Do I need Part D if I have a Medigap plan?
Yes. Supplements sold today include no drug coverage, and skipping Part D starts a permanent penalty.
Yes. Medicare Supplement policies sold today do not include prescription drug coverage. If you go with a supplement, you need a standalone Part D plan alongside it.
Why supplements have no drug coverage
Older Medigap policies, plans H, I and J sold before 2006, did include drug benefits. When Part D was created, drug coverage was removed from all newly sold supplements.
If you somehow still hold one of those older policies with drug coverage, that is worth reviewing, because Part D has changed considerably and the old benefit is unlikely to compare well.
What happens if you skip Part D
A penalty accrues for every full month you go without creditable drug coverage, roughly 1 percent of a national base premium per month, and it attaches permanently once you enroll.
It applies whether or not you take any medications. See whether you need Part D if you take nothing.
The complete supplement setup
- Medicare Part A and Part B
- A Medigap policy to cover your share of Medicare costs
- A standalone Part D plan for prescriptions
Three pieces, three premiums, and that is the full picture. When comparing against a Medicare Advantage plan that bundles everything, compare all three or the comparison is not honest.
One genuine advantage of this setup
Your drug plan is independent of everything else. You can change Part D plans every October based purely on your medications, without touching your supplement or your doctors. With a bundled Advantage plan, the drug coverage and the medical network come as a package, so a worsening formulary means choosing between them.
Choosing the drug plan
Since your supplement handles the medical side, optimize the Part D plan entirely for your prescriptions.
- List every medication with exact dosage.
- Run them through the Plan Finder at Medicare.gov with your ZIP and your pharmacy.
- Sort by total estimated annual cost, not premium.
- Check for prior authorization, step therapy and quantity limits.
- Redo this every fall, because formularies change every January.
See the full comparison method.
If your income is limited
Extra Help reduces Part D premiums, deductibles and copays substantially, and waives the late enrollment penalty. Medicare Savings Programs can pay your Part B premium outright.
Both are widely underclaimed in this area and the limits are higher than most people assume. See Extra Help.
Common follow-up questions
Does any Medigap plan include drugs?
Not any sold today. A few pre-2006 policies did, and those are worth reviewing against modern Part D coverage.
Can I skip Part D if I take no medications?
You can, but a permanent penalty accrues. A low cost plan is almost always cheaper than the surcharge later.
Do I buy the supplement and the drug plan from the same company?
You can, but there is no requirement or advantage. Choose each on its own merits.
Want this looked at properly?
We are an independent agency in McAllen serving Hidalgo, Cameron and Starr counties. No cost to talk it through.
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What is Medigap (Medicare Supplement insurance)?
Medigap