Can I have more than one Medicare Prescription Drug Plan?
This article was updated on: 09/15/2018
Medicare Prescription Drug Plans help Medicare beneficiaries pay for medications prescribed by a doctor. This coverage is available to anyone who is eligible for Medicare, whether he or she is enrolled in Original Medicare (Part A and Part B) or in a Medicare Advantage plan. Although prescription drug coverage is optional, you may pay a late-enrollment penalty with your monthly premium if you don’t sign up as soon as you are eligible, unless you have creditable coverage through another source, such as an employer’s plan.
How do Medicare Prescription Drug Plans work?
Medicare Part D coverage for prescription drugs is offered through private insurance companies approved by Medicare. You must enroll through the plan and pay any required premiums in order to get coverage.
There are two types of Medicare Prescription Drug Plans:
- A stand-alone Medicare Part D Prescription Drug Plan to work alongside your Medicare Part A and/or Part B coverage
- A Medicare Advantage Prescription Drug plan. Medicare Advantage gives you a way to receive your Part A and Part B benefits through a private, Medicare-approved insurance company. Hospice benefits are still covered under Part A. Many Medicare Advantage plans include prescription drug coverage.
Every Medicare Prescription Drug Plan typically uses a drug formulary to determine which medications are covered and how much you will pay for each. The drug formulary will also spell out any particular requirements and cost containment measures that apply to any medication your doctor prescribes. For example, the drug formulary may require prior authorization before your plan pays for your medication, or it may impose quantity limits on the amount of medication you can get at one time. A formulary may change at any time, but the plan must notify you in writing when it does.
How many Medicare Prescription Drug Plans can I have?
Medicare has very specific guidelines about Part D prescription drug coverage. Although you are not required to purchase a plan, you may be subject to late-enrollment penalties if you do not have prescription drug coverage for a period of time and then decide to enroll. You may only have one type of the various Medicare Prescription Drug Plans at any one time. For example:
- If you have prescription drug coverage through a union or employer plan and you sign up for Medicare Part D coverage for prescription drugs, you may lose your employer-sponsored plan.
- If you have Medicare Advantage with Part D coverage for prescription drugs and you sign up for a stand-alone Medicare Prescription Drug Plan, you may be dropped from your Medicare Advantage plan and automatically switched to Original Medicare.
- If you have a Medicare Supplement (Medigap) policy with prescription drug coverage and you enroll in a stand-alone Medicare Part D Prescription Drug Plan, your Medigap plan must drop your coverage for prescription drugs and adjust your premium. Note that Medicare Supplement plans that cover prescription drug coverage are no longer sold, but if you bought a plan in the past that included this coverage, you may keep it. Check your plan documents, however, because some Medigap prescription drug coverage is not considered creditable under the rules for Medicare Prescription Drug Plans, so you may pay a late-enrollment penalty if you enroll in Part D coverage for prescription drugs at a later date.
- If you get veteran’s benefits through the U.S. Department of Veterans Affairs (VA) that include prescription drug coverage, you may still enroll in a Medicare Part D Prescription Drug Plan, but you may not use both benefits for the same prescription.
- If you have Medicaid and you are eligible for Medicare, you will need to enroll in one of the Medicare Prescription Drug Plansavailable in your area. Your medication costs are paid by Medicare first if you have both Medicare and Medicaid. In fact, if you don’t enroll in Medicare Part D coverage for prescription drugs on your own, Medicare may enroll you in a plan automatically.
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