On this page we help consumers: Compare 2020 Medicare Part D Plans available in Oklahoma and find the best OK 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 Oklahoma
People with Medicare benefits in Oklahoma 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, a 5% increase 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 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.
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 Oklahoma 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 Oklahoma Medicare Advantage Plans come in. Most offer Part D coverage.
Combining a Supplement and Medicare Part D Benefits
The new healthcare law did not change the coverage you get from Medicare for major medical. You are still responsible for paying the remaining 20 percent of all hospital and doctor bills. Even a brief hospital stay can cost you thousands. That's why we maintain a complete catalog of Oklahoma Medicare Supplement Insurance, also known as Medigap. We make it easy to find the best price on the plan you want. All Medigap plans are 100% compatible with the Medicare Part D plans listed above.
Getting Medicare Part D with Oklahoma Medicaid
If you meet the requirements for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) in Oklahoma, you will automatically receive a Medicare Prescription Drug Plan, as well as Extra Help from Social Security. If you qualify for Extra Help, the program will cover most of the costs of your prescriptions. Even if you qualify, the dual eligible option may not suit your needs. In this case, enroll in the prescription drug plan of your choice. If you receive Medicaid now, call your local Medicaid office for assistance with your dual eligible benefits.
PDP Eligibility and Availability
You are eligible to enroll in a Oklahoma 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 Oklahoma City, Tulsa, Norman, Lawton, Broken Arrow, Edmond, Enid, Stillwater, Muskogee, and all rural areas of Oklahoma.