Are there Medicare Advantage Plans without Part D?
Asked by: Cassie Larson Jr. | Last update: July 26, 2025Score: 4.3/5 (54 votes)
Do I need Part D if I have Medicare Advantage?
Summary: Original Medicare allows you to choose a stand-alone Medicare Part D prescription drug plan, while some Medicare Advantage plans may include prescription drug coverage. You cannot have a stand-alone Medicare Part D prescription drug plan if your Medicare Advantage plan already includes prescription coverage.
What is the biggest disadvantage of the Medicare Advantage plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
Can I go without Medicare Part D?
A person may owe a late enrollment penalty if, after their Initial Enrollment Period (when they first get Medicare Part A and/or Part B), they go without Part D or other creditable prescription drug coverage for any period of 63 or more days in a row.
Why are people dropping Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Do You Really Need Medicare Part D?
Why do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
Why are seniors leaving Advantage plans?
Key takeaways: People leave Medicare Advantage plans because out-of-pocket costs vary between plans, network restrictions can cause frustration, prior authorization requests can delay care, and it can be difficult to use the additional benefits they provide.
Is Medicare Part D mandatory for seniors?
Enrollment in Part D is generally voluntary, however, some people are required to be enrolled, and others should not enroll. People who have Medicare and who receive assistance under certain federal programs (Medicaid, Medicare Savings Programs, SSI or the Part D Low Income Subsidy) are required to enroll.
Can you go back to original Medicare from an advantage plan?
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
Why would someone not have Medicare Part D?
You may not need it if you have drug coverage from elsewhere that's “creditable” — meaning Medicare considers it to be of the same or better value than Part D. This coverage could come from an employer or union, retiree benefits, COBRA, Tricare or the Veterans Affairs health program.
Why is original Medicare better than Medicare Advantage?
Medicare Advantage plans typically require that you use care providers within a geographic service area, and once you get outside that area, you'll be covered for emergency care only. Original Medicare offers access to a national network of providers — no matter where you are in the U.S. Like to minimize risk.
What is the best Medicare plan that covers everything for seniors?
Original Medicare with Medigap likely offers the most comprehensive coverage, but it may also be the most costly. A person can consider their income and how much they are able to spend before choosing a Medicare plan. Original Medicare with Medigap also offers a lot of flexibility when choosing a doctor or specialist.
Do all hospitals accept Medicare Advantage plans?
While most hospitals do accept Original Medicare, there may be some that do not accept Medicare Advantage Plans. However, if you have a medical emergency while you're enrolled in a Medicare Advantage plan, you can seek care at any ER or hospital in the country.
What are the negatives of a Medicare Advantage plan?
- Problems With Switching Later.
- More Restrictions.
- Provider Network Limitations.
- Plans in Flux.
- Limitations on Extra Benefits.
- Overwhelming Choices.
- People Who Can't Afford or Can't Get Medigap.
- Healthy People With Healthy Emergency Funds.
What is the $2000 limit for Medicare Part D?
Thanks to the Inflation Reduction Act, in 2025 annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D.
Which company has the best Medicare Advantage plan?
- Best Overall, Best for Low Costs: Cigna.
- Also Great for Low Costs: Alignment Health.
- Best for Nationwide Coverage: Aetna.
- Best for Patient Experience, Best for Drug Coverage: Kaiser Permanente.
- Best for Special Needs Plans: Humana.
Why are hospitals refusing Medicare Advantage plans?
Health systems have cited delayed reimbursements, cumbersome prior authorization requirements and high rates of patient claim denials for their decisions to drop Medicare Advantage plans.
What are the top 5 medicare supplement plans?
💬 From our Nerds: What are the top five Medicare supplement plans? "Based on NerdWallet's Medigap rubric, I picked five best Medicare Supplement Insurance companies for 2025: AARP/UnitedHealthcare, Mutual of Omaha, State Farm, Anthem and Blue Cross Blue Shield.
Can I skip Medicare Part D?
If you don't sign up for a Part D plan when you are first eligible to do so, and you decide later you want to sign up, you will be required to pay a late enrollment penalty equal to 1% of the national average premium amount for every month you didn't have coverage as good as the standard Part D benefit.
Does AARP have Part D plans?
Medicare Part D plans help cover the cost of generic and brand-name prescription drugs. Available to AARP members and non-members. Plans and pricing are on the UnitedHealthcare website.
What is the new Medicare rule for 2025?
Medicare Part D cap of $2,000
Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications.
Why are doctors dropping Medicare Advantage?
Providers often argue that Medicare Advantage plans impose restrictions that can hinder patient care. Low reimbursement rates, complicated billing recesses and stringent pre-authorization requirements have pushed CFOs to their boiling point.
Are most people happy with Medicare Advantage?
Beneficiaries in Traditional Medicare and Medicare Advantage plans say they're largely happy, but have plenty of issues with each program. When Americans are asked what they think about Medicare, they generally rate the program highly.
Why is Humana losing Medicare Advantage plans?
To protect profits, Humana and its peers in MA slashed their plans for 2025, cutting benefits and exiting underperforming markets. Plans appear to have focused cuts around supplemental benefits like over-the-counter and flex cards, which give seniors funds to spend on eligible items.