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:
- Original Medicare with a supplement and separate prescription drug plan (Part D)
- An all-in-one Medicare Advantage (Part C) plan with prescription drug coverage included
Do all MA plans include prescription drug coverage?
Most, but not all, Medicare Advantage (MA) plans include prescription drug coverage. MA 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.
Podcast: Questions to ask when shopping for Medicare Rx coverage
What pharmacies are 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. View our pharmacy directory.
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. View our formulary.
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.
More resources:
Medicare Part D terms to know
Understanding pharmacy and drug coverage
Download a free guide to Medicare Advantage plans from Align powered by Sanford Health Plan or contact a licensed agent at (888) 535-4831 (TTY: 711) Monday through Friday from 8 a.m. to 5 p.m. local time, excluding holidays, to learn more.
Align powered by Sanford Health Plan is a PPO plan with a Medicare contract. Enrollment in [CD3.1]Align powered by Sanford Health Plan depends on contract renewal. Sanford Health complies with applicable federal civil rights laws and does not discriminate, exclude or treat people differently based on race, color, national origin, religion, pregnancy and related conditions, sex (including sexual orientation, gender identity, sex stereotypes, sex characteristics and intersex traits), age, disability, health status, marital status, arrest or conviction record or military participation in the administration of the plan, including enrollment and benefit determinations. Free interpretation services are available to you. Additional services and resources necessary to provide information on accessible formats are also available at no cost. Call (877) 509-4979 (TTY: 711) or speak with your healthcare provider. Spanish: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. También están disponibles de forma gratuita ayuda y servicios auxiliares apropiados para proporcionar información en formatos accesibles. Llame al (877) 509-4979 (TTY: 711) o hable con su proveedor. Oromo: Yoo afaan Oromoo dubbattu ta'e, tajaajilli gargaarsa afaanii bilisaa siniif ni argama. Gargaarsi gargaaraa fi tajaajilli sirrii ta’ee fi odeeffannoo bifa dhaqqabamaa ta’een kennuunis bilisaan ni argama. Bilbilaa (877) 509-4979 (TTY: 711) yookiin dhiyeessaa kee waliin haasa'aa. If you require large-print materials, please call (877) 509-4979 (TTY: 711).
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Last Updated On: 9.24.26 at 10:30 AM