by Russell Noga | Updated January 31st, 2024
If you’re signing up for Medicare supplement plans with a healthcare provider, you’ll need to choose the right plan to suit your healthcare requirements.
What is the best Medicare supplement for prescription drugs? How do you enroll in these plans, and what are the benefits?
Unfortunately, Medicare supplement plans (Medigap) don’t cover prescription drugs.
Medicare Parts A & B only cover expenses involving hospitalization and medical care. Medicare Part D prescription drug plans offer coverage for prescriptions.
Since Medigap policies don’t cover Part D out-of-pocket expenses, you don’t get any benefits for Part D out-of-pocket expenses.
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What Benefits Do You Get with Medicare Supplement Plans?
Medicare supplement plans come in a range of ten options. Each has a set scale of benefits regulated by the Federal government. The CMS is responsible for ensuring all Medigap providers offer the same benefits in each of the ten Medigap plans, bringing consistency to the industry.
All Medigap plans offer the following benefits.
- Part A coinsurance and hospital costs for up to 365 days after using Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
Plans F*, G, and N offer additional Medicare Parts A & B benefits.
- Part A deductible.
- Part B excess charges (Plan N doesn’t cover these charges).
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- Unlimited coverage for all out-of-pocket costs.
Medigap plans don’t cover the cost of prescription medications. The plans also don’t provide coverage for private-duty nursing, long-term stays at nursing homes, or preventative treatments involved with podiatry, chiropractic, physiotherapy, acupuncture, and other similar services.
Medigap plans don’t cover vision, hearing, or dental services. However, some providers offer add-on plans covering these expenses. Or the provider might offer discounted rates on hearing, vision, and dental services through their partner provider networks.
*Plan F is available to individuals eligible for Medicare before January 1, 2020. If you’re eligible for Medicare after this date, call our agents to assist you with choosing the best plan for your healthcare needs.
What Is the Best Medicare Supplement for Prescription Drugs?
As mentioned, no Medigap plan provides coverage for prescription medications. If you want drug coverage, you need to go with a Part D policy. Medicare beneficiaries have an average of 54 Medicare plans offering Part D coverage and 766 Medicare Part D stand-alone prescription drug plans.
What are the Benefits of Medicare Part D?
Every Part D plan consists of a list of covered medications, known as the “formulary.” If the drug you need isn’t registered on the formulary, you’ll have to request an exemption from the provider. Or you’ll have to pay for it out-of-pocket or register an appeal with the provider for coverage.
Drug categories are groups of medications used in the treatment of the same symptoms or those that have the same medicinal effect on the body when administered. All Part D plans must include a minimum of two medications in most categories. They must also cover all medications in the following categories.
- Anticonvulsive for seizures.
- HIV/AIDS drugs.
- Immunosuppressant medications.
- Anticancer drugs (unless otherwise covered by Original Medicare Part B).
All Part D policies must cover vaccines, except for vaccine products covered by Original Medicare Part B. The law may explicitly exclude certain drugs from Medicare coverage. These medications include those used to treat weight problems and OTC medications. For certain medicines or specific circumstances, your prescriptions may not have coverage under Original Medicare Parts A or B.
Where Do You Buy Medicare Part D Policies?
Medicare Part D policies are available from the same healthcare insurers offering Medigap plans. There are hundreds of options for stand-alone Part D plans, each providing a different coverage level. You can buy a Part D policy direct from the insurer, or you can use a Medicare supplement agent to assist you with handling the enrollment process into these plans.
Using an agent is a good call because they have experience dealing with healthcare insurers. They can assist you with finding the right Part D policy to suit your individual prescription drug requirements. Dealing with an insurer yourself can be a frustrating and complicated process, so let an agent guide you through it.
What Does a Medicare Part D Policy Cost?
The cost of a stand-alone Part D policy varies by plan and provider. The national average Part D premium is $32.74. The average range for monthly Part D premiums from the 16 national Part D providers is between $7 to $99.
However, there are income thresholds accounting for the cost of your monthly premium. Individuals earning over $96,000 pay a higher premium for Part D policies.
The annual deductible for Part D policies varies, depending on the plan. Unless you have “extra help,” your deductible cannot be over $505. Those individuals qualifying for “Full extra help” pay a $0 deductible for Part D policies.
Individuals with “partial extra help” have a $104 deductible for Part D policies or might have to pay the plan’s standard deductible, whichever is the lower fee. For most Part D plans, if you spend $4,660 in annual total drug costs, you reach the coverage threshold.
During the coverage gap, you’ll pay 25% of the cost of your prescription medications. All Part D plans offer catastrophic coverage after spending $7,400 out-of-pocket. During the period while you’re bridging the gap, beneficiaries pay 5% of the cost for your prescriptions, or $10.35 for brand-name medications and $4.15 for generics.
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Frequently Asked Questions
What is Medicare Supplement insurance?
Medicare Supplement insurance, also known as Medigap, is private health insurance that helps cover the gaps in Original Medicare. It can help pay for out-of-pocket costs such as deductibles, coinsurance, and copayments.
Call Us for Advice on Medicare Supplement Plans for Prescription Drugs
If you need Part D coverage for your prescriptions, call our team at 1-888-891-0229. We offer free advice and consultations on Medigap plans and Part D policies.
Our team will get you the best rates on Medigap and Part D from leading providers in your state. If you can’t call right now, leave your contact details on our web form, and we’ll get an agent to call you back.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.