Does Medicare cover prescriptions?
Medicare covers prescriptions through Part D (or a Medicare Advantage plan with drug coverage) — not through Original Medicare Parts A and B, which only cover drugs given in a hospital or doctor's office.
What flips the answer
- Covered when
You have a Part D plan or a Medicare Advantage plan with drug coverage, and your drug is on the plan's formulary.
- Not covered when
You have Original Medicare (Parts A and B) only — your self-administered pharmacy prescriptions aren't covered.
- Not covered when
Your specific drug isn't on your plan's formulary, or requires prior authorization/step therapy — coverage and cost hinge on the plan's rules.
Medicare covers prescription drugs, but you have to have the right part. Part D is the prescription drug benefit, sold as stand-alone plans or built into most Medicare Advantage plans. Without one, Original Medicare leaves your everyday pharmacy drugs uncovered.
Parts A and B cover only drugs administered in specific settings — medications during a covered inpatient stay (Part A) and clinic-administered drugs, certain vaccines, some oral cancer drugs, and drugs used with covered equipment (Part B).
Each Part D and Advantage plan has its own formulary — the list of drugs it covers — plus tiers, and sometimes prior authorization or step therapy. So whether a particular prescription is covered, and what you pay, depends on the plan you choose.
That's the general answer. Yours is written in your actual policy.
Drop in your policy or benefits document and get the answer for your exact coverage — with the clause it comes from. Nothing is stored.
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