Factor Prescriptions Into Medicare Choices

IF YOU HAVE a health insurance plan, you may not spend much time thinking about prescription drugs.

But whether you take daily maintenance medication for an ongoing condition or just need the occasional injection to beat back seasonal allergies, you probably benefit from the cost break your coverage provides.

Without that break, out-of-pocket costs on drugs such as an acid-reflux medication, for example, could soar from a $10 copay to around $200 for a month’s supply.

So, when you decide to enroll in Medicare-based health coverage, you’ll want to keep medicines in mind when reviewing your choices. In fact, USAA suggests making your prescription drug needs — now and in the future — a major factor when you select a plan.

Here’s a basic breakdown of Medicare options and how prescription drug coverage is handled in each:

Plan Choice

Prescription Drug Coverage

Medicare — Parts A and B

Parts A and B offer almost no coverage for prescriptions, so you will either need to have another source of coverage (i.e., a group insurance plan or VA benefits) or sign up for Medicare Part D (see below).

Medicare Advantage Plan — Part C

Prescription drugs are usually part of these plans. Review the list and prices of covered prescription drugs as you review Part C plans to see which best fits your needs. For plans that don’t cover drugs, you also can add a Medicare Part D plan.

Medicare prescription drug coverage — Part D

Works with Parts A, B and C and includes tiers for drug pricing. A lower-tier drug is generally less expensive. It also works with private insurance plans such as employer coverage, but it may affect your current coverage. So do your research first.


Not all drug plans look alike.

With a variety of plans — and premiums — on the market, don’t assume every company will offer your medications or that the drug prices will be the same from plan to plan. Also keep in mind Medicare Supplement Insurance plans do not offer prescription drug benefits.

“When you’re looking at different prescription plans, you’ll want to make sure the medicine you take is included,” says Kelly Koehn, USAA product manager. “And look at how it is priced, because that will affect your out-of-pocket costs.”

Choosing one prescription drug plan over another recently saved one USAA member about $800 per year on medications, Koehn adds.

Two other things to keep in mind when you’re choosing a Medicare plan:

  • Even if you aren’t regularly taking medication currently, it can still be costly to forgo coverage. “Just because you don’t take prescriptions now doesn’t mean that you’ll never have to,” Koehn says.
  • If you aren’t regularly taking medication now, choose the plan with the lowest premium, since you can always change it in the future. If you do sign up for Medicare Parts A and B, but don’t sign up for Part D in your initial enrollment period (or have another source of coverage), you may pay a late-enrollment penalty.
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This material is for informational purposes. Consider your own financial circumstances carefully before making a decision and consult with your tax, legal or estate planning professional.

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