Do Medicare Supplement Plans Cover Prescription Drugs?

No, Medicare Supplement plans typically do not cover prescription drugs.

Medigap plans help pay for the “gaps” in Original Medicare coverage, such as copayments, coinsurance, and deductibles. However, Medigap coverage does not extend to prescription drugs.

For Medicare drug coverage, beneficiaries often enroll in a separate Medicare Prescription Drug Plan (Part D), specifically designed to help manage the costs of prescription medications.

What Is Medicare Part D?

Medicare Part D is a program that helps beneficiaries cover the cost of prescription drugs. It’s offered by private insurance companies approved by Medicare, and it’s designed to help individuals who have considerable medication needs.

In addition to providing coverage for medications, Part D helps with preventive care services.

Each plan will vary in the types of medications covered, so it’s important to consider your specific drug needs when shopping for a Part D plan. Some plans may cover generic medications, while others may cover brand-name drugs.

Additionally, certain plans may also provide coverage for specific specialty medications.

What Drug Coverage Does Part D Provide?

The specific medications covered can vary from plan to plan as each Part D plan has its own list of covered drugs, known as a formulary.

Here are some general drug categories typically covered under Part D plans:

• Antidepressants include medications used to treat depression, anxiety disorders, and some chronic pain conditions.
• Antipsychotics are used for conditions such as schizophrenia and certain stages of bipolar disorder.
• Immunosuppressants are typically covered if prescribed to prevent organ rejection after a transplant.
• Anticancer Drugs are used to treat various forms of cancer.
• Antiretrovirals are drugs used in the treatment of HIV/AIDS.

Remember, the drugs covered will depend on the specific Part D plan, and it’s always recommended to check with the plan provider or Medicare for the most current and accurate information.

Can I Get a Medicare Supplement Plan and a Prescription Drug Plan?

Yes, you can. While Medicare Supplement plans do not provide prescription drug coverage, you can separately enroll in a Medicare Prescription Drug Plan (Part D) to get this coverage.

This allows you to complement your existing Medigap benefits with a Part D plan to help manage the costs of your prescription medications.

How Much Does Part D Cost?

The cost of Part D can vary based on the plan and prescribed drugs. However, you can anticipate certain expected costs:

• Monthly Premium: Most Part D plans require a monthly premium, typically between $15 and $100.
• Deductible: Some Part D plans have a yearly deductible that you must pay out-of-pocket for prescriptions before your plan starts covering them. In 2024, the maximum deductible is $545.
• Copayments/Coinsurance: After meeting your deductible, you’ll usually pay a fixed copayment or a percentage of the cost as coinsurance for each prescription.

How Do I Enroll In Part D?

Enrolling in Medicare Part D is a straightforward process. Here’s a step-by-step guide:

1. Determine your eligibility: You are eligible to enroll in Part D if you have either Medicare Part A or Part B.
2. Choose a plan: Review available Part D plans in your area and choose one that best suits your prescription drug needs. You can use the Medicare Plan Finder tool to assist with this process.
3. Enroll in your chosen plan: You can enroll in your chosen Part D plan online, over the phone, or by filling out and mailing an enrollment form to the plan provider.
4. Wait for confirmation: Once you’ve submitted your enrollment form, the plan provider will process your application and send you a confirmation letter. This letter will contain your plan membership ID, which you’ll need to fill prescriptions.

Remember, enrollment in Part D is not automatic. You must manually enroll during an eligible enrollment period. You could face a late enrollment penalty if you miss these periods unless you qualify for a Special Enrollment Period.

Bottom Line

Medicare Supplement plans don’t cover prescription drugs but can be combined with a Medicare Prescription Drug Plan (Part D), covering a broad range of medications.

Part D plans vary in cost and coverage level, so it’s important to compare different plans or consult a licensed insurance agent before enrolling.

Sources: Medicare.gov | CMS.gov | How Medigap Works | BCBS

FAQs

Does a Medicare Advantage plan cover prescription drugs?

Many Medicare Advantage Plans (Part C) include Part D drug coverage.

When do I enroll in Part D?

You can enroll during your Initial Enrollment Period, Annual Enrollment Period, or a Special Enrollment Period.