If you’ve ever had healthcare coverage through an employer or other group health plan, you might think “health insurance” covers everything from doctor visits to hospital stays to the prescriptions you pick up at your local pharmacy.
When it comes to Medicare, however, health insurance is divided into “parts,” and how you choose to get Part D—prescription drug coverage—is important to understand.
Whether you’re currently taking prescription drugs or worried about the prospect of high Rx costs in the future, prescription drug coverage is a valuable benefit for Medicare members. And you have options for how you choose to get it:
- Medicare Advantage prescription drug (MAPD) plans offer all the benefits of Original Medicare Part A and Part B and include prescription drug coverage.
- Prescription drug plans (PDPs) are stand-alone Medicare Part D plans that can be purchased separately from a private insurer—like Humana—to complement the Part A hospital and Part B medical coverage provided by Original Medicare.
Of course, there are pros and cons to each option.
MAPD plans are required to offer at least all the benefits of Original Medicare Parts A and B, so you’ll enjoy the convenience of hospital, medical and Rx coverage all in 1 plan. Most MAPD plans have low or even $0 monthly premiums. Most also offer benefits not covered by Original Medicare, like coverage for routine dental, vision and hearing care.
The downside? With a Medicare Part C MAPD plan, you may need to use in-network healthcare providers and pharmacies to take full advantage of your benefits. Humana’s network includes more than 67,000 pharmacies—from major chains to independent pharmacies. Search for a pharmacy near you.
If you’ve opted for Original Medicare, a stand-alone PDP may be a great complement to your Part A and Part B coverage. There are no networks with Original Medicare, so if you travel often to see the grandkids or have a second home in another state, your Original Medicare plan travels with you. But it doesn’t cover prescription drugs.
On the downside, you’ll pay a separate monthly premium for a stand-alone PDP plan. And these plans usually offer greater savings when you stay in the plan’s network.
If you opt for Original Medicare and don't sign up for Part D when you're first eligible, you may have to pay a Part D late enrollment penalty. That penalty is added to your monthly premium for as long as you have your plan. So even if you don’t feel you need that extra protection now, it might be worth exploring low-premium plan options to avoid higher costs later.