begin with choosing your Medicare Part D plan?
Medicare beneficiaries can telephone Medicare at 1-800-633-4227, speak with a Medicare representative, and learn more about their 2020 Medicare Part D or Medicare Advantage plan options.