As one of the most important healthcare programs, Medicare provides senior citizens and persons with disabilities with medical assistance. But do they include prescription drug coverage? In ttoday’s blog post, we explore the topic of Medicare Advantage plans and prescription drug coverage. Keep reading to learn more.
Medicare Advantage and Prescription Drug Coverage
Yes, most Medicare Advantage Plans include prescription drug coverage. These are often referred to as “MA-PDs” and provide all of your Medicare coverage including Medicare Part A (Hospital Insurance), Medicare Part B (Medical Insurance), and Medicare Part D (prescription drug coverage).
Here’s what you need to consider about prescription drug coverage depending on the type of Medicare Advantage plan:
- Health Maintenance Organization (HMO) Plans. Most of these plans include coverage for prescription drugs. However, you should talk to a plan representative to make sure.
- Preferred Provider Organization (PPO) Plans. This plans usually include prescription drug coverage, but you must talk to the plan to confirm this. Keep in mind that if you join a PPO Plan that doesn’t offer prescription drug coverage, you can’t join a Medicare drug plan (Part D)
- Private Fee-for-Service (PFFS) Plans. PFFS plan may cover prescription drugs, but that’s not always the case. If your PFFS Plan doesn’t offer drug coverage, you can join a Medicare Prescription Drug Plan to get coverage.
- Special Needs Plans (SNPs). All SNPs must provide Medicare prescription drug coverage.
Each Medicare Advantage plan has a formulary, or list of covered drugs. It is important to check a pospective plan’s formulary to see if the drugs you need are included. If the covered drugs don’t meet your medical requirements, you can file for an exception.
It’s also worth noting that each Medicare Advantage Plan can charge different out-of-pocket costs and have different rules for how you get services (like whether you need a referral to see a specialist or if you have to go to doctors, facilities, or suppliers that belong to the plan for non-emergency or non-urgent care).
Wrapping It Up
Most Medicare Advantage plans offer prescription drug coverage, and many provide cost savings to beneficiaries.
However, you should always seek the assistance of a plan representative or insurance professional to ensure that you understand your coverage.
Ultimately, it is essential to evaluate the different plans based on one’s medication needs and lifestyle to find the most suitable one.
Need Help Making Sense of Medicare Advantage? Mint Insurance Agency Is Here To Help
We are an insurance agency dedicated to becoming a lifetime partner for your Medicare needs.
If you need assistance or want to learn more about the alternatives at your disposal, contact our licensed agents today or call 1.888.225.MINT (6468). Our team stands ready to answer all your questions.
