If you are about to enroll into a 2020 Medicare prescription drug plan for the first time or you are thinking about changing your plan during their open-enrollment period, you will be faced with several options, which can be daunting. A nonprofit organization known as The Kaiser Family Foundation, which specializes in health care policies, has issued a guide that can guide you through the fundamentals.
The Kaiser Family Foundation’s Medicare Prescription Drug Benefit Fact Sheet for 2019, which is a seven-page paper that provides a wealth of detail regarding prescription drug plan and most importantly it explains that acknowledgment on how the plans work can save you money.
Medicare beneficiaries will have access to Medicare’s prescription drug benefits, which is known as Medicare Part D that is through private plans, which are approved by the federal government. According to Kaiser, in 2019, a total of 901 prescription drug plans were offered across the 34 prescription drug plan regions nationwide.
Beneficiaries in each state will have to choose at least two dozen stand-alone prescription drug programs, as well as drug benefits, offered through private Medicare Advantage plans. The latter will operate as a health maintenance organization program.
Savings: October 15 will mark the start of Medicare’s annual 2020 open enrollment period. For seven weeks, you can switch, drop, add, or change prescription drug plans. Research shows that you can often save money when you switch plans, but many people do not get around to switching plans.
Coverage and Costs: In 2019, Part D set standard benefit with a $415 deductible and 25% coinsurance up to a limit of $3,820 in total drug costs. For total drug costs above that price, out-of-pocket spending reached $5,100.
Medicare Part D Prescription Drug Benefits: Out of Pocket costs for brands amounted to 25% in 2019, falling from 35% in 2018. In 2020, the plans’ share of costs will increase from 50%, as brands will be 5% and the manufacturer discount will be 70%.
Those who were registered in 2019 paid 37% coinsurance for generic drugs. This portion of costs for brands and generics in the coverage gap affected total out-of-pocket spending until it reached $5,100, the out-of-pocket threshold for catastrophic coverage in 2019.
For total drug costs above the catastrophic threshold, Medicare paid 80%, plans pay 15%, and enrollees paid either 5% of total drug costs or $3.40/$8.50 for each generic and brand-name drug.
Part D program does include cost-sharing and premiums assistance for those with modest assets and low incomes.
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