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 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 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.
What is The Medicare Advantage Open Enrollment Period?
Medicare Advantage plans, also known as Medicare Part C plans, are a way to get your Medicare Part A, Part B, and even Part D coverage combined in a single plan. Depending on the Medicare Advantage plan, additional benefits may also be included.
Your coverage needs may change over time, and if you are enrolled in Medicare Advantage, you may need a new plan that fits your needs better. It is vital to know that you can only change your plan during certain periods of the year, and these are known as enrollment periods. This article will look at what a Medicare Advantage Open Enrollment Period is.
What is the Medicare Advantage Open Enrollment Period?
This is a Medicare Advantage enrollment window from January 1 through March 31. This open enrollment period allows the people who are signed up for Medicare Advantage to change their coverage. If you find something you are not happy with within your current Medicare Advantage plan, this 3-month window is the chance you have to find a Medicare Advantage plan that meets your needs. During the Medicare Advantage Open Enrollment Period, you can:
- Return to Original Medicare and, if required, also sign up for a Medicare Part D prescription drug plan
- Switch to another Medicare Part C plan
- Add a stand-alone Medicare Part D plan if you switch to a different Medicare Advantage plan without prescription drug coverage or drop the Medicare Advantage plan
Keep in mind that this enrollment period is only available to those already enrolled in Medicare Advantage.
Do I Have to Make a Change During This Period?
Just because the Medicare Advantage Open Enrollment Period allows you to make a change to your Medicare Advantage coverage doesn’t mean you should. When trying to decide whether you should switch or make changes to your plan during this period, here are a couple of things to consider:
- What are your health needs?
- Have your out-of-pocket costs increased?
- Are your providers still in your plan’s network?
- Are you satisfied with the coverage you receive from your plan?
- Are all of your prescription drugs covered by your plan?
- Are there new Medicare Advantage plans available in your area?
If your review of your current Medicare Advantage plan shows that a change is required, then you can decide to make changes during the Medicare Advantage Open Enrollment Period.
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