Are prescription drugs covered by dual health plans?

Worried about the high cost of prescription drugs? You’re not alone. Many people who rely on medicines wouldn’t be able to pay for them out of pocket. So it’s no wonder that prescription drug coverage is one of the first things people ask about dual health plans. These plans are for people who have both Medicaid and Medicare. And this article covers the prescription drug coverage that dual health plans typically include.

Doesn’t Medicaid cover prescriptions?

That’s true. Most Medicaid plans cover some prescription drugs. But exactly which ones can change from state to state. Also, different states may have different rules for copayments and cost sharing, so not all medicines may be fully covered.

What prescriptions does Medicare cover?

Part D is the part of Medicare that helps pay for prescription drugs for Medicare beneficiaries. But this is extra coverage you don’t get with Original Medicare. The good news is that dual health plans are a type of Medicare Advantage plan, so they include Medicare Part D. That means you could get more prescription coverage than you get now with Medicaid or Original Medicare plans. 

How can you tell exactly what drugs are covered?

All health plans have what’s called a formulary. This is a list of drugs your health insurance or plan covers. It’s also called a preferred drug list (PDL). If you’re looking at a dual plan from UnitedHealthcare, you can View Drug List in English or Spanish on the plan details page.

Most likely, you’ll want to find out details about drugs you’re taking now. That’s easy to do, because you can look up an alphabetical list of any drug you’re interested in.

See UnitedHealthcare plans in your area.

Search by your ZIP code to find the right plan to meet your health care needs. 

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