Can I Enroll Into a Medicare Advantage Without Rx Coverage from 2 Separate Carriers?

Medicare offers the opportunity to obtain prescription drug coverage to all of its eligible enrollees. There are two ways in which to obtain this type of coverage. One way is to purchase a stand-alone Medicare Part D prescription drug plan. The other way is to purchase a Medicare Advantage plan that also includes prescription drug coverage within the overall plan.

How Many Medicare Advantage Plans Can You Have?

If you have coverage through a Medicare Advantage plan, you will typically have Medicare’s prescription drug coverage through this plan as well. In fact, in most of the Medicare Advantage plans that are offered, you must get prescription drug coverage through your Medicare Advantage plan.

You can only have one Medicare Advantage plan at a time. However, there may be a time when you need to also join a Medicare Part D prescription drug plan in order to add this type of coverage.

For example, there are some Medicare Private Fee-for-Service (PFFS) plans that do not include prescription drug coverage. In this case, you would need to purchase the coverage separately through Medicare Part D.

Likewise, there are also certain Medicare Medical Savings Account (MSA) plans that don’t automatically include prescription drug coverage. In this case, you would also need to purchase a Medicare Part D plan separately if you wanted to have this coverage.

If you are enrolled in a Medicare Cost Plan that also offers Medicare prescription drug coverage, it is still possible for you to also enroll in a separate Medicare Part D prescription drug coverage plan. In this case, you should decide whether you wish to obtain your drug coverage directly from your Medicare cost plan, or alternatively from a stand-alone Medicare Part D prescription drug coverage plan.

How Medicare Prescription Drug Coverage Works

For those who have prescription drug coverage through Medicare, it is likely that you benefits could change every year. If this is the case, your plan will send you a notice titled the Evidence of Coverage that will tell you what the plan covers, as well as how much you need to pay, how to file an appeal, and other important information.

Your plan will also send you a notice titled the Annual Notice of Change. This document is typically sent out each fall, and it contains information regarding any of the changes that will occur in your benefits, as well as changes in the cost of your benefits, beginning the following year.

The Annual Notice of Change will also include information on any changes regarding the formulary of drugs with the benefit plan. It is important for you to read over this notice particularly carefully – especially because it could contain information about your particular prescription medications. If it does – and if it is a change that will affect you in a negative way – you may want to consider switching to a different plan that will serve your prescription needs better or in a less costly manner.

What About Purchasing A Medicare Supplement (Medigap) Insurance Plan?

If you have a Medicare Advantage plan, you will not be allowed to also have a Medicare Supplement insurance policy for paying any of the out-of-pocket costs that you incur from the Medicare Advantage plan.

In fact, if you already own a Medicare Advantage plan, you cannot purchase a Medicare Supplement insurance policy at all unless you dis-enroll from Medicare Advantage and return to Medicare Parts A and B (Original Medicare). Only then will you be allowed to use Medicare Supplement insurance for filling in the “gaps” in Medicare’s coverage such as its deductibles and copayments.

Before Making Any Changes

Prior to making any changes or plan additions, you should weigh out all of your potential options. Then, you should contact Medicare directly in order to ensure that you are taking all of the necessary steps for ensuring the right coverage for your particular needs without jeopardizing your Medicare coverage eligibility.

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