On this page we help consumers: Compare 2020 Medicare Part D Plans available in District of Columbia and find the best Prescription Drug Plan (PDP) by comparing premiums, deductibles, copays, and ratings.
2020 Part D plans will be published here on or about 7 October. Until then current year plans will be available.
Changes to 2020 Medicare Part D in District of Columbia
People with Medicare benefits in District of Columbia have more Medicare Part D Plan (PDP) choices in 2020. However, the standard initial deductible is now $435, up from $415 last year, a $20 increase over last years' standard deductible. The Initial Coverage Limit has increased to $4,020, a 5% bump over last year.
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.
2020 Medicare Part D Initial Coverage Limit (ICL)
The 2020 Initial Coverage Limit (ICL) is $4,020, up 5% from 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.
|AARP MedicareRx Preferred||$30.20||$435||N||Basic|
|Humana Basic Rx Plan||$30.20||$435||N||Basic|
|AARP MedicareRx Preferred||$43.40||$435||N||Basic|
|AARP MedicareRx Preferred||$45.20||$435||N||Basic|
|AARP MedicareRx Preferred||$47.40||$435||N||Basic|
|AARP MedicareRx Preferred||$50.80||$435||N||Basic|
|Humana Premier Rx Plan||$61.80||$190||N||Enhanced|
|Express Scripts Medicare Saver||$20.20||$435||N||Enhanced|
|Express Scripts Medicare Value||$41.80||$435||N||Basic|
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 MedicationsThe 2020 brand-name Coverage Gap discount remains the same at 75%. The pharmaceutical industry is responsible for picking up 70% of the cost of medications for beneficiaries in the Donut Hole. You get credit for 95% of the retail drug cost toward meeting your 2020 total out-of-pocket maximum or Donut Hole exit point.
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.
Medicare Part D is Included with Most District of Columbia Medicare Advantage Plans
There's more than one way to get prescription drug coverage with your Medicare benefits. The first way is by enrolling in one of the Medicare Prescription Drug Plans listed above. The second way to get help paying for your prescriptions is through one of the District of Columbia Medicare Advantage Plans that include Part D.
Using Supplement Insurance with Medicare Part D
Thinking about supplemental insurance that can offer you more coverage? It's a smart move. Even with the new health care law, Medicare only covers 80 percent of the hospital and doctor bills incurred by most seniors in the great state of District of Columbia, leaving you to handle the rest. We make it easy to find the lowest price on the District of Columbia Medicare Supplement, commonly called a Medigap plan, you want. The choice is yours, because all Medicare Part D plans are compatible with District of Columbia Medigap plans.
Medicare Part D for Dual Eligible People in District of Columbia
In District of Columbia, if you are eligible for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) you will automatically be enrolled in a District of Columbia Medicare Prescription Drug Plan and the Social Security Extra Help program. Extra Help pays for most of the costs of your prescriptions if you meet the eligibility requirements. You may also enroll in a plan of your own choosing that better meets your needs. If you qualified for Medicaid before you were eligible for Medicare, contact your local Medicaid office.
PDP Eligibility and Availability
You are eligible to enroll in a District of Columbia PDP plan if:
- You are a resident of the state,
- You are enrolled in Medicare Part A and Medicare Part B, and
- You are age 65+ or have Medicare due to a qualifying disability.
All plans on this page are available to beneficiaries in , and all rural areas of District of Columbia.