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Medicare prescription drug coverage (Part D) is offered through private insurance companies, like Aetna®. You can get Part D coverage through either:
A prescription drug plan (PDP) is a stand-alone Medicare Part D plan. PDPs only offer Part D and work together with your Original Medicare. This is a good option for someone who wants to stay in Original Medicare but add prescription drug coverage.
You are eligible to enroll in a PDP if you are already enrolled in Medicare Part A and/or Medicare Part B. Medicare Part D prescription drug plans are only available through private insurers such as Aetna®.
For more information, please visit our Unpacking Medicare prescription drug coverage page.
A Medicare Advantage prescription drug plan (or MAPD) is a plan that includes medical and prescription drug coverage. MAPD plans are only available through private insurers like Aetna®.
An MAPD plan includes:
Like other health plans, MAPDs come in various forms, such as HMOs (health maintenance organizations) and PPOs (preferred provider organizations).
There are four phases of Medicare Part D coverage you may enter in a plan year. What you pay for covered prescriptions may change as you move through the phases. Coverage phases do not affect monthly premium amounts.
Here are some examples of what Part D prescription drug plans do not cover:
ⓘ SilverScript® Plus (PDP) and some of our MAPD plans include coverage for some excluded drugs not normally covered by Medicare Part D. This includes a variety of prescription vitamins and generic erectile dysfunction drugs.
For a more complete list of drugs not covered by Medicare, please visit our Prescription drug formulary FAQ page.
Yes. Part D, in general, covers recommended adult vaccines when needed to prevent illness.
Under the Inflation Reduction Act, most Part D vaccines recommended for adults (ages 19 and older) given to prevent an illness now have a $0 copay. Vaccines eligible for the $0 copay include those recommended by the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP). This includes the shingles vaccine.
Check the formulary (drug list) for a list of covered vaccines. And talk to your provider about which ones are right for you.
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