--- title: What is prescription drug coverage? What’s covered and what’s not? description: Prescription drug coverage helps reduce the cost of medications prescribed by healthcare providers. It can be part of a health insurance plan, purchased separately (like Medicare Part D), or added as a supplemental benefit. image: https://blog.massgeneralbrighamhealthplan.org/hubfs/iStock-2229564737.jpg --- [![MGB_Health_Plan_horiz_rgb-1](https://blog.massgeneralbrighamhealthplan.org/hubfs/Mass%20General%20Brigham%20Health%20Plan/Logos/MGB_Health_Plan_horiz_rgb-1.svg)](https://www.massgeneralbrighamhealthplan.org/) ![](https://blog.massgeneralbrighamhealthplan.org/hubfs/iStock-2229564737.jpg) # What is prescription drug coverage? What’s covered and what’s not? Published by [Michael Buttimer](https://blog.massgeneralbrighamhealthplan.org/author/michael-buttimer) on July 15, 2026 Prescription drug coverage helps reduce the cost of medications prescribed by healthcare providers. It can be part of a health insurance plan, purchased separately (like Medicare Part D), or added as a supplemental benefit. Prescription coverage makes medications more affordable for members, especially those managing chronic or acute illnesses. Under the Affordable Care Act (ACA), you can get certain drugs at no cost if they're covered by your plan and you have a prescription. Check your plan details for a list of covered prescriptions. **Key elements of prescription drug coverage** Prescription drug coverage consists of several important components that determine how much you pay and which medications are available to you. Understanding these elements can help you make informed decisions about your health plan and prescription costs. **Medicare Part D prescription drug coverage** Medicare Part D is for individuals who are on or eligible for Medicare—helping pay for brand-name and generic drugs. It's an optional benefit offered by approved private insurers. Even if you don't take prescriptions now, enrolling early prevents late penalties. See below for more details on the three types of enrollment: - Initial Enrollment Period (IEP): Your unique 7-month window to sign up for Medicare when you first become eligible. It begins 3 months before your 65th birthday, includes your birth month, and ends 3 months after. - Annual Enrollment Period (AEP): Also known as Open Enrollment, this runs every year from October 15 to December 7. During this time, anyone with Medicare can change, drop, or add Medicare Advantage or Prescription Drug Plans (Part D), with new coverage starting January 1. - Special Enrollment Period (SEP): A temporary window triggered by specific, life-changing events (e.g., moving to a new area, losing employer-sponsored health coverage, or qualifying for Extra Help). An SEP allows you to make changes to your plan outside of standard dates. Some Medicare Advantage plans include Part D as part of their coverage. Learn more about Rx benefits for our [Medicare Advantage plans](https://massgeneralbrighamadvantage.org/plans/rx-information). **For Mass General Brigham Health Plan members** We work with **Rx Savings Solutions (RxSS)** to help you and your covered family members save money on prescriptions. This free service is linked to your health plan, so everything is personalized based on your medications. You can access RxSS through the Mass General Brigham Health Plan [Member Portal](https://member.massgeneralbrighamhealthplan.org/Authentication/LogIn?ReturnUrl=%2F). Here's how it works: 1. **Review Rx options**: Your online RxSS account shows what lower-cost prescriptions may be available under your plan and lets you compare prices. 2. **Easily switch**: If you choose to make a change, RxSS will consult with your doctor and handle the approval and other details, so you can switch and save with ease. 3. **Get saving alerts**: RxSS will notify you via email, text, or mail when you can save money on prescriptions you’re currently taking, or new ones you’re prescribed in the future. Members can call **800-268-4476** or visit [Member.MGBHP.org/singlesignon/rxss](https://member.massgeneralbrighamhealthplan.org/singlesignon/rxss) to get started. If you don’t have a Member Portal account, visit the [Member Portal](https://member.massgeneralbrighamhealthplan.org/Authentication/LogIn?ReturnUrl=%2F) sign-on page and select **Not Registered Yet**. If you have questions, please call RxSS Pharmacy Support at **800-268-4476** (for TTY users: 800-877-8973) Monday through Friday from 8 a.m. to 9 p.m. ET. The RxSS team of certified pharmacy technicians is ready to help explain all your options. [![Option 2](https://blog.massgeneralbrighamhealthplan.org/hs-fs/hubfs/Option%202.png?width=3000&height=1250&name=Option%202.png)](https://blog.massgeneralbrighamhealthplan.org/introducing-our-new-wellness-hub) [Back to Blog](https://blog.massgeneralbrighamhealthplan.org) ## Related articles ## [What role does health insurance play in cancer care?](https://blog.massgeneralbrighamhealthplan.org/what-role-does-health-insurance-play-in-cancer-care) Just as cancer care is specific to the patient, health insurance is also specific to the member.... 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