Provision of qualified prescription drug coverage through enrollment in plans

Subject to the succeeding provisions of this part, each part D eligible individual (as defined in paragraph (3)(A)) is entitled to obtain qualified prescription drug coverage (described in section 1395w–102(a) of this title ) as follows:

(A) Fee-for-service enrollees may receive coverage through a prescription drug plan A part D eligible individual who is not enrolled in an MA plan may obtain qualified prescription drug coverage through enrollment in a prescription drug plan (as defined in section 1395w–151(a)(14) of this title ).

(B) Medicare Advantage enrollees (i) Enrollees in a plan providing qualified prescription drug coverage receive coverage through the plan A part D eligible individual who is enrolled in an MA–PD plan obtains such coverage through such plan. (ii) Limitation on enrollment of MA plan enrollees in prescription drug plans Except as provided in clauses (iii) and (iv), a part D eligible individual who is enrolled in an MA plan may not enroll in a prescription drug plan under this part. (iii) Private fee-for-service enrollees in MA plans not providing qualified prescription drug coverage permitted to enroll in a prescription drug plan A part D eligible individual who is enrolled in an MA private fee-for-service plan (as defined in section 1395w–28(b)(2) of this title ) that does not provide qualified prescription drug coverage may obtain qualified prescription drug coverage through enrollment in a prescription drug plan. (iv) Enrollees in MSA plans permitted to enroll in a prescription drug plan A part D eligible individual who is enrolled in an MSA plan (as defined in section 1395w–28(b)(3) of this title ) may obtain qualified prescription drug coverage through enrollment in a prescription drug plan.

For purposes of this part:

(A) Part D eligible individual The term “part D eligible individual” means an individual who is entitled to benefits under part A or enrolled under part B (but not including an individual enrolled solely for coverage of immunosuppressive drugs under section 1395 o (b) of this title).

(B) MA plan The term “MA plan” has the meaning given such term in section 1395w–28(b)(1) of this title .

(C) MA–PD plan The term “MA–PD plan” means an MA plan that provides qualified prescription drug coverage.