Medicare Changes in 2020


Medicare Changes in 2020

Starting in 2020, there will be no more first-dollar coverage plans available to those who are considered Medicare eligible after 2020. First-dollar coverage plans are Medicare Supplement Plans that leave you with zero out of pocket costs. The Medicare Part B premium will also be increasing.

The three Medicare Supplement Plans considered first-dollar coverage plans are:

  1. Plan C
  2. Plan F
  3. High Deductible Plan F

First-dollar coverage plans that will be discontinued include Plan C, Plan F, and High Deductible Plan F

The Medicare Access and CHIP Re authorization Act of 2015 eliminates all Medigap Plans that cover the Medicare Part B deductible.

The reason for the change is due to some members of Congress believing Medicare beneficiaries are over-using health-care services.

By making everyone meet the Medicare Part B deductible, legislators hope to prevent beneficiaries from running to the doctor for every minor ailment.

Critics argue that the deductible may keep people from getting the care they need.

When people don’t see a doctor, they can end up with more serious conditions down the road.

How Medicare Changes in 2020 Will Impact Beneficiaries

These changes will only impact beneficiaries who are not considered “Medicare-eligible” until after 2020. If you turned 65 prior to January 1st, 2020, you can continue to enroll in these first-dollar coverage plans after they have been discontinued. They’re only being discontinued to those who are not considered Medicare eligible until AFTER 2020.

For those currently enrolled in a first-dollar coverage plan, you’ll be grandfathered in. You don’t need to make any changes to your coverage unless you’re simply comparing benefits and/or rates to see if there’s a better plan for you.

Even if you’re Medicare-eligible before 2020, but don’t enroll in Medicare Part B for one reason or another until after 2020, you can still enroll in a first-dollar coverage plan to supplement your Medicare benefits.

For Those “Medicare-Eligible” After 2020

For beneficiaries that are not eligible for Medicare until after 2020, you still have alternatives that will keep your out of pocket costs low. The only difference between the alternative plans listed below and first-dollar coverage plans is the Part B deductible, which is $185 as of 2019.

Projected Medicare Premiums for 2020

There has been some buzz about the 2020 Medicare premiums, but CMS has not officially announced them yet. As of now, it looks like the 2020 Medicare Part B premium will be $144.30. That’s an increase of $8.80 from 2019.


Prescription Drug Plan Changes

Donut Hole Closing by 2020

In addition to Medicare Supplement Plan F and Plan C going away, the Medicare Part D Donut Hole is closing. The percentage you will pay in the coverage gap will decrease as the Donut Hole closes.

If you’re in the Donut Hole, you will now get a discount on your brand-name drugs and additional savings on your generic and brand-name drugs until it’s officially closed in 2020. The gap is closing because the manufacturers will continue paying large percentages of the drug, while Medicare drug plans will increase the amount they cover.

Currently, Medicare pays 56% of the price of your generic drugs while you’re in the Donut Hole. You are responsible for the remaining 44%. In 2020, the number you will be responsible for is only 25% of the cost. This results in a huge saving for Part D beneficiaries in the Donut Hole.

If you’re unsure if your prescriptions will be covered at this new discount, you should contact your drug plan or pharmacist. Ask if your current medications will receive a discount while in the Donut Hole. In 2020, Part D will cover your brand-name drug if a company that is participating in the Medicare Coverage Gap Discount Program makes the drug. This is the program that provides these discounts and aid once you’re in the Donut Hole, or coverage gap. If the company does not participate in the program, Part D won’t cover your medication at all.

To recap: by 2020, you will not pay any more than 25% for a covered brand-name drug or prescription drug during the coverage gap. This 25% is the same percentage you’ll pay once you meet your plan’s deductible. This is until you meet the out-of-pocket spending limit. These changes will result in more savings for you, the Part D beneficiary, as you will have to pay less than your plan pays.


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