Medicare Advantage (Part C) plans bundle hospital, medical, and usually prescription drug coverage (MA-PD) into a single plan from a private insurer. Each MA plan has its own formulary, which must meet CMS minimum coverage standards. Over 50% of Medicare beneficiaries are now enrolled in Medicare Advantage, making these formularies critical to understanding senior drug coverage.
Key Facts
Check Your Specific Plan's Formulary
Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerFrequently Asked Questions
Most Medicare Advantage plans (called MA-PD plans) include Part D prescription drug coverage. However, some MA-only plans do not include drug coverage. If you choose an MA-only plan, you would need a separate standalone Part D plan. Check the plan details before enrolling.
Both must meet CMS minimum coverage requirements. However, MA plans may have different formularies, preferred pharmacies, and copay structures compared to standalone Part D plans. Some MA plans negotiate exclusive deals with pharmacy chains. Compare both options using the Medicare Plan Finder.
MA plans have pharmacy networks with preferred and standard pharmacies. You will pay less at preferred pharmacies. Out-of-network pharmacies may not be covered except in emergencies. Many MA plans include mail-order pharmacy options for maintenance medications at reduced costs.
Related Resources
- Medicare Part D Formulary 2026
- Humana Formulary 2026
- UnitedHealthcare Formulary 2026
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