Simple Truths: Do I need to buy Prescription Drug Coverage separately if I have Original Medicare?

Posted on October 26, 2017

Original Medicare does not provide prescription drug coverage. You must buy separate Part D prescription drug coverage if you have Original Medicare or a Medicare Supplement plan. Part D prescription drug plans help pay for the cost of prescription drugs and are sold through private companies.

Solution: If you want prescription drug coverage, there are two ways to get a Part D plan. You can purchase a Medicare Advantage plan with drug coverage (MAPD) or a stand-alone Prescription Drug Plan (PDP).

You may not be enrolled in a stand-alone PDP and also be enrolled in a Medicare Advantage Plan at the same time.*

*Exceptions: Medical Savings Account (MSA), Private Fee-for-Service (PFFS) or Cost Plans

Tips for choosing a Part D Plan?

• Make sure that the plan you choose covers the medications you take.
• Review the plan’s formulary, which is a list of covered drugs.
• Ensure the plan covers the pharmacy that you use; some may have limitations.
• Compare the premium cost of the plan and the cost sharing for the drugs, i.e., deductible, copays, coinsurance.
• Determine if the company offers a savings through mail order.
• Look for a Part D or Medicare Advantage plan with Drug Coverage with a higher star rating. Ratings are based on quality and performance.
• Join the plan when you are eligible for Medicare to avoid the late enrollment penalty.
• Review your plan yearly during the Annual Enrollment Period (October 15th through December 7th) to determine if the plan still fits your needs

Categories: Medicare Simple Truths, Simple Truths