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

Virginia Medicare Part D 2020 Updates

There are more Virginia Medicare Part D Plans (PDPs) in 2020 than in previous years. The bad news is that the standard initial deductible is now $435 per year, that's an increase of $20 over last year. However, the Initial Coverage Limit increased 5% to a new high of $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.

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.

Don't make a decision on your choice of Part D Medicare plans based on the premium and deductible alone. It's critical that you verify that your medications are covered. You find this information, and the co-payment tiers, in the formulary. On each PDP page (above) we post links to the formulary and pharmacy web pages, and the phone numbers to contact the plan.

VITAL: Identifying the best Medicare Part D Plans requires research. What works the best for you is all about your regular prescriptions (if any), your health and what you can afford.

Medicare Part D is Included with Most Virginia 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 Virginia Medicare Advantage Plans that include Part D.

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 Virginia healthcare bills. We keep an up-to-date catalog of Virginia 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 Virginia supplemental insurance.

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.