" is the abbreviation used for a stand-alone Medicare Part D "prescription drug plan". A PDP provides coverage of your out-patient prescription drugs that are found on the plan's formulary.
" is the abbreviation for a "Medicare Advantage plan that offers prescription drug coverage". An MAPD provides coverage for your out-patient Medicare Part D prescription drugs, and also includes coverage of your Medicare Part A (in-patient and hospital coverage) and Medicare Part B (out-patient and physician coverage). An MAPD may also provide supplemental benefits beyond usual Medicare coverage such as vision care, dental care, health club memberships (like Silver Sneakers), transportation, and more. In general, a Medicare Advantage plan (with or without Part D drug coverage) is also called a Medicare Part C plan.
Both a PDP and an MAPD provide Medicare Part D drug coverage.
If you need prescription drug coverage, and are eligible for Medicare Part A and/or Medicare Part B, you can enroll in a either a stand-alone Medicare Part D prescription drug plan (PDP
) or Medicare Advantage plan that provides drug coverage (MAPD
), depending on whether you want drug only coverage or both health and drug coverage.
A note on Medicare drug coverage and Medigap policies
If you are enrolled in a Medicare Supplement or Medigap plan
- you can only join a PDP
for your Medicare Part D prescription drug coverage. You cannot use
a Medicare Advantage plan (MAPD or MA
) together with your Medicare Supplement. (It is illegal for someone to sell you a Medigap policy if the salesperson knows that you are enrolled in a Medicare Advantage plan - unless your Medicare Advantage plan coverage ends before the effective date of the Medigap policy.)
A note on Medicare drug coverage and VA, TRICARE, and Employer Drug Coverage
You may already be receiving prescription drug coverage through the VA or TRICARE
- and since this coverage is considered "creditable
" (meaning it is at least as good as basic Medicare Part D coverage), you do not need to join a Medicare Part D plan, but you can join a Medicare Part D plan (PDP or MAPD) and use either
drug benefit depending on your purchase. Keep in mind that you cannot use both coverages for a single purchase.
, if you receive employer drug coverage
that is considered "creditable" (ask your employer health plan administrator whether your drug plan is creditable
), you probably cannot join a Medicare Part D plan
and also keep your employer coverage.
In fact, if you join a Medicare Part D plan, you probably will lose all of your employer health plan coverage (not just drug coverage) - so ask your employer plan before enrolling in a PDP or MAPD.
Question: How does a Medicare drug plan actually work?
In general, Medicare Part D prescription drug plans
provide insurance coverage for your prescription drugs. So like any insurance, you will pay a monthly premium (unless you join a plan with a $0 premium), pay an initial deductible (unless you join a plan with a $0 deductible), and receive some form of coverage for any drugs that are on your plans drug list or formulary.
Every Medicare Part D or Medicare Advantage plan is a little different, with different premiums, deductibles, drug coverage (plans do not cover the same drugs), and cost-sharing (what you pay for your drugs).
For more information, please see our popular Frequently Asked Question, "What is a Medicare Part D plan?
" found at: https://Q1FAQ.com/563.html
Question: Where can I see the PDPs or MAPDs in my area?
You can use our Medicare Part D Plan Finder to see all stand-alone Medicare Part plans in your state. You can begin at https://PDP-Finder.com
and then just choose your state. You can then click on the plan name and see plan details. We also have links to the plan's formulary or drug list.
You can see all Medicare Advantage plans in your county (or ZIP code area) using our Medicare Advantage Plan Finder. You can begin at https://MA-Finder.com
and then enter your ZIP and click on the green button to see plans in your area - or you can click on your state and then choose your county from the list and see Medicare Advantage plans in your area. You can click on the plan name and see coverage details for the plan, the plan's contact information, and a link to the plan's formulary or drug list.
And for more information, please see our FAQ:
will I choose between a stand-alone Medicare Part D prescription drug
plan (PDP) and a Medicare Advantage plan that includes prescription drug