Virginia Medicare Part D Plans (PDP) 2020 Medicare Prescription Drug Plans

2020 Medicare Prescription Drug Plan Changes in Virginia

Virginia 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.

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.

2020 Coverage Gap (Donut Hole) Details

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

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 Virginia 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 Virginia Medicare Advantage Plans come in. Most offer Part D coverage.

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 Virginia, leaving you to handle the rest. We make it easy to find the lowest price on the Virginia Medicare Supplement, commonly called a Medigap plan, you want. The choice is yours, because all Medicare Part D plans are compatible with Virginia Medigap plans.

Medicare Part D for Dual Eligible People in Virginia

In Virginia, if you are eligible for both Medicare and Medicaid (aka, dual eligible or Medi-Medi) you will automatically be enrolled in a Virginia 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.