District of Columbia Medicare Part D Plans (PDP) 2020 Medicare Prescription Drug Plans

2020 Medicare Prescription Drug Plan Changes in District of Columbia

District of Columbia seniors, you have more Medicare Part D plan (PDP) choices this year. Also, you'll find 2020 plans with lower monthly premiums, however, the standard initial deductible is now $435 per year, a $20 increase over last year. This increase is offset by a higher Initial Coverage Limit, which increased to $4,020.

2020 Medicare Part D Standard Initial Deductible

The initial deductible is the amount that you pay before your Medicare Part D plan begins paying its share of the costs. So, if you enroll in a 2020 prescription drug plan with a standard initial deductible, you'll spend $20 more out-of-pocket in 2020 before coverage begins. Most Medicare Part D plans have an initial deductible, but many popular Medicare Part D plans exclude Tier 1 and Tier 2 drugs from the deductible, giving immediate coverage on most lower-cost medications.

Part D Initial Coverage Limit (ICL)

The 2020 Initial Coverage Limit (ICL) is $4,020, a 5% jump over last year. The Coverage Gap (donut hole) starts when you reach the ICL and ends when you spend a total of $5,100. The Initial Coverage Limit marks the coverage gap entry point. You enter the coverage gap when the total negotiated retail value of your prescription drug purchases exceed your plan’s Initial Coverage Limit.

Will You Fall Into The 2020 Donut Hole?

An easy way to estimate if you will run out of coverage is to look at that average monthly cost of your medications. If your prescriptions have an average retail value of over $335 per month, you will enter the 2020 Donut Hole at some point in the year. This assumes that your current retail drug prices remaining stable.

The 2020 Donut Hole Discount is 75% for Generic Drugs

If you reach the 2020 Coverage Gap phase of your Part D coverage, the generic drug discount will be 75% (up from 63%). This means your generic drug costs in the Donut Hole will be 25% of your Part D plan's negotiated retail prices. What you pay counts towards your true out-of-pocket costs (This amount counts toward your TrOOP).

The 2020 Donut Hole Discount is 75% for Brand-Name Medications

Some plans offer additional gap coverage, so look for it on the plan information pages.

How Much Will You Spend To Exit The Donut Hole in 2020?

Your Total Out-of-Pocket Cost (TrOOP) threshold will increase to $6,350 in 2020. That's $1,275 more than the 2019 TrOOP limit of $5,100. TrOOP is the dollar amount you'll spend to get out of the Donut Hole or Coverage Gap and into your Medicare Part D plan's Catastrophic Coverage phase.

It's important to remember that TrOOP doesn't include your monthly premiums or over the counter purchases. Some plans offer additional gap coverage, so look for it on the plan information pages.

Evaluate Part D Medicare plans wisely. If you have a regular prescription or two, we suggest that you verify that the plan you want offers your medication(s) at a good price. You find this information in the formulary. We post links to the formulary and pharmacy web pages, as well as the plan's phone number, on each of the PDP pages listed above.

IMPORTANT: Identifying the best Medicare Part D Plans for you takes a bit of research. What's best for you is personal and must consider multiple factors, including your regular prescriptions, your health and your finances.

Get Your Prescriptions and More with a District of Columbia Medicare Advantage Plan

Medicare realizes that one type of plan does not suit everyone. That's why there are two ways to get help with your prescriptions. The Medicare Prescription Drug Plans above work with Original Medicare. That's one way. But maybe you'd like even more benefits. That's where District of Columbia Medicare Advantage Plans come in. Most offer Part D coverage.

Medicare Part D and Supplements Work Together

Medicare does not pay for all of your hospitalization and doctor bills. Even with the new healthcare law fully in place, your Original Medicare only pays about 80 percent of your District of Columbia healthcare bills. We keep an up-to-date catalog of District of Columbia Medigap Plans, also call a Medicare Supplement, with the tools you need to find the best price and coverage. The Medicare PartD plans above are fully compatible with District of Columbia supplemental insurance.

District of Columbia Medicaid and Your Medicare Part D

District of Columbia seniors who qualify for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) may be enrolled in a District of Columbia Medicare Prescription Drug Plan automatically, as well as Social Security's Extra Help program. The Extra Help program pays for most of your prescriptions, but only if you meet the strict eligibility requirements. If the dual eligible option does not meet your needs, you have the option to enroll in a District of Columbia Part D plan that does. If you are already receiving Medicaid, contact your local Medicaid office for assistance in the transition to Medicare.