Does Medicare Advantage Offer Prescription Drug Coverage?

prescription drugs
iHealthcareNovember 26, 2021

Medicare Advantage plans, also known as Medicare Part C plans, are provided by private insurance companies approved by Medicare. Medicare Advantage plans provide coverage for all the services offered by Original Medicare, as well as other healthcare benefits such as prescription drug coverage. Medicare Part C covers different prescription drug types, helping you save money on your medications and reduce out-of-pocket costs.

Prescription Drug Coverage Under Medicare Advantage

Private health insurance companies manage Medicare Advantage plans, so the benefits vary between plans. However, many of the plans cover prescription drugs. When you register for a Medicare Part C plan, the private health insurance company will provide a formulary. The formulary lists the medications that are covered under the beneficiary’s plan.

The formulary is required by Medicare to cover different tiers of drugs. Each formulary must contain at least 2 drugs in the most common medication categories, such as blood pressure and diabetes medications.  

  • Usually, generic drugs are the lowest-cost drugs, and they serve as the alternative to brand-name drugs. You can find most of the generic drugs in the formulary Tier 1, and this has the lowest copayment.
  • Tier 2 medications have an average copayment and mostly include brand-name drugs and a couple of generic drugs.
  • Tier 3 drugs have a higher copayment, which includes both brand name and generic prescription drugs.
  • Specialty-tier drugs are the ones that have a higher cost, so you pay the highest copayment.

The insurer will have to approve all the medications listed on the Medicare Advantage plan’s formulary, and each plan will vary according to how the drugs are organized on their formulary. Before you enroll for Medicare Part C, you should review the formulary of the plan. While you may not find a formulary that contains all the drugs you require, opting for a Medicare Advantage plan that has the most coverage can save you money.

Finding a Medicare Advantage Plan with Prescription Drug Coverage

There are several ways to find Medicare Advantage plans with prescription drug coverage. If you qualify for a Medicare Advantage Special Needs Plan, these plans are required to provide prescription drug coverage.

Choosing a plan with prescription drug coverage can be challenging at a glance, but iHealthcare Direct can help you compare every Medicare Advantage plan available in your area. Our experienced Medicare experts can filter the available options according to your needs and then evaluate them side by side.

Contact iHealthcare Direct today for any Medicare-related questions and assistance about Medicare Advantage and prescription drug coverage.

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