A preliminary analysis of the 2020 stand-alone Medicare Part D prescription drug plan (PDP) data recently released by the Centers for Medicare and Medicaid Services (CMS) shows that Medicare beneficiaries will have more low-premium 2020 Medicare Part D PDP options but, many current plan members will pay higher 2020 monthly PDP premiums (unless they enroll in a lower-premium 2020 Medicare Part D or Medicare Advantage plan).
Here are a few highlights of the 2020 stand-alone Medicare Part D landscape:
More 2020 stand-alone Medicare Part D plan options in most states.
total number of stand-alone 2020 Medicare Part D plans will increase to
948 plans nationwide as compared to 901 plans offered in 2019. The
average number of 2020 stand-alone Medicare Part D plans offered in each
state will increase to 28 plans as compared to the 2019 national average of 26 stand-alone PDPs per state.
You can click here
to read more about plan availability and see a chart of how the average
number of stand-alone Medicare Part D plans has changed since 2007.
Some 2020 Medicare Part D plans are changing names or carriers.
in past years, some 2020 stand-alone Medicare Part D plans (PDPs) in
your state may be changing their name or even their plan carriers (with
changes in cost and coverage).
In fact, our analysis shows that over six million people currently enrolled in a 2019 plan will find their plan’s name changing in 2020. Some examples of plan changes are: the 2019 Humana Walmart Rx Plan (PDP) will become the 2020 Humana Premier Rx Plan – and a new 2020 Humana Walmart Value Rx Plan (PDP) will be introduced. And the 2019 Aetna Medicare Rx Value Plus (PDP)
plan will become the 2020 WellCare Medicare Rx Value Plus (PDP). You
can see more Medicare Part D plan changes using our 2019/2020
PDP-Compare tool. Here is an example showing California Part D plan
The average 2020 stand-alone Medicare Part D premium will decrease.
In late-July, CMS forecasted
a decline in the Part D combined (PDP & MAPD) average premium, and
our analysis of the 2020 stand-alone Medicare Part D plans (PDP-only)
supports the CMS forecast. Based on available information, we expect a
13% decrease in the average PDP premium from $47.21 in 2019 to $40.90 in
However, when Part D
premiums are weighted by current 2019 Part D plan enrollment, the
weighted average Medicare Part D plan premium will increase 6% to
$41.40. This means that, although Medicare Part D premiums are
decreasing, many current 2019 Part D members can expect significant
increases in their 2020 premiums (please see the following section).
58% of current 2019 Medicare Part D plan members will have increases in 2020 monthly premiums.
Based on 2020 PDP premium increases and current 2019 plan enrollment, around 58%
of all Medicare Part D beneficiaries currently enrolled in a
stand-alone 2019 Medicare Part D plan (PDP) will see an increase in
their 2020 monthly premium -- unless they change coverage to a more
affordable 2020 Medicare Part D (PDP) or Medicare Advantage plan that
includes prescription drug coverage (MAPD). You can click here to view a chart of how the average and average weighted Medicare Part D plan premiums have changed since 2007.
More lower-premium 2020 Medicare Part D plan options.
Not only will you see more stand-alone 2020 Medicare Part D plans, our analysis of the 2020 PDP landscape also found a significant increase in the number of PDPs with a premium under $25. For example, Medicare beneficiaries in Nevada will find eight (8) additional 2020 Medicare Part D plans with premiums under $25 as compared to 2019.
The lowest and highest premium stand-alone Medicare Part D plans
The 2020 Medicare Part D plan with the most expensive premium will be the BlueCross Rx Plus (PDP) in South Carolina at $191.40 per month. You can click here
to read more about the Medicare Part D plans with the lowest and
highest premiums and how the range of premiums has changed since 2007.
More 2020 Medicare Part D plans qualifying for the LIS $0 premium.
Most states will have the same or more 2020 Medicare Part D plans qualifying for the state’s Low-Income Subsidy (LIS) $0 benchmark premium. The state offering the smallest selection of $0 premium LIS PDPs is Ohio, offering only two 2020 $0 premium LIS plans. Arizona will offer the largest number of $0 premium LIS plans (12 plans). You can click here
to read more about $0 premium LIS plan availability and see a chart of
how the average number of $0 LIS-qualifying Medicare Part D plans has
changed since 2007.
Fewer stand-alone Medicare Part D plans with a $0 initial deductible.
The 2020 Donut Hole discount
will increase to a 75% discount for all formulary medications -- you
pay 25% of retail for both brand-name and generic formulary medications
purchased while in the Coverage Gap. Remember, all Medicare Part D
plans honor the Donut Hole discount. You can click here to read more on the 2020 Donut Hole.
Fewer 2020 Medicare Part D plans will offer additional Donut Hole coverage.
About 20% of all stand-alone 2020 Part D plans offer some level of gap coverage. For brand-name drug purchases, this gap coverage is in addition to the brand-name drug manufacturers Donut Hole discount.
Please note: The above information is from our Medicare Part D plan landscape summaries and is based on stand-alone Medicare Part D prescription drug plans (or PDPs) – and does not include the U.S. territories.
The 2020 Medicare Advantage plan landscape summary will be presented in our next newsletter. A number of 2020 Medicare Advantage plans (MA/MAPD / MSA / SNP)
may be available in your area and may include prescription drug
coverage, along with Medicare Part A (hospitalization coverage),
Medicare Part B (out-patient and physician coverage), and additional
healthcare (and non-health-related) benefits. You can use our Medicare
Advantage plan finder (MA-Finder.com) for an overview of plans in your area (enter your ZIP to get started).
Copyright Q1Group LLC, Saint Augustine, Florida (2019)