Prescription Drug Coverage with Medigap

Does Medigap Cover Prescriptions?

No. Medigap policies don't include prescription drug coverage. You need a separate Medicare Part D plan for drug coverage.

Why You Need Part D

Without drug coverage:

• You pay full retail price for medications
• You'll face late enrollment penalties if you wait to enroll
• Unexpected prescription needs can cost thousands

When to Enroll in Part D

Enroll during your Initial Enrollment Period (same 7-month window when you first get Medicare Part B). If you miss this window, you can only enroll during the Annual Enrollment Period (October 15 - December 7).

Part D Late Enrollment Penalty

If you don't have creditable drug coverage and wait to enroll, you'll pay a penalty for as long as you have Part D:

Penalty = 1% of the national base premium × number of months delayed

Example: If you wait 24 months, your penalty is about $7-8 per month added to your premium forever.

How to Choose a Part D Plan

1. Make a list of all your prescriptions
2. Use Medicare's Plan Finder at medicare.gov
3. Enter your medications
4. Compare total estimated annual costs (not just premiums)
5. Check if your pharmacy is in network
6. Enroll in the plan with lowest total cost for YOUR medications

Part D Costs in 2026

• Premiums: Vary by plan ($0-$100+/month)
• Deductible: Up to $590 (many plans have lower or $0 deductibles)
• Out-of-Pocket Maximum: $2,000 (new for 2026!)

Comparing Medigap + Part D vs. Medicare Advantage

Medigap + Part D:

• Two separate plans and premiums
• Maximum flexibility in choosing doctors
• More predictable costs overall

Medicare Advantage with Drug Coverage:

• One plan, one premium
• Network restrictions
• Variable costs depending on usage