Medicare Moment: Does my Medicare Advantage Plan have drug coverage?

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If you have a Medicare Advantage Plan (also called Part C or an MA Plan), you may get your prescription drug benefits through this plan. Most Medicare Advantage Plans offer drug coverage.

Do I need prescription drug coverage? Although not required, if you do not have creditable coverage now, you may be subject to a penalty if you try to enroll in Medicare prescription drug coverage later. If you have drug coverage through another organization, such as the Veterans Administration (VA), you may not need Medicare prescription drug coverage.

What is creditable prescription drug coverage? This is drug coverage that is expected to pay at least as much as Medicare prescription drug coverage on average[1]. Employer or union coverage should send an annual notice on whether their coverage is creditable each September. If you have creditable coverage, you may be able to delay enrollment into Medicare prescription drug coverage.

Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) Plans[2] usually include prescription drug coverage, but if they don’t, you are not able to enroll in a separate Medicare Prescription Drug Plan.

Private Fee-for-Service (PFFS) Plans are a less common plan type that may or may not include Medicare prescription drug coverage. If your PFFS plan does not include drug coverage, you may join a stand-alone Prescription Drug Plan.

Special Needs Plans (SNPs) must include drug coverage. These plans are for Medicare beneficiaries who have certain chronic conditions, are institutionalized, or are dually eligible for Medicare and Medicaid[3].

Your plan can answer specific questions that you may have about your current plan’s coverage. If you would like to speak to a licensed insurance agent about your Medicare options, call 330-683-1050.

By: Steven Thomas Smith

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We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area.  Please contact or 1-800-MEDICARE to get information on all of your options. Not affiliated with or endorsed by the government or Federal Medicare Program. This is a solicitation for insurance. Calling the number above will direct you to a licensed insurance agent.