The Difference Between MA and MAPD Plans
Most (but not all) Medicare Advantage plans include prescription drug coverage. Plans that combine medical coverage AND prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans. It is important to understand the difference between MA-only and MAPD plans.
MA-only plans
- Replace Original Medicare
- Administered by private insurance companies approved by Medicare
- Offer medical coverage only (do not cover prescription medications)
- Patients can add prescription drug coverage by enrolling in a stand-alone prescription drug plan (PDP)
MAPD plans
- Replace Original Medicare
- Administered by private insurance companies approved by Medicare
- Offer combined medical and prescription drug coverage in one comprehensive benefit
If you enroll in an MA Only plan, you are not allowed to get a separate Part D plan unless the MA-Only plan is a Private fee-for-service or PFFS plan without drug coverage or an MSA plan. Please correct above statement
can a person join an MA plan without prescription coverage to avoid a PDP penalty
Thank you for being honest in your explanation of MAPD vs MA.
The sad part is if you are 74 the cost of a MAPD is more like $219 per month! You are right the TV ads trying to get you into an Advantage plan never talk about that high out of pocket costs. Some ads say $0 copays but not in my area! They want you in an advantage plan because they make a fortune from what the government, our tax money pays them per person. like $1000 per month!
So, I just ran into an issue that I was completely caught off guard on and want to confirm if what I was told was correct. I was under the impression that I have a MAPD that has drug coverage I don’t need to sign up for Part D…. However, what I just got hit with was my first bill from Medicare. Which SS completely screwed up on how they billed me – but that’s another story… What I was shocked to see is that I was being billed for PART D drug plan even though I have an Advantage Plan that has the coverage… I thought that was one of the purposes of having an advantage plan… – and it’s hitting harder as I am hit with IRMMA — is that correct that I still pay for the drug coverage as though I have a plan d?