Are prescription drugs covered with Medicare Advantage?

Prescription drug or pharmacy coverage is an important aspect of your health insurance. When you’re eligible for Medicare, there are a variety of ways you can receive prescription drug benefits, depending on the type of Medicare plan you choose.

Two of the most popular ways to get Medicare coverage include:

  • Original Medicare with a supplement and separate prescription drug plan (Part D)
  • An all-in-one Medicare Advantage plan with prescription drug coverage built in

Do MA plans include prescription drug coverage?

Most, but not all, Medicare Advantage plans include prescription drug coverage. Medicare Advantage plans are Medicare-approved private health insurance alternatives that take the place of Medicare Parts A and B. Most MA plans offer additional coverage that is not provided through Original Medicare, such as vision, dental, care for chronic illnesses and drug coverage.

If you choose an all-in-one MA plan, you do not need to enroll in a separate prescription drug plan because it’s already included in your coverage.

It’s important to learn about the different kinds of prescription drugs covered in your plan and which pharmacies to choose so you can get the medications you need at the most affordable price.

What are the pharmacies included in our network?

Align powered by Sanford Health Plan includes a pharmacy network of over 60,000 regional and national pharmacies. To have your prescriptions covered at the highest level, be sure to fill them at a pharmacy that’s part of our network, such as:

  • Costco
  • Hy-Vee
  • Sam’s Club
  • Walmart

Our pharmacy network also includes independently owned pharmacies. To view the entire list, click here.

What are preferred pharmacies?

Our pharmacy network also includes preferred pharmacies, which offer prescriptions at the lowest cost-share amount. If you have a preferred pharmacy in your area, you could save more on your medications at these locations.

Our preferred pharmacies include: 

  • CVS
  • Gateway Pharmacy
  • Lewis Drug
  • OptumRx
  • Sanford Health Pharmacy
  • Seip Drug
  • Thrifty White

How can you see if your prescriptions are covered?

A plan’s list of covered medications is called a formulary. You can use this tool to see if your prescriptions are covered and view other drug information, such as if a prescription requires prior authorization.

Tip: The formulary is divided into tiers or different cost levels. Using lower-tier or preferred medications can help you pay the lowest out-of-pocket cost.

To view our formulary, click here.

What else is important to know?

Our Medicare Advantage plans include the Part D Senior Savings Model to provide a stable copay for certain types of insulin. In addition, you can have over-the-counter (OTC) medications shipped directly to you. Depending on your plan, you’ll receive a credit each quarter to purchase medications such as aspirin or cold and flu medicine.

Align powered by Sanford Health Plan is a PPO with a Medicare contract. Enrollment in Align powered by Sanford Health Plan depends on contract renewal. Sanford Health Plan complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

CMS ID Number: H8385_444-507-691-PY2022-ND-SD_M, H3186_444-507-691-PY2022-MN_M

Last Updated On: 5.8.24 at 10:30 AM

Your guide to Medicare Advantage

Learn how you can get all the benefits of Original Medicare and more with a Medicare Advantage plan through Align powered by Sanford Health Plan.