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MAPD vs PDP | Differences and Similarities

November 15, 2023

MAPD vs PDP | Differences and Similarities

As a Medicare beneficiary, you know that you have options in the coverage you choose. However, sometimes the acronyms and different plan types can be hard to keep straight. 

For example, what is a Medicare PDP vs MAPD? Understanding the difference between these two Medicare options can help you choose the right plan for your needs.

This guide will demystify the acronyms and help you understand MAPD vs PDP. Let’s get started!

What is a Medicare Advantage Prescription Drug Plan?

MAPD stands for Medicare Advantage Prescription Drug plans. These are Medicare Advantage plans that include prescription drugs in a single package, instead of requiring you to buy drug coverage separately.

One of the things that makes Medicare Advantage plans so popular is that they are an all-in-one replacement for Original Medicare. You get at least as much coverage as Original Medicare, and you often get additional benefits — such as having drug coverage included in an MAPD plan.

The thing to keep in mind is that Medicare Advantage plans are issued by private insurance companies who have a contract with the Federal Government to offer these plans.  These plans usually have specific provider networks that you have to use. This means your prescriptions might have to go through specific pharmacies. Also, you’ll want to review the drug list for each plan to ensure that the prescriptions you need are included.

What is a Prescription Drug Plan?

PDP stands for Prescription Drug Plan. These are plans that only offer prescription drug coverage; you can purchase these in addition to your Original Medicare coverage for Part A and Part B.

When you have Original Medicare, you can choose which parts to include. There is  Part A (hospital coverage) and Part B (medical coverage). From there, you can choose to add prescription drug coverage (Part D), which is also known as a PDP. 

If you add a PDP to Original Medicare, you’ll want to compare more than just the price. Make sure that the pharmacies that are in the network make sense for you, and review the medication list to ensure your prescriptions are included. 

Most people will want to include a PDP with Original Medicare, so be sure you review your options and make the choice that’s best for you.

Choosing The Right Plan for You

When choosing between a Medicare Advantage Prescription Drug plan (MAPD) and Original Medicare with a stand-alone prescription drug plan (PDP), think about your lifestyle and your medical needs.

If you stay mostly within your local area, Medicare Advantage could be a way to get more predictable out-of-pocket costs and extra benefits at a low cost. As long as your medical providers are within the medical network of the plan, you can get the care you need.

If you travel more often, or your preferred doctors aren’t within a Medicare Advantage plan that makes sense for you, it might be better to stick with Original Medicare and add a PDP. That way you can access Medicare-approved providers around the country, even if you do miss out on some of the extra benefits of an Advantage plan.

Learn More About Medicare Advantage Plan Options

Understanding the wide variety of Medicare options available to you can be overwhelming. That’s why talking to a licensed agent can help by answering your questions and help you think through the options that are available.

We’re here to help. Contact us if you have additional questions about Medicare Advantage or want help comparing plans,

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