South Carolina Medicare Part D Plans (PDP) 2020 Medicare Prescription Drug Plans

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 South Carolina

People with Medicare benefits in South Carolina 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.

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.

Choose from the available Part D Medicare plans carefully, and don't settle on a Part D plan until you know that your most expensive medications are covered at a price you can afford. This information is available in the plan's formulary. You'll find links to the formulary information, pharmacy information, and the customer service phone number on each PDP page (above).

CRITICAL: The best Medicare Part D Plans for you can only be determined by factoring in what you can afford, your regular prescriptions and your health. A bit of time spent on research will pay off in the long run.

Get Your Prescriptions and More with a South Carolina 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 South Carolina 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 South Carolina healthcare bills. We keep an up-to-date catalog of South Carolina 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 South Carolina supplemental insurance.

South Carolina Medicaid and Your Medicare Part D

South Carolina seniors who qualify for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) may be enrolled in a South Carolina 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 South Carolina Part D plan that does. If you are already receiving Medicaid, contact your local Medicaid office for assistance in the transition to Medicare.