Do I Need Part D If I Have a Medicare Advantage Plan?

No, you don’t need Part D if you have Medicare Advantage. In fact, you may already get prescription drug coverage through your Advantage (Part C) plan, and you can add it otherwise.

Medicare Advantage Coverage

There are 5 main types of Medicare Advantage plans:

  • Health Maintenance Organization (HMO)
  • Preferred Provider Organization (PPO)
  • Private Fee-For-Service (PFFS)
  • Special Needs Plans (SNPs) (includes D-SNPs, C-SNPs, and I-SNPs)
  • Medicare Medical Savings Account (MSA)

While each of these plans offers its own benefits at different price points, they all offer the same benefits as Original Medicare, including hospital and general medical coverage. Their main function is to reduce necessary out-of-pocket costs by providing a network of insured providers. 

Part D Coverage

On top of this coverage, Advantage plans offer a variety of potential benefits, such as limited dental, vision, and hearing. They may also offer Part D prescription drug coverage. 

The main takeaway, then, is that a lot of Medicare Advantage plans fully include Part D, but not all of them do.

Adding Part D to Advantage

If you purchase an Advantage plan that does not include Part D, but you want coverage, you can always purchase an additional plan to go along with your Part C coverage.

Or, alternatively, the Part D coverage included with your Advantage plan may not be enough for your needs. In that case, you can look for a better plan elsewhere. 

There are a few things you need to look for when choosing a Part D plan. One of the most important things to consider is how much and what type of prescriptions you use. Say, for instance, you frequently need specialty or higher-cost drugs—you’ll then want a higher-coverage plan. This is also useful if you want protection from higher-cost drugs in the future.

What if you want lower month-to-month costs? You’ll want to look for plans with higher deductibles and/or higher cost-sharing. Or, on the opposite end of the spectrum, for lower cost-sharing and/or deductibles, you’ll want a plan with a high premium.

Be sure to keep in mind that drug plans within Medicare Advantage may come with restrictions on what doctors, hospitals, and other healthcare providers you can use. 

Find Out About Your Medicare Options with iHealthBrokers—Call Today

There are so many different options and combinations for Medicare—from Advantage and Part D to Original Medicare and Medigap. How, then, can you choose what coverage you want and need?

A good place to start is with iHealthBrokers. Without agents like us, you may miss out on great coverage, and even better prices. So, if you’re new to the world of Medicare and are ready to go, call iHealthBrokers at (888) 918-0518.

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Jesse Smedley is the Principal Broker for iHealthBrokers and the founder, president, and CEO of Smedley Insurance Group, Inc. and iHealthBrokers.com. Since the inception of SIG in 2007, Jesse has been dedicated to helping people save money on their health insurance by providing them with resources to educate themselves on all their health insurance options, both under age 65 and Medicare beneficiaries. He is featured in many publications as well as writes regularly for expert columns regarding health insurance and Medicare.

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