2 ways to get prescription drug coverage

Published by Medicare Made Clear®

Original Medicare (Parts A & B) does not cover most prescription drugs. Part A only covers certain drugs during an inpatient stay. If you want a plan that offers prescription drug coverage, you have two options.

Option 1: A Medicare prescription drug plan (also known as a stand-alone Part D plan or a PDP plan)

Option 2: A Medicare Advantage plan with included drug coverage

Both types of plans are offered by private insurance companies approved by Medicare and will vary in costs and coverage.

Medicare Part D drug coverage

Many people who have Original Medicare will choose to purchase a stand-alone Medicare prescription drug plan (Part D plan). By law, all Part D plans must cover a federally regulated list of commonly prescribed drugs. However, each plan can decide which specific brands of drugs it will cover. To get a Part D plan, you need to be enrolled in either Medicare Part A or Part B.

Note: PDP plans can also be bought alongside certain Medicare Advantage plans that don’t include drug coverage.

Medicare Advantage Prescription Drug plans (MAPD)

The second way to get prescription drug coverage is through a Medicare Advantage plan that includes prescription drug coverage (often known as an MAPD plan). Medicare Advantage plans include all benefits of Medicare Part A and Part B, and often include a variety of additional benefits, such as dental, vision and hearing care.

To get a Medicare Advantage plan, you must first be enrolled in both Part A and Part B.

Choose your drug coverage carefully

Both the above Medicare prescription drug coverage options are only offered by private insurance companies approved by Medicare. Plans will vary in the list of drugs they cover, the costs they include and the area in which your plan works. No matter which plan you choose, a good rule of thumb is to always make sure the drugs you need are covered.

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