What Types of Medicare Part D Coverage Does UnitedHealthcare Offer?
Last Updated : 10/21/20185 min read
If you’re a Medicare beneficiary who currently takes prescription medications, you may be wondering if Medicare helps with your prescription drug costs. Prescription drug coverage is available under the Medicare Part D program, and depending on how you get your Part A and Part B coverage, you can get prescription drug coverage in two different ways.
If you’re enrolled in Original Medicare (Part A and Part B), then Part D coverage is available through a stand-alone Medicare Prescription Drug Plan that works alongside your Original Medicare coverage. Another option is to enroll in a Medicare Advantage Prescription Drug plan, which covers your prescription drugs, along with your Part A and Part B coverage, under the same plan. Unlike the Original Medicare program, which is administered by the federal government, private insurance companies like UnitedHealthcare contract with Medicare to offer both Medicare Part D Prescription Drug Plans and Medicare Advantage plans.
If you are interested in UnitedHealthcare Medicare Part D prescription drug coverage, here’s what you should know about available plans and coverage options.
What kind of UnitedHealthcare Medicare Part D prescription drug coverage is available?
As mentioned, you can get your Medicare Part D coverage for prescription drugs in one of two ways with UnitedHealthcare:
- A UnitedHealthcare Medicare Advantage plan with prescription drug coverage, also known as a Medicare Advantage Prescription Drug (MAPD) plan.
- A stand-alone UnitedHealthcare Medicare Part D Prescription Drug Plan.
If you want prescription drug coverage with your UnitedHealthcare Medicare Advantage plan, be sure to choose a plan that includes it, because stand-alone Medicare Part D Prescription Drug plans generally can’t be combined with most types of Medicare Advantage plans.
You may be eligible for Medicare prescription drug coverage if you have Part A and/or Part B and live in the service area of a Medicare plan that covers prescription drugs.
Some things to remember:
- Plan benefits may vary from place to place, and not all UnitedHealthcare Medicare plans with prescription drug coverage may be available in all locations.
- You may have copayments, coinsurance amounts, and/or deductibles with your UnitedHealthcare Medicare plans that cover prescription drugs.
- You should get Medicare Part D prescription drug coverage as soon as you are eligible to avoid potentially paying a late-enrollment penalty with your monthly premium for as long as you have coverage. This may apply any time that you go without Medicare prescription drug coverage after you’re first eligible and don’t have other creditable prescription coverage (insurance that is as good as the Part D benefit) for 63 days in a row or longer. If you owe a late-enrollment penalty, you’ll need to pay this for as long as you’re enrolled in Part D.
How does UnitedHealthcare Medicare Part D prescription drug coverage work?
All UnitedHealthcare Medicare Part D prescription drug coverage is designed around a formulary, or list of covered medications. By law, Medicare Part D Prescription Drug Plan and Medicare Advantage Prescription Drug plan formularies must include a broad range of medications, including both generic and brand-name drugs, to treat most medical conditions and diseases. Your UnitedHealthcare Medicare plan with prescription drug coverage may change its formulary from time to time, but you be notified if necessary before any changes take place.
If you’re interested in enrolling in a UnitedHealthcare Medicare plan that covers prescription drugs, it’s a good idea to first check the plan formulary to make sure all of your medications are covered by the plan (or enroll in a plan that does cover your prescription drugs). You can contact the Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan you’re interested in if you need help finding this information.
UnitedHealthcare Medicare plans with coverage for prescription drugs may use one or more of the following formulary rules to help control costs:
- A tiered formulary. Your plan may place covered prescription medications into different tiers, with generics and low-cost brand-name medications in the lower tiers and more expensive medications in the higher tiers. Your copayments, coinsurance amounts, and/or deductibles are lower with medications in lower tiers and increase as you move up the tiers.
- Prior authorization. In some cases, your plan may require your doctor or prescriber to verify that a medication is medically necessary before approving coverage for a particular prescription drug. If you do not get prior approval from your plan, it may not cover your prescription drug.
- Step therapy. If two or more medications are approved to treat your condition and one is less expensive, your plan may require you to first try the lower-cost medication and evaluate your response to the treatment before approving the more expensive prescription drug.
Taking the time to compare Medicare plan options that cover your medications can save you money, since costs may vary widely from plan to plan (even if the covered medications are the same). If you’re ready to explore what’s available, check out the UnitedHealthcare Medicare profile page for more information. You can also use the Find Plans button on this page; simply enter your current list of prescription drugs to filter your search to Medicare plan options that cover your specific medications.