How to Find the Right Medicare Drug Plan

Health, Home & Family
on October 4, 2011
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Prescription drug plans can be a key aspect of health care coverage. For individuals that have Medicare coverage, various types of programs can cover the high cost of prescription drugs. This is the basis of the Medicare Part D plan, a hotly debated government program that likely will continue to be controversial as politicians wrangle about how to cover the high cost of medical coverage in the United States. With that in mind, here are a few details on the different Medicare drug plan options, according to Medicare.gov.

Medicare Health Maintenance Organization (HMO). The HMO option through Medicare is typically offered through a Medicare Advantage Plan or other programs that have prescription options. An HMO may offer fewer choices and options in exchange for lower premiums. In many cases, the cost of prescriptions may be the same between the HMO and PPO.

Medicare Preferred Provider Organization (PPO). The PPO plan is also offered through various Medicare programs, such as the Medicare Advantage Plan. Some individuals choose a PPO because they have more choices in terms of care providers. Drug coverage often is included in these programs, but benefits can vary depending on when the person originally signed up for Medicare.

Medicare Private Fee-for-Service (PFFS). The PFFS plan is designed for those who want to use specific providers. Consumers can go to any provider who is willing to treat the individual. It's important to note that only some PFFS plans offer prescription drug coverage. Therefore, if individuals want drug coverage, they must make sure that their PFFS provides this benefit and will cover particular expenses.

Medicare Medical Savings Account (MSA). In general terms, an MSA account is a medical savings fund that is used by consumers to pay expenses. The individual can put money into the account throughout the year and use it to reimburse medical costs, such as prescription drugs. However, as noted by the Centers for Medicare & Medicaid Services, only medical expenses may apply to a plan deductible. Therefore, it may be necessary to add specific drug coverage to an MSA plan.

Medicare Special Needs Plans (SNP). The SNP is designed specifically for “special needs” consumers and has particular requirements to enroll in the program. Only those individuals who are actually designated as this population may enroll in this specific Medicare program, but prescription drugs are typically covered through this plan.