Medicare Prescription Drug Coverage and Medigap
Supplemental Medicare Plans and Medicare Part D Coverage Policies
Oct 16, 2009
According to Medicare.gov's "Choosing a Medigap Policy," if you purchased a Medigap insurance supplemental Medicare plan before December 31, 2005, it may have prescription drug coverage included. Current Medicare (Part D) also provides prescription drug coverage, so if your already-purchased Medigap supplemental insurance policy contains prescription drug coverage as well, then you did not join the Medicare Prescription Drug Plan as a health care option.
Since everyone's prescription drug needs change, it is always important to review your policy's prescription drug coverage policies. If you find that Medicare (Part D) offers prescription drug coverage which fits your needs better than your current supplemental Medicare plan, it is still possible to enroll in Medicare's prescription drug plan. Remember that "It is a good idea to review your coverage each fall, because you can join a Medicare Prescription Drug Plan between November 15—December 31 each year."
Reasons to Switch from a Medigap Supplemental Plan to Medicare (Part D)
In Medigap insurance supplemental plans, policy owners must both pay the entire premium for prescription drug benefits and be subjected to maximum limits which the policy will pay out. With Medicare (Part D), this is not the case, as Medicare Prescription Drug Plans pay for large portions of prescription drug coverage (while having a monthly premium) with no yearly maximum amounts.
It's important to keep in mind that a "Medicare Prescription Drug Plan might only cover certain prescription drugs (on its “formulary” or “drug list”)...Check whether or not your current prescription drugs are on the Medicare Prescription Drug Plan’s list of covered prescription drugs before you join. If your Medigap premium, or your prescription drug needs, were very low when you had your first chance to join a Medicare Prescription Drug Plan, your Medigap prescription drug coverage may have met your needs. However, if your Medigap premium, or the amount of prescription drugs you use, has increased recently, a Medicare Prescription Drug Plan might now be a better" health care option for you.
Joining a Medicare Prescription Drug Plan from Supplemental Medicare Plans
There is no late enrollment fee for joining a Medicare Prescription Drug plan, so long as you drop your Medigap insurance supplemental plan first. Remember that enrollment into a Medicare Prescription Drug plan from a private insurer (such as Humana or Aetna) is only open from November 15—December 31. (There is an exception in cases where you lose your supplemental Medicare plan, and thus need another health care option).
Due to the above dates (during which it is possible to enroll for a Medicare Prescription Drug Plan), it is essential that careful planning goes into changing your health care option, meaning if you decide to drop your Medigap insurance supplemental plan, it is important to do so at a time in which you will be eligible to enroll in the fall. (Note, this does not apply for those interested in merely swapping insurance supplemental Medicare plans, in which case a careful comparison of the costs for Medigap insurance supplemental plans should be done).
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