Do I need Part D if I have a Medigap plan?
Yes. A Medigap policy pays medical bills, not drug bills, so you need a Part D plan too. Skipping it starts a late penalty that stays.
- A Medicare Supplement policy sold today does not pay for prescriptions. You need a separate Part D drug plan with it.
- Skip Part D and Medicare adds a late penalty that grows each month you go without drug coverage, and it stays.
- A supplement setup has three parts, Part A and Part B, the Medigap policy, and the drug plan.
Yes. A Medicare Supplement policy, also called Medigap, helps pay your share of Medicare's medical bills, and it does not cover prescriptions. So you also need a standalone Part D plan, a drug plan you buy on its own.
Why supplements have no drug coverage
Older Medigap policies, plans H, I and J sold before 2006, did include a drug benefit. When Part D started, drug coverage was taken out of every new supplement sold.
If you still hold one of those, it is worth a look. Part D has changed a lot, and the old benefit is unlikely to hold up well.
What happens if you skip Part D
Medicare charges a late penalty. It grows for every full month you go without creditable drug coverage, which means drug coverage at least as good as Part D.
Once you sign up, it is added to your drug plan bill and stays for as long as you have Part D. It counts even if you take no medicine at all. See whether you need Part D if you take nothing.
The complete supplement setup
- Medicare Part A and Part B, the hospital and doctor sides of Medicare.
- A Medigap policy, to cover your share of what Medicare does not pay.
- A standalone Part D plan for your prescriptions.
Three pieces, three premiums. A premium is the monthly bill for the coverage. Weigh that whole cost against a Medicare Advantage plan that bundles it all, or the comparison is not fair.
One advantage of this setup
Your drug plan stands on its own. Each October you can change Part D plans based only on your medicine, and your supplement and your doctors stay put. An Advantage plan ties the drug list and the doctor network together, so a worse drug list means giving up your doctors too.
Choosing the drug plan
Your supplement handles the medical side. Pick the Part D plan on your prescriptions alone.
- Write down every medicine you take, with the exact dose.
- Run the list through the Plan Finder at Medicare.gov, with your ZIP code and your pharmacy.
- Sort the results by total cost for the year, not by the monthly bill.
- Look for prior authorization (the plan must say yes before it pays), step therapy (you try a lower cost drug first) and quantity limits.
- Do this again each fall, because the plan drug list, called a formulary, changes every January.
See how to compare drug plans step by step.
If your income is limited
Extra Help is a program that lowers what you pay for Part D. It cuts the monthly bill, the deductible (the amount you pay yourself before the plan starts paying) and your copays, and it waives the late penalty.
Medicare Savings Programs can pay your Part B bill. Fewer people in South Texas claim these than qualify, and the limits are higher than most people expect. See how Extra Help works.
If you are leaning toward a supplement, line up the drug plan at the same time. Call our McAllen office at (956) 687 3334, or enter your ZIP code in the plan pricing box on this page.
Common follow-up questions
Does any Medigap plan include drugs?
Not one sold today. A few sold before 2006 did, and if you still hold one, check it against what Part D covers now.
Can I skip Part D if I take no medications?
You can, but the late penalty starts adding up and it does not go away. A low cost drug plan usually costs less over time.
Do I buy the supplement and the drug plan from the same company?
You can, but nothing requires it and there is no advantage. Judge each one on its own.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. There is no obligation to talk it through.
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Gerino Alejos
Licensed insurance agent · License 3128710 · NPN 18243381
Owner of McAllen Insurance Group, an independent agency on North 10th Street in McAllen. Works with clients across Hidalgo, Cameron and Starr counties on Medicare, Marketplace health, life and auto coverage. Se habla español.