Does Medicare Cover Prescriptions?

Original Medicare (Parts A and B) does not cover most outpatient prescription drugs. To get drug coverage, you can add a standalone Part D plan to Original Medicare or choose a Medicare Advantage plan that includes prescription drug coverage. Part A and Part B do cover some drugs administered in a hospital or doctor's office.

Each Part D and Medicare Advantage drug plan has a formulary, which is the list of covered medications organized into cost tiers. Formularies vary from plan to plan, so it is important to confirm that your specific prescriptions are covered and to compare what you would pay at the pharmacy before enrolling.

A major protection now in place caps what you pay out of pocket for covered Part D drugs at $2,000 per year, which helps shield people with high medication costs. Because the right plan depends on the exact drugs you take and the pharmacies you use, a licensed Medicare advisor can help you compare options and find coverage that fits your prescriptions.

If you have limited income and resources, you may also qualify for Extra Help, a program that can significantly lower your Part D premiums and copays. It is worth reviewing your drug coverage every year during open enrollment, since formularies and pharmacy networks change annually, and a plan that fit your medications this year may cost more or cover less in the year ahead.