Medicare Prescription Drug Plans

Posted in Medicare Advantage, Medicare Part D

When you are ready to enroll in a Medicare Prescription Drug plan, you have options. Here is some information that will help you to understand Medicare Advantage Prescription Drug plans and stand-alone Medicare Prescription Drug Plans.

There are two ways to get prescription drug coverage with Medicare. There are Prescription Drug Plans (PDP) and Medicare Advantage Prescription Drug Plans (MA-PD).

Colorado Medicare Prescription Drug Plan (PDP)

A Medicare Prescription Drug Plan in Colorado adds prescription drug coverage to Medicare plans including Original Medicare, some of the Medicare cost plans and selected Medicare Private fee for service plans and Medicare Medical Savings Account plans.

A standalone Prescription Drug plan helps to pay for prescription drugs. You are eligible for this type of prescription coverage if you receive Medicare benefits in Colorado under Medicare Part A or Medicare Part B. A PDP pays for things such as:

  • Prescription prescribed as an outpatient
  • Vaccinations
  • Some medical supplies
  • Biologic drugs

A PDP plan does not cover drugs that are covered under Medicare Parts A or B, non-prescription or some prescription vitamins or drugs that are not included in the plan’s formulary.

Colorado Medicare Advantage Prescription Drug Plan (MA-PD)

Prescription drug coverage plans in Colorado may also be purchased through a Medicare Advantage Prescription Drug Plan (MA-PD). Recipients who enroll in a Medicare Advantage Program are eligible to choose a plan that includes prescription drug coverage.

These plans, called Part C, are offered by private insurance companies who are contracted with Medicare to provide coverage for Part A, Part B, and Part D benefits. Medicare Advantage plans with prescription drug benefits may be part of a Health Maintenance Organization (HMO), a Preferred Provider Organization known as a PPO, a Private Fee for Service Plan (PFFS), or a Medicare Medical Savings Account (MSA).

A Medicare Advantage Prescription Drug Plan determines exactly what drugs are covered and may vary. It is always best to check the plan’s formulary to ensure your prescriptions drugs are covered.

Remember that plan formularies can change, so be sure to review you Annual Notice of Change each year to ensure your plan meets your current prescription drug needs.

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