Blog 4/11/2019

CMS has released parameters for the Medicare Part D prescription drug benefit in 2020

CMS has released parameters for the Medicare Part D prescription drug benefit in 2020, for use in determining the actuarial value of any prescription drug coverage employers may offer to Part D eligible individuals:

  • Deductible:$435 (a $20 increase from 2019);
  • Initial coverage limit:$4,020 (a $200 increase from 2019);
  • Out-of-pocket threshold:$6,350 (a $1,250 increase from 2019);
  • Total covered Part D spending at the OOP expense threshold for those who are not eligible for the coverage gap discount program:$9,038.75 (a $1,385 increase from 2019);
  • Estimated total covered Part D spending at the OOP expense threshold for those eligible for the coverage gap discount program:$9,719.38 (a $1,579.84 increase from 2019); and
  • Minimum cost-sharing under catastrophic coverage benefit:$3.60 for generic/preferred multi-source drugs (a $.20 increase from 2019), and $8.95 for all other drugs (a $.45 increase from 2019).

For details, see: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2020.pdf

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