Medicare consists of four different parts: Medicare Part A, Medicare Part B, Medicare Advantage Plans (Part C), and Medicare Prescription Drugs (Part D). Part D is what we will mainly be focusing on today. This part of Medicare helps pay for prescription drugs that you need, even if you aren’t in need of prescription drugs at the moment; we recommend that you consider adding it to your plans. One of the better assets of Medicare is that all plans must cover a wide range of prescription drugs that those on Medicare take, such as drugs to treat cancer or HIV/AIDS. All plans place drugs into different tiers and their relative tier can determine the cost of the drug. An example of this is that a drug in a lower tier will generally cost you less than a drug in a higher tier. Below we will go over ways that Medicare covers prescription drugs.
How to Get Coverage for Prescription Drugs
The most effective ways to get prescription drug coverage with Medicare are through two ways; Medicare drug plans and a Medicare Advantage Plan (Part C).
Medicare Drug Plans
Add drug coverage to Original Medicare, some Medicare Cost Plans, some Private Fee‑for‑Service plans, and Medical Savings Account plans. In order to add a Medicare drug plan to your coverage, you must have Medicare Part A (Hospital Insurance) and/or Medicare Part B (Medical Insurance).
Medicare Advantage Plan (Part C)
Under this plan you get Part A, Part B, and drug coverage. Remember, you must have Part A and Part B to join a Medicare Advantage Plan, and not all of these plans offer drug coverage.
Can You Lower Prescription Drug Costs?
The short answer to this question is, yes, you can. However, there are a few ways to go about this. You can take these four steps to help get a lower prescription drug cost.
- Ask your doctor if there is a generic drug and if you can take it instead of the brand name.
- Research about mail-order pharmacies as an option for getting your prescriptions.
- Compare the available Medicare drug plans to find the option best suited for your needs and cost/budget.
- Apply for Extra Help, a program that has been put in place to help pay prescription drug costs for those with limited income and resources.
Coverage with Medicare Advantage Plans
One way to get both Medicare Part A and Part B coverage in one plan is through a Medicare Advantage Plan, also referred to as Part C or MA Plans. These plans are offered by Medicare-approved private companies that abide by the rule set by Medicare, most of these plans include prescription drug coverage, referred to as Part D. Below are a few of these plans and how they handle prescription drug coverage.
- Health Maintenance Organization (HMO) Plans
Most of these plans cover prescriptions drugs, always ask if you are unsure. If you are wanting prescription drug coverage you must join one of these plans that include it. - Preferred Provider Organization (PPO) Plans
Most of these plans cover prescriptions drugs, always ask if you are unsure. If you are wanting prescription drug coverage you must join one of these plans that include it. You cannot join a Medicare drug plan if you join a PPO plan that doesn’t offer prescription drug coverage. - Private Fee-for-Service (PFFS) Plans
Most of these plans cover prescriptions drugs, always ask if you are unsure. If prescription drug coverage is not included in you play, you can get a Medicare prescription drug plan.
- Special Needs Plans (SNPs)
All SNPs must provide Medicare prescription drug coverage.
Are you needing more information on how Medicare affects your health coverage? Reach out to your local agent today to learn more.