Medicare Supplement

Dearborn Heights Medicare: why Medigap plus Part D is a two-step signup

DEARBORN HEIGHTS, Mich. — If you're pairing Original Medicare with a Medigap policy here in Wayne County, there's one detail that trips people up every year: Medigap does not cover prescription drugs. To get drug coverage, you need to add a separate stand-alone Part D plan — and the clock on that decision starts sooner than many people realize.

Medicare SupplementDearborn Heights, MI

This guide walks through how the three pieces fit together, and how to time your Part D enrollment so you don't get stuck with a late penalty for the rest of your life.

The three pieces, and what each one does

Think of Original Medicare, Medigap and Part D as three separate puzzle pieces.

Original Medicare is the federal program — Part A (hospital) and Part B (doctor and outpatient). It pays most of your medical bills, but it leaves you with deductibles and coinsurance, and it does not cap your yearly out-of-pocket costs on its own.

Medigap (also called Medicare Supplement Insurance) is a private policy that helps pay the out-of-pocket costs Original Medicare leaves behind, like coinsurance and copays. Medigap policies are standardized by letter (Plan G, Plan N and so on), and the benefits in each letter are the same no matter which insurer sells it.

Part D is a separate, stand-alone prescription drug plan sold by private insurers and regulated by Medicare. It covers most retail prescriptions you pick up at a pharmacy.

Here's the key point: a Medigap policy will not add drug coverage. That has been true since 2006, when Part D was created. If you want drug coverage alongside Medigap, you buy a Part D plan on top.

Why Medigap doesn't include drugs

Older Medigap policies sold before 2006 sometimes included limited drug coverage, but those plans are no longer sold. Today, Medigap policies are built to work alongside Part D, not replace it. That's why Medicare treats the two as separate decisions, with separate enrollment rules.

If you're on Original Medicare and you want full coverage — medical, hospital, and prescription — you generally need both pieces.

The Part D penalty, and how to avoid it

The Part D late enrollment penalty is permanent. If you go 63 days or more without "creditable" drug coverage after you're first eligible for Medicare, and then later sign up, Medicare adds a surcharge to your Part D premium — and keeps adding it for as long as you have Part D.

"Creditable" coverage means drug coverage that's expected to pay, on average, at least as much as a standard Part D plan. Common examples include some employer or union plans, VA benefits, or TRICARE. Your plan should send you a notice each year telling you whether it's creditable — keep that letter.

To stay out of penalty territory:

• Sign up for Part D during your Initial Enrollment Period — the 7-month window around your 65th birthday (or around your 25th month of disability benefits).
• If you have creditable drug coverage through work or a spouse's plan, you can delay Part D. But once that coverage ends, you have 63 days to enroll in a Part D plan.
• During the Annual Enrollment Period (Oct. 15 – Dec. 7), you can switch Part D plans for the following year.

If you missed your window and don't have creditable coverage, don't wait longer hoping it will fix itself — each month without coverage makes the eventual penalty larger.

What's new for 2026

A few program-level numbers matter when you're comparing drug plans this fall:

• The maximum Part D deductible is $615 in 2026. Plans can set a lower deductible, but not higher.
• There's a $2,100 annual out-of-pocket cap on covered drugs. Once you hit it, you pay $0 for covered prescriptions the rest of the year.
• The old "donut hole" coverage gap was eliminated starting in 2025, so Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying large amounts at the pharmacy counter. It's optional and free to opt into.
• Higher-income enrollees pay an IRMAA surcharge on top of their Part D premium; for a single filer in 2026, IRMAA begins above $109,000 in income.

A Dearborn Heights snapshot

Dearborn Heights is in Wayne County, and plan availability — including stand-alone Part D plans — is set at the county level by Medicare. That means your neighbor one street over sees the same list of plans you do. You can see the full lineup for your ZIP code using the Plan Finder at medicare.gov.

For free, unbiased help comparing options, Michigan's State Health Insurance Assistance Program (called MMAP here — the Michigan Medicare/Medicaid Assistance Program) offers one-on-one counseling at no cost. Counselors do not sell insurance.