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Medigap plan changes are limited, but 11 states offer Medigap enrollees special enrollment – and five do it with a 'birthday rule.'
Nearly three-quarters of readers feel overwhelmed by Part D options
We asked how confident our readers were with comparison shopping for a Medicare Part D plan during the 2022 Medicare Annual Enrollment Period. Here's what we learned from more than 350 survey responses.
Four signs you need to change your Medicare Part D coverage
Reasons to consider a change to your Medicare prescription drug coverage may include high premiums, changes to your prescriptions or your plan's formulary, and your access to in-network pharmacies.
8 ways to cut your prescription drug costs
But prescription drugs – and drug coverage – can be less expensive if you're willing to do a little research and to reach out for help. Here are eight strategies that will empower you to take control of your drug coverage and your medication costs.
Is there a best time to enroll in a Medicare supplement plan?
The best time to enroll in a Medicare supplement plan is during your Medigap open enrollment period, a six-month window that begins on the first of the month you're enrolled in Medicare Part B and are 65 or older.
Medigap – Medicare supplement insurance
Medigap plans limit Medicare enrollees’ out-of-pocket exposure, covering coinsurance and deductibles – as well as any medical expenses incurred during travel outside the United States and its territories.
Q: Do Medicare supplement plans include prescription drug coverage?
A: Modern Medigap plans do not include prescription drug benefits. Instead, Medicare offers prescription drug coverage under Part D. Medicare enrollees can get prescription coverage either by switching to a Medicare Advantage plan (most of them include prescription coverage) or by purchasing a stand-alone Medicare Part D plan (PDP) to go along with Original Medicare.
However, if you purchased a Medigap policy prior to January 1, 2006 and still have the same plan, it may include prescription drug coverage. Plans H, I, and J included limited prescription coverage for beneficiaries who purchased them prior to 2006, although those plans are no longer sold. If you’re in this situation and you want to join a PDP, you must drop the prescription drug coverage from your Medigap since you can’t have two separate prescription drug coverage policies at the same time.
Although there was a guaranteed issue period for people with pre-2006 Medigap plans to switch to a new Medigap plan and a PDP, if you’re doing that now you’ll probably have to go through medical underwriting for the Medigap plan (unless you qualify for a guaranteed issue right).
The good news if you’re in this situation is that you should be allowed to drop just your Medigap prescription coverage and keep the other coverage provided by your current Medigap plan. But you’ll have to pay a late enrollment penalty for Part D, if the Medigap plan has been providing your only prescription drug coverage.
Medigap prescription drug coverage is not “creditable coverage” that allows you to delay Part D enrollment. You’ll owe a penalty if you didn’t enroll in Part D when you were first eligible, and either didn’t have prescription coverage while your enrollment was delayed, or your coverage wasn’t considered creditable. The penalty is 12% for each year that enrollment was delayed and is calculated in one-month increments. It is based on the nationwide base Part D premium, so your penalty won’t be higher if you enroll in a more expensive plan.
This booklet has more details about the switch from pre-2006 Medigap plans on page 178.