Medicare Supplement (Medigap) insurance policies do not provide prescription drug coverage. If you have a Medicare Supplement plan, you can still get drug coverage through a separate prescription drug plan through companies that offer drug plans. Prescription drug plans are also known as Medicare Part D.
New for 2025: $2,000 Annual Cap On Out-of-pocket Prescription Costs
In 2024, once your out-of-pocket spending on prescriptions exceeds $3,300, you qualify for Medicare’s “catastrophic coverage” and won’t have to pay anything for your covered Part D drugs for the remainder of the year. (In 2023, when you reached catastrophic coverage, you still had to pay 5% of your drug costs.)
However, a new rule goes into effect for 2025. Individuals with Part D plans will be limited to $2,000 in out-of-pocket costs, because of the Inflation Reduction Act of 2022.
Insurance Companies Are Making Cuts and Adjustments
How To Get Medicare Part D Prescription Drug Coverage
If you are on a Medicare Supplement plan, you can enroll in a stand-alone Medicare Part D prescription drug plan. Another option is to move to a Medicare Advantage plan. Although over 80% of Medicare Advantage plans have drug coverage included, most Seniors are not willing to give up the freedom and autonomy they have with a Medigap plan to go onto a Medicare Advantage plan with all of its restrictions. You cannot be enrolled in a Medicare supplement and a Medicare Advantage plan at the same time.
There are only certain situations under which you can enroll in a Medicare Part D plan. This includes when turning 65 or going onto Part B of Medicare for the first time. In both cases, you can enroll three months before or three months after the month that your Part B coverage begins. You can also enroll or change plans each year during the Annual Election Period (AEP). That period runs from October 15 through December 7. AEP restrictions apply to Part D or Medicare Advantage plans only. With your Medigap plan, you can make changes to your plan at any time of year.
Enrolling in Standalone Medicare Part D Prescription Drug Plans
There are a lot of prescription drug plans to choose from, and you don’t want to shop on premium alone. If you need a standalone Part D prescription drug plan, you can find a plan on our website. You can enter your current drugs to see what your total out-of-pocket costs will be.
We do not offer every company through our DrugPlanInfo.com website. This is intentional. We have selected the companies that we work with and we recommend available for comparison. If you want to see every possible option for drug coverage, you can visit the Medicare.gov website. You can also call Medicare at 1-800-MEDICARE (800-633-4227).
Compare recommended drug plans in your area – CLICK HERE
Simply going with the lowest-priced plan is not a good idea. There are premiums, deductibles, and co-pays on each drug that should all be considered. By using the link that I provided above, you can enter your current drugs and it will check all plans for those premiums, deductibles, and co-pays to see which will be the cheapest based on your total out-of-pocket costs.
You may find a plan with a low premium that has a very high co-pay for a drug you currently take. But maybe another plan with a higher premium has a lower co-pay each time you get your prescription filled. This is why it is important not to shop Medicare Part D drug plans on premium cost alone.
The advice on this website is informational.
Stanley Keith Murray is an independent agent and the founder of Integrity Senior Inc. He has 30 years of experience working with Seniors to meet their insurance and financial needs.