What Makes a Medicare Advantage Prescription Drug (MAPD) Plan a Smart Choice?

Like many people, you may take a prescription medicine or two … maybe more. And those costs can really add up, especially people who are 65 or older and are on a fixed income. That’s why you might want to consider adding a prescription drug plan to your Medicare coverage.

It’s Easy to Get Medicare Prescription Drug Coverage

You may already know Original Medicare doesn’t cover the drugs you buy from a pharmacy. But you can easily get prescription drug coverage, known as a Medicare Part D Plan, from private companies in two ways:

1. A stand-alone Prescription Drug Plan (PDP), which you can add to Original Medicare or a Medicare Supplement insurance plan.
2. A Medicare Advantage plan (Part C) that includes prescription drug coverage.

About Medicare Advantage Prescription Drug Plans

A Medicare Advantage plan with prescription drug coverage, also called an MAPD plan, can be a great choice because it includes all the benefits of Medicare Parts A (hospital insurance) and B (medical insurance) as well as drug coverage.

Medicare Prescription Coverage and More in Simple, All-in-One Plans

MAPD plans are approved by Medicare to provide your Parts A and B benefits — plus they cover prescription drugs and extra benefits that Original Medicare doesn’t. By bundling everything together, these MAPD plans make controlling Medicare drug costs and managing all aspects of your medical care easier.

With an MAPD plan, you’ll also receive low monthly premiums, an annual limit on out-of-pocket costs, and additional options that could include wellness programs, fitness memberships, dental, vision and hearing benefits, and more.

Choosing the MAPD Plan That Fits Your Needs

When considering MAPD plans, you’ll want to take into account their coverage and their costs, which can include monthly payments, deductibles, copayments and/or a percentage of a service or drug’s overall cost.

To make the most of your MAPD plan’s Medicare prescription drug coverage, here are a few things to keep in mind:

• All MAPD plans have a list of covered drugs, known as a formulary. It’s required to include common types of drugs, but not specific drugs within each type. Check to make sure any medications you need are included in your plan’s drug list.
• MAPD drug lists place medications into three to six different “tiers” or levels of cost to you. Drugs listed in lower tiers may be generic and generally cost less than drugs listed in higher tiers.
• MAPD plans can specify which pharmacies you must use. If you get a prescription filled by a pharmacy that’s not in your plan, you may pay more or all of the cost.
• Find out if you can save by using a mail-order pharmacy, which typically supplies a two- or three-month refill for a single copayment.

Remember, prescription plans for Medicare (Part D) are optional and you don’t automatically get one with Original Medicare. You have to choose Medicare prescription coverage from a private company. It’s best to make your Part D choice during your Initial Enrollment Period, because if you wait more than 63 days you may be subject to a late enrollment penalty. And when you get Part D bundled into a Medicare Advantage plan that includes prescription drug benefits, your MAPD will give you valuable all-in-one coverage.

Please note: Some Medicare Advantage plans do not cover prescription drugs, so be sure the plan you choose is an MAPD plan if you want it to include prescription drug coverage.

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Anthem Blue Cross Life and Health Insurance Company is a PDP plan with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends on contract renewal. Anthem Blue Cross Life and Health Insurance Company (Anthem) has contracted with the Centers for Medicare & Medicaid Services (CMS) to offer the Medicare Prescription Drug Plans (PDPs) noted above or herein. Anthem is the state-licensed, risk-bearing entity offering these plans. Anthem has retained the services of its related companies and authorized agents/brokers/producers to provide administrative services and/or to make the PDPs available in this region. Anthem Blue Cross Life and Health Insurance Company is an independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends on contract renewal. Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.

This information is not a complete description of benefits. Contact the plan for more information. Limitations, copayments, and restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.

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