No medical variant for FS2020. The 2020 update is all flight modeling/systems/etc. So the 2024 version is what your want if you only want the medical version. (That said, if you buy it now, the 2024 upgrade will be free when you move to the current sim.)
Here’s the release info from their discord, which spells out the 2020 update:
The FlightFX Piaggio P.180 Avanti II for MSFS 2024 releases on March 12, 2026.
Built specifically for MSFS 2024, this version brings the Avanti II forward with a major focus on depth, realism, and aircraft character. It features advanced flight and engine modeling, including custom engine damage logic, custom propeller simulation with custom controls, simulated auto feather in emergencies, and a custom pressurization model. Performance has been tuned for true-to-book takeoff, climb, and cruise behavior with feedback from real-world pilots. The aircraft also includes ProLine 21 avionics, full careers compatibility, specialized system pages, a custom CAS panel, realistic nose wheel steering control modes, and realistic alerts and alarms.
The VAMS 2.0 tablet has also been expanded for the 2024 release, Navigraph and OpenStreetMap integration, a SimBrief-linked load manager, ground services management, and Active Noise Reduction functionality.
Visually, the aircraft has been built to match that same level of fidelity, using on-site 3D scanning as the foundation for highly detailed modeling and texturing. The package also includes selectable cabin enhancements, detailed cabin lighting, controllable blinds, selectable cargo elements, and a Medevac variant.
At the same time, the MSFS 2020 version will also receive a new update on March 12 with Version 2.0.3. That update includes the new licensed aircraft branding, a reworked flight model for improved weight and balance accuracy, updated engine logic with enhanced damage modeling and more accurate ITT and startup temperature simulation, a new Weight & Balance app in the custom EFB, Ground Services control through the EFB, smoother autopilot behavior, improved LNAV tracking, and a wide range of fixes and refinements across systems, lighting, avionics, and aircraft behavior.
This release also marks another major milestone for the product, as the aircraft is now officially licensed as the Piaggio P.180 Avanti II. As part of that change, updated naming and branding will be reflected across both the MSFS 2024 and MSFS 2020 versions.
A few important notes:
MSFS 2024 release date: March 12, 2026
MSFS 2020 update 2.0.3 releases the same day
MSFS 2020 owners receive a free upgrade to the 2024 version
We recommend purchasing in the sim you primarily use first, as entitlements can sometimes take a little time to sync between platforms
This is a huge milestone for this aircraft and for our team, and we’re excited to finally bring the officially licensed Piaggio P.180 Avanti II into MSFS 2024 while continuing to improve the 2020 version as well.