How do you cover your prescriptions as a Medicare beneficiary? Medicare covers prescription drugs but if you enroll in the Original Medicare plan, you have to purchase the plan separately under the Medicare Part D plan. The Medicare Advantage Plan usually includes the prescription plan.
Buy a separate Medicare drug policy
There are many options with a separate Medicare prescription drug plan. These plans are usually standalone drug plans offered by private health insurance companies. To be eligible for these plans, you must have Medicare Part A (hospital insurance) and/or Medicare Part B (medical insurance) upon enrolling; or
Get a Medicare Advantage Plan that includes prescription coverage
If you choose Medicare Advantage instead of Original Medicare Part A and Part B, most Medical Advantage plans cover prescriptions. These are called Medicare Advantage Prescription Drug Plans, or MAPDs. If the Medical Advantage does not have drug prescription coverage, you are allowed to buy a separate prescription drug plan (PDPs).1
Medicare includes prescription drug benefits through Part D and Part B in some instances. Prescription drug benefits are available through private insurance companies.
With Original Medicare, you can choose several prescription drug plans (PDPs) because they are standalone prescription plans offered by private insurance companies.
Original Medicare Part A covers most prescriptions when you are an in-patient in a hospital setting.
If you are an inpatient for a hospital stay and are moved to a skilled nursing facility (SNF), prescriptions are covered under Medicare Part A.2
Prescription coverage while hospitalized or in a SNF is for a limited time and on a short-term basis. There are limitations on stay and coverage. 3
Want to learn more about Medicare Supplement Insurance?
See the options available.
When to enroll in Part D Prescription Drug Plan
An important fact to consider when buying a prescription drug plan is timing. When you are eligible for Medicare Part A and B, and you sign up for a prescription drug plan during your initial enrollment period, you avoid the late penalty fee. Your initial open enrollment period runs for seven months. It is three months before you turn 65 years of age and four months following your 65th birthday.
If you wait and sign up during subsequent enrollment periods, you will incur a late penalty fee that is added to your premium for the life of the PDP.
The exception is if you have other creditable drug coverage from another source that you have continuously maintained such as group coverage with an employer. 4
Private insurance companies offer many variations of prescription drug coverage. The premiums may range, depending on the formulary choices (the drugs that are covered), the benefits of the drug plan, and pricing.
If you have a disability that allows you to receive Medicare benefits before you are 65 years of age, you have a seven-month window as well, with three months prior to the 25th month of a disability, and the four following the 25th month of a disability diagnosis.
The same drug prescription guidelines apply to Medicare beneficiaries as for Medicare retirement beneficiaries.