{"id":55635,"date":"2022-12-19T12:33:02","date_gmt":"2022-12-19T17:33:02","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=55635"},"modified":"2025-03-13T14:44:46","modified_gmt":"2025-03-13T18:44:46","slug":"medicare-prescription-drug-plans","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/medicare-prescription-drug-plans\/","title":{"rendered":"What part of Medicare covers prescriptions?"},"content":{"rendered":"

About 66% of adults<\/a> in the United States take prescription drugs. The affordability of these medications is a common concern, as the average American spends more than $1,400 per year<\/a> on medications. Fortunately, people in this age group are eligible for Medicare coverage of prescription drugs. According to a Medicare survey by SingleCare<\/a>, 28% of respondents did not know that Medicare offers prescription drug coverage. Learn how to join the 50.5 million people<\/a> receiving Medicare prescription drug plans (PDPs).<\/p>\n

What are my options for Medicare prescription drug coverage?\u00a0<\/span><\/h2>\n

When enrolling in Medicare, many beneficiaries don\u2019t realize prescription drugs aren\u2019t included in Medicare Part A or Medicare Part B. To receive coverage for prescription medications, you must choose between a Part C Medicare Advantage plan that includes a prescription drug benefit or a stand-alone prescription drug plan under Medicare Part D.<\/span><\/p>\n

RELATED: <\/b>Medicare Part D vs. Medicare Advantage<\/b><\/a><\/p>\n

Private insurance companies like Blue Cross are contracted with the Medicare program to administer Part C and Part D plans.<\/span><\/p>\n

Part C<\/span><\/h3>\n

Medicare Advantage plans<\/span><\/a> combine the benefits from Original Medicare Parts A and B into one privately-administered plan. Not all Medicare Advantage programs include a prescription drug benefit. However, the majority do. Eligibility for a Medicare Part C plan requires you to be enrolled in Medicare Parts A and B and live in the plan\u2019s service area.<\/span><\/p>\n

Part C Medicare Advantage plans are most commonly offered as HMO or PPO plan options. You can expect similar prescription coverage from Medicare Advantage plans as a stand-alone Part D plan.<\/span><\/p>\n

Part D<\/span><\/h3>\n

Medicare Part D<\/span><\/a> is optional prescription drug coverage under Medicare. To enroll in Part D coverage, you must be eligible for Medicare Part A or enrolled in Medicare Part B.\u00a0<\/span><\/p>\n

RELATED: <\/b>Compare Medicare Part D plans<\/b><\/a><\/p>\n

What do Medicare drug plans cover?\u00a0<\/span><\/h2>\n

Each Medicare Part D or Advantage plan has a <\/span>formulary<\/span><\/a>\u00a0or list of covered drugs. Part D plans aren\u2019t required to cover all prescriptions, but they must cover a certain number of drugs in each drug category. Before enrolling in a plan, review the formulary and ensure your prescriptions are covered and with as few restrictions as possible. PDP coverage breaks the prescriptions down into coverage tiers. These tiers outline the copays and costs and are broken into generic and brand-name medications.<\/span><\/p>\n

Most Medicare drug plans consist of five drug tiers:<\/b><\/p>\n