OP&F News

Medicare Part D “Donut Hole” changes for 2020

The Medicare Part D donut hole is a term for the stage of Medicare Part D that is officially called the coverage gap, which will be changing in 2020.

All Medicare Part D plans have four stages, with the third stage being the coverage gap (or donut hole). This coverage gap will have changes after 2019. Starting in 2020, the percentage that Medicare Part D participants will pay for generic drugs in the coverage gap will be set at 25 percent, which is the typical percentage that participants would pay in the initial coverage level prior to reaching the gap. A similar change for brand-name drugs was implemented for 2019.

Aon provided this information during health care meetings in September 2019. However, since the meetings Aon has found out that there could be situations where a retiree is paying less or more than 25 percent for a drug before they hit the coverage gap. If these cases, they would see an increase or decrease once they reach the coverage gap because they would be paying 25 percent of the drug’s price in the coverage gap.

Be aware that there are certain drugs (for example, specialty drugs) that may have a higher percentage cost than 25 percent (up to 33 percent) in the initial coverage level.

Posted 11/26/2019

Other News

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DROP distributions information
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