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Thursday, December 3, 2020

What to know about Medicare’s prescription coverage

Luckily, both original Medicare and Medicare Advantage plans offer some form of prescription drug coverage.
Medicare Series

What to Know About Prescription Coverage

For most Medicare beneficiaries, prescription drug coverage is just as much of a necessity as hospital and medical coverage — and under Medicare rules, it's required.

What is Medicare's prescription drug coverage rule?

When you enroll in Medicare, whether that's original Medicare (parts A and B) or Medicare Advantage (Part C), you're required to have standard prescription drug coverage. This means that in addition to enrolling in a plan that covers your hospital and medical services, you must also enroll in a prescription drug plan.

In fact, Medicare will charge you a permanent Part D late enrollment penalty if you go without prescription drug coverage for 63 days or more after enrollment. This means that you have roughly 2 months to get your prescription drug coverage squared away before you're penalized by Medicare. If you're penalized, you'll owe an additional premium amount each month for as long as you're enrolled in Medicare.

Luckily, both original Medicare and Medicare Advantage plans offer some form of prescription drug coverage:

  • With original Medicare, you'll need to enroll in a Medicare Part D plan in your state. Part D plans, like Medicare Advantage plans, are offered by private insurance companies who contract with Medicare to supply coverage.
  • With Medicare Advantage, you'll generally be covered for the same standard prescription drug coverage that all Part D plans offer. If your Medicare Advantage plan doesn't offer prescription drug coverage, you'll want to make sure you're enrolled in another form of creditable coverage, such as a separate Part D plan or private employer plan.

If you already have creditable prescription drug coverage that you don't want to drop, such as drug coverage through your employer or your spouse's employer, you can keep it without facing a late penalty fee as long as it pays the same as Medicare's standard prescription drug coverage. To find out, check with your existing plan to make sure it counts as creditable coverage.

In tomorrow's email, look out for our top tips for how to control your Medicare costs and save money on healthcare expenses.

Until tomorrow,
The Healthline Team

Learn more about Medicare and find answers to your questions.

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