Drug coverage in Medicare Advantage plans

Drug coverage in Medicare Advantage plans

Drug coverage in Medicare Advantage plans

Drug coverage in Medicare Advantage plans, Most Medicare Advantage plans offer prescription drug coverage (Part D). You can join a different Medicare prescription drug plan with certain types of plans that:

  • May not offer drug coverage (such as Medicare medical savings account plans)
  • They choose not to offer drug coverage (like some private fee-for-service plans)

You will be disenrolled from your Medicare Advantage Plan and return to Original Medicare if both of these conditions apply:

  • You are in a Medicare Advantage HMO or PPO plan.
  • You join a separate Medicare Prescription Drug Plan.

Note: If you have a plan that doesn’t offer drug coverage, and you don’t have a Medicare drug plan, you may have to pay a late enrollment penalty if you later decide to join a Medicare drug plan. Visit Medicare.gov/drug-coverage-part-d/costs-for-medicare-drug-coverage/part-d-late-enrollment-penalty to learn more about the Part D late enrollment penalty.

How Medicare Supplement Insurance (Medigap) Policies Work with Medicare Advantage Plans

You can’t (and don’t need to) sign up for Medigap if you have a Medicare Advantage plan. You cannot use Medigap to pay costs (

cousins) that you have in a Medicare Advantage Plan. Learn about the choices you have regarding Medigap policies and Medicare Advantage plans.

Medicare Part C Review: Could a Medicare Advantage Plan be Right for You?

There is much to be said for the benefit of being able to have everything you need in one place. To begin with, it is more convenient. That’s the principle behind Medicare Advantage: a single part of Medicare that brings many benefits, care options, and costs together in one plan. 

What is Medicare Advantage?

Medicare Advantage plans are offered by private insurance companies approved by Medicare. These plans are also known as “Medicare Part C.” By law, all Medicare Advantage plans must include coverage for everything covered by Medicare Part A and Part B, often called “Original Medicare.” This means they include the same inpatient and outpatient services. But Medicare Advantage plans may cover more than Original Medicare.

Medicare Advantage is a unique part of Medicare that brings together many benefits, care options, and costs in one plan.

What does Medicare Advantage cover?

While plans vary, some additional Medicare Advantage benefits include:

  • dental coverage
  • vision coverage
  • Hearing coverage
  • gym memberships

Some plans include prescription drug coverage.

Therefore, an appropriate choice of a Medicare Advantage plan can include all the coverage you receive from Medicare Parts A, B and D. In addition to what the other parts of Medicare offer, the additional coverage is like the icing on the cake of Medicare.

What does choosing Medicare Advantage mean for your health care costs?

The costs may be different from what you pay with Original Medicare. These are some of the main differences. 

Cousins

After you choose a Medicare Advantage plan, you will continue to pay a monthly Part B premium to Medicare. And sometimes you will pay a premium to the company that provides the plan. But there are some Medicare Advantage plans that don’t charge an additional premium.

Deductibles

Although Original Medicare has standard deductibles, these can vary from one Medicare Advantage plan to another. Also, with some plans you will not have to pay any deductible.

copays

To see a doctor with Medicare Advantage, you may have to pay a lower copay (a set amount you pay for care) than you would under Original Medicare.

Firm limit on what you pay for health care

What if I need more medical attention due to an unforeseen event or illness? Medicare Advantage plans have a firm limit on how much you pay for covered health care each year. This means that once you have reached your yearly limit, you will not pay any additional costs for covered medical services. Original Medicare does not include this limit.

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