Medicare Supplement

Medigap Won't Cover Your Drugs — Here's How to Add Part D

# Medigap Won't Cover Your Drugs — Here's How to Add Part…

LONG BEACH, Calif. — If you're leaning toward Original Medicare with a Medigap policy, there's one gap that trips up a lot of people: Medigap doesn't pay for prescription drugs. To get drug coverage, you pair it with a stand-alone Medicare Part D plan — and the timing matters, because waiting too long can lock in a late enrollment penalty that follows you for life.

Here's how the pieces fit together, and how to line up the dates so you don't pay more than you have to.

How the three pieces fit together

Original Medicare is the federal program itself — Part A (hospital) and Part B (doctor and outpatient). It pays most of your medical bills, but leaves deductibles and coinsurance for you.

A Medigap policy (also called a Medicare Supplement) is private insurance that helps pay those leftover costs. Depending on the letter plan you choose, it can cover the Part A deductible, Part B coinsurance, and more. What it does not cover is prescription drugs from the pharmacy.

A stand-alone Part D plan is the third piece. It's separate private drug coverage that works alongside Original Medicare and your Medigap policy. You pay a monthly premium to the Part D plan, and it helps cover medications on its formulary.

This combination — Original Medicare + Medigap + Part D — is one of two main paths people take. The other is a Medicare Advantage plan, which usually bundles drug coverage in but doesn't work with Medigap.

Why Medigap alone leaves a drug gap

Older Medigap policies sold before 2006 sometimes included limited drug coverage, but those have been phased out. Every Medigap policy sold today is medical-only. That's not a loophole — it's how the program is designed.

So if you take even one regular prescription, going without Part D means paying full retail price at the pharmacy. And it means the Part D late penalty clock is ticking.

The timing that keeps you out of the penalty

The Part D late enrollment penalty is a permanent surcharge added to your monthly drug plan premium if you go 63 days or longer without "creditable" drug coverage after you're first eligible for Medicare.

"Creditable" means coverage that's expected to pay, on average, at least as much as standard Part D — often an employer or union plan. If you have that, you're fine to delay Part D. If you don't, you generally want to enroll in a Part D plan during your Initial Enrollment Period, which is the 7-month window around your 65th birthday.

The penalty is calculated as 1% of the national base beneficiary premium for every full month you were eligible but uncovered, and it's added to your premium for as long as you have Part D.

A few timing points worth knowing:

• Your Initial Enrollment Period runs from 3 months before the month you turn 65 through 3 months after.
• If you're delaying Part B because you have job-based coverage, ask your benefits administrator whether the drug portion is creditable, and get that in writing.
• The Annual Enrollment Period (Oct. 15 – Dec. 7) is when you can join, switch, or drop a Part D plan for the coming year.

What Part D looks like in 2026

A few program-level numbers apply everywhere, including Long Beach:

• The Part D maximum deductible is $615.
• Once your out-of-pocket spending on covered drugs hits $2,100, you pay $0 for covered drugs the rest of the year.
• The old "donut hole" coverage gap is gone as of 2025 — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan is an optional tool that lets you spread your drug costs across the year in monthly installments instead of paying big amounts at the pharmacy counter.
• Higher earners pay an income-related surcharge (IRMAA) on top of the Part D premium; for a single filer in 2026, IRMAA starts above $109,000 in income.

Choosing a Part D plan in Los Angeles County

Long Beach is in Los Angeles County, where a number of stand-alone Part D plans are offered by different insurers. Plans differ on premium, deductible, which pharmacies are in-network, and — most importantly — which drugs are on the formulary and at what tier.

The most useful thing you can do is make a list of your current prescriptions (name, dose, and how often you take them) and run it through the Plan Finder at medicare.gov. That tool estimates your total yearly cost under each available plan based on your actual drugs, not averages.

If comparing plans on your own feels like a lot, California's SHIP program — called HICAP here — offers free, unbiased counseling. They don't sell insurance.