No, you do not need Part D if you have Medicare Advantage. In fact, you may already receive Part D through your Advantage (Part C) plan, and you may be able to add it if it does not.
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 their 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 may be able to purchase an additional plan to go along with your Part C coverage.
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 will 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 will 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.
