Medicare D
Low-Income Subsidy Benchmark Premium Amounts for Medicare D for New York is $36.55
All plans that were benchmark in 2019 will still be benchmark in 2020:
Aetna Medicare Rx Saver (PDP) is now WellCare Medicare Saver Rx (PDP)
Cigna-Healthspring Rx Secure (PDP)
Express Scripts Medicare - Value (PDP)
Humana Basic Rx Plan (PDP) (formerly Humana Preferred Rx plan (PDP))
SilverScript Choice (PDP)
WellCare Classic (PDP)
EnvisionRxPlus (PDP)
Magellan Rx Medicare Basic (PDP)
In addition, there is one new benchmark plan for 2020:
Journey Rx Standard (PDP) from MII Life Insurance, Inc.
NINE of the 27 stand-alone PDPs in NYS are "benchmark" plans that are free to people with FULL Extra Help in NYS (no monthly premium)-See above.
Benchmark plans are "Basic" Part D plans with premiums below the benchmark amount, which is $36.55 in 2020.
"Enhanced" Part D plans cannot be "benchmark" plans even if their premium is below the benchmark amount. In an enhanced plan, the premium is subsidized for people with Extra Help but not always fully.
If a person receiving the low-income subsidy (LIS) enrolls in a Medicare Part D plan that has a premium higher than the subsidy amount listed for their state, the beneficiary is responsible for paying the difference in premium.
One could consider switching to a different plan, but that would require careful attention to whether the new plan's formulary covers the medications that you are taking and if the pharmacy you have been using is accepted in the new plan.
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Some Changes in 2019
excerpts from Q1Medicare.com
- Starting in 2019, the Special Enrollment Period (SEP) for Dual-Eligible and Extra Help recipients will be limited to one plan change per quarter during the first 9 months of the year.
In 2019, Medicare beneficiaries who are dual-eligible (Medicare/Medicaid) or eligible for the Medicare Part D Extra Help program will no longer have a continuous month-to-month Special Enrollment Period (SEP). Instead, the Dual-Eligible or Extra Help SEP “ may be used only once per calendar quarter during the first nine months of the year.”
- You will not receive your 2019 ANOC letter and your Medicare Part D plan’s Evidence of Coverage at the same time.
In late-September or early October, your Medicare plan will send you a 2019 Annual Notice of Change letter (ANOC) detailing how your current 2018 Medicare plan is changing in 2019. However, CMS is separating the delivery of the ANOC letter and the delivery of your Evidence of Coverage (EOC) document so that the two documents arrive at different times.
You may recall that your ANOC is a relatively short, 10+ page document that summarizes upcoming plan changes and your EOC document is a rather long, 140+ page document that details your 2019 Medicare plan coverage. As noted by CMS, the “ANOC must be delivered 15 days prior to the [Annual Election Period (AEP)] and will be received by enrollees ahead of the EOC, thus allowing enrollees to focus on materials that drive decision-making during the AEP.” You should expect your 2019 EOC to be delivered on the first day of the Annual Election Period (October 15th) .
