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What is a Medicare PDP and an MAPD?

PDP is an abbreviation for "prescription drug plan" and refers to stand-alone Medicare Part D prescription drug plans. PDPs only cover prescription drugs, they do not cover health services.

MAPD is an abbreviation for "Medicare Advantage plan that offers prescription drug coverage".  MAPDs cover both prescription drugs and health services.

If you need 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 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" (at least as good as basic Medicare Part D coverage), you do not need to join a Medicare Part D plan or you can join a Medicare Part D plan (PDP or MAPD) and use both benefits.  However, 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.

What is a Medicare drug plan?

In general, Medicare Part D prescription drug plans provide insurance coverage for your prescription drugs - just like other types of insurance.  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.

As noted above, you will find that your Medicare prescription drug coverage can be provided by either:
  • a "stand-alone" Medicare Part D plan (PDP ) or
  • a Medicare Advantage plan that includes prescription coverage (MAPD).
A PDP or stand-alone Medicare Part D prescription drug plan only provides drug coverage (see PDP-Finder.com).

An MAPD or a Medicare health plan will include Medicare Part A (in-patient and hospital coverage), Medicare Part B (out-patient and physician coverage), and Medicare Part D prescription drug coverage - all for one monthly premium.  Medicare Advantages plans (with and without prescription drug coverage) are also called Medicare Part C plans.  Your MAPD may also include other benefits such as fitness (Silver Sneakers), vision, hearing, and some dental coverage (see MA-Finder.com).

For more information, please see our FAQ:

How will I choose between a stand-alone Medicare Part D prescription drug plan (PDP) and a Medicare Advantage plan that includes prescription drug coverage (MAPD)?

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Tips & Disclaimers
  • The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change.
  • Medicare has neither reviewed nor endorsed the information on our site.
  • We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227.
  • We are an independent education, research, and technology company. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. We are not compensated for Medicare plan enrollments. We do not sell leads or share your personal information.
  • Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Our PDP-Compare.com and MA-Compare.com provide highlights of annual plan benefit changes.
  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
  • Limitations, copayments, and restrictions may apply.
  • We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service area. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov.
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.