There are two types of plans available to get Medicare prescription drug coverage:
- Stand-alone prescription drug plans. These plans add drug coverage to the Original Medicare Plan, some Medicare Cost Plans, some Medicare Private Fee-For-Service Plans, Medicare Medical Savings Account Plans, and Medigap insurance (supplemental insurance).
- Medicare Advantage Plans with prescription drug coverage (MA-PDs). These plans add a prescription benefit to HMO or PPO type of medical coverage.
Some plans offer national coverage, while others offer coverage only in certain regions. In general, MA-PDs are regional plans.
To find out which plans are available in a particular region, contact the Centers for Medicare & Medicaid Services at 1-800-MEDICARE (1-800-633-4227), 24 hours a day, 7 days a week. TTY/TDD users should call 1-877-486-2048.
Medicare Advantage Plan with Prescription Drug Coverage (MA-PD): A plan offered by a private company that contracts with Medicare to provide hospital, medical, and drug coverage. A Medicare Advantage Plan can be an HMO, PPO, or a Private Fee-For-Service Plan.
Medicare Cost Plan: An HMO health plan in which members generally use services within the plan network. If a member gets services outside the plan's network without a referral, Medicare-covered services will be paid for under the Original Medicare Plan. (However, the Medicare Cost Plan will pay for emergency or urgently needed services).
Medicare Medical Savings Account Plan: This combines a high-deductible Medicare Advantage Plan (like an HMO or PPO) with a Medical Savings Account for medical expenses.
Medigap Insurance: A specific type of private insurance policy that provides additional coverage for costs not covered under the Original Medicare Plan. Individuals who are covered through a Medicare Advantage Plan cannot sign up for Medigap insurance. (Also called Medicare Supplemental Insurance).
Original Medicare Plan: A fee-for-service health plan that lets members go to any doctor, hospital, or other healthcare supplier who accepts Medicare. This plan has two parts: hospital insurance (Medicare Part A) and medical insurance (Medicare Part B).
Private Fee-For-Service (PFFS) Plan: A type of Medicare Advantage Plan (Part C) in which members may go to any Medicare-approved doctor or hospital that accepts the plan's payment. The insurance plan, rather than the Medicare program, decides how much it will pay and how much members will pay for the services they get. The plan may pay more or less for Medicare-covered benefits and may provide extra benefits than the Original Medicare Plan.
Your Guide to Part D:
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General Part D Information
Learn about the Medicare Part D benefit:
- What is Medicare Part D?
- Who is eligible for Medicare Part D?
- What are the different Medicare Part D plan options?
- How can I save more and delay the Coverage Gap longer?
- What do I need to know about prescription safety?
- Where can I find other useful resources?
My Current Situation
Get information for your specific circumstances:
