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Medigap & Medicare drug coverage (Part D)

You can't join a Medicare Prescription Drug Plan and have a Medigap policy with drug coverage

If you have a Medigap policy with prescription drug coverage, this means you chose not to join a Medicare Prescription Drug Plan.

If your Medigap policy covers prescription drugs, you'll need to tell your Medigap insurance company if you join a Medicare Prescription Drug Plan. You'll need to do this so it can remove the prescription drug coverage from your Medigap policy and adjust your premium. Once the drug coverage is removed, you can't get that coverage back even though you didn't change Medigap policies.

Note

The same insurance company may offer Medigap policies and Medicare Prescription Drug Plans.

If you join a Medigap policy and a Medicare drug plan offered by the same company, you may need to make 2 separate premium payments for your coverage. Contact your insurance company for more details.

Your Medigap company must send you a notice each year telling you if the prescription drug coverage in your Medigap policy is creditable. Keep these notices in case you decide later to join a Medicare drug plan.

Medigap policy with creditable drug coverage

If you have a Medigap policy that includes creditable prescription drug coverage, you can only join a Medicare Prescription Drug Plan between October 15–December 7, unless you lose your Medigap policy (for example, if it isn't guaranteed renewable, and your company cancels it). In that case, you can join a Medicare drug plan at the time you lose your Medigap policy.

Medigap policy without creditable drug coverage

You'll probably have to pay a late enrollment penalty if both of these apply:

  • You have a Medigap policy that doesn't include creditable prescription drug coverage.
  • You decide to join a Medicare Prescription Drug Plan later.

This means you'll pay a higher monthly premium than if you joined when you were first eligible.

Your penalty amount increases for each month that you wait to join a Medicare drug plan. And, in general, you'll have to pay this penalty for as long as you have a Medicare drug plan. Learn more about the Part D late enrollment penalty.