Do you need prescription drug coverage? According to the U.S. Centers for Disease Control and Prevention (CDC), between 2015 and 2018, more than 48 percent of Americans reported using at least one prescription medication within the past 30 days. If you're one of the many U.S. adults who needs a prescription drug, take a look at the top Medicare and Medigap questions answered.

Does Medicare Include Prescriptions?

People 65 and older, some younger people with disabilities, and people with end-stage renal disease qualify for this federal health insurance program. This includes Part A (hospital insurance) and Part B (medical insurance). Even though your prior private insurance policy may have covered hospital, medical, and prescription expenses, the federal program doesn't.

How Can You Pay for Prescriptions?

While Parts A and B don't include prescription coverage, Part D does. Before you enroll in Part D coverage, make sure you don't already have a plan that will pay for your prescription costs—or a higher amount of your costs. If you still have coverage from a former employer or private plan, compare the costs.

Is Part D the Only Prescription Option?

Part D is not the only way to pay for your prescriptions. A Medicare Advantage plan (also known as Part C or MA) also includes drug coverage. This means one MA plan will help to pay for your hospital, medical, and prescription costs. These plans are similar to what you may have had through your employer or private insurer. MA plans include health maintenance organization (HMO) plans, preferred provider organization (PPO) plans, private fee-for-service (PFFS) plans, or special needs plans (SNPs).

How Much Do Federal Plans Pay for Prescriptions?

The answer to this question depends on your individual plan and the type of prescription drugs you need. Each plan has a formulary—or list of covered drugs. If your prescription isn't on the formulary, the plan won't pay for the costs. But this doesn't mean the policy will pay for 100 percent of the costs of a drug that is on the formulary. Policies list drugs on tiers. The tier determines what the insurance covers and what you'll pay.

Does Medigap Pay for Prescriptions?

Medigap or Medicare Supplement Plans are not the same as MA. A supplement is exactly what the name implies. This type of plan supplements existing Parts A and B coverage. It pays for would-be potential out-of-pocket costs your other insurance (Parts A and B) doesn't cover. These costs could include copayments, coinsurance, and deductibles.

Older supplement policies could include some prescription coverage, but some newer one may not. This means a current supplement may not pay for your prescription drugs.

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