Medicare Supplement

Cherry Hill readers: your Medigap policy won't pay for prescriptions — here's the Part D fix

CHERRY HILL, N.J. — If you are pairing Original Medicare with a Medigap policy here in Camden County, there is one gap the supplement will not close: your prescriptions at the pharmacy counter. Medigap policies sold today do not include drug coverage, so most people who choose this path also enroll in a stand-alone Medicare Part D plan. Getting the timing right is what keeps you out of a lifelong late-enrollment penalty.

Medicare SupplementCherry Hill, NJ

How the three pieces fit together

Think of Original Medicare, Medigap and Part D as three pieces that snap 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 behind, and it does not cover most outpatient prescriptions you pick up at a pharmacy.

A Medigap policy (also called Medicare Supplement Insurance) is sold by a private insurer and helps pay the out-of-pocket costs Original Medicare leaves behind, like the Part B coinsurance. It does not add drug coverage. That has been true for every new Medigap policy since 2006.

A stand-alone Part D plan is the separate prescription drug plan you buy from a private insurer to cover medications. Cherry Hill sits in Camden County, where a number of stand-alone Part D plans are offered each year. You can compare them on medicare.gov by entering your ZIP code and your drug list.

Why Medigap and Part D are bought separately

Medigap and Part D are two different products, with different rules, sold under different parts of federal law. Medigap fills in gaps in Parts A and B. Part D is its own benefit created by Congress in 2003. That is why you sign up for each one on its own and pay a separate premium for each.

One important note: if you choose a Medicare Advantage plan (Part C) instead of Original Medicare, you cannot also use a Medigap policy. Most Advantage plans include drug coverage built in. The Medigap-plus-Part-D route is for people who stay with Original Medicare.

The timing that keeps you out of the Part D penalty

The Part D late-enrollment penalty is a permanent charge added to your monthly drug premium if you go without creditable drug coverage for 63 days or more after you were first eligible for Part D. "Creditable" means coverage that is at least as good as standard Part D — for example, some employer or union retiree plans qualify.

Two rules will keep you clear:

• Enroll in a Part D plan during your Initial Enrollment Period, the seven-month window around your 65th birthday, unless you have creditable coverage from somewhere else.
• If you do have other creditable coverage and later lose it, sign up for Part D within 63 days.

The penalty is calculated by multiplying 1% of the "national base beneficiary premium" by the number of full months you were uncovered, and it is added to your premium for as long as you have Part D. It does not go away.

What Part D looks like in 2026

A few program-level numbers are worth knowing before you shop:

• The maximum Part D deductible is $615 in 2026. Plans can charge less, but not more.
• Once your out-of-pocket spending on covered drugs hits $2,100, you pay $0 for covered drugs for the rest of the year.
• The old "donut hole" coverage gap was eliminated in 2025. Part D now has three phases: deductible, initial coverage, and catastrophic.
• The Medicare Prescription Payment Plan lets you spread your drug costs across the calendar year in monthly installments instead of paying big amounts at the pharmacy.
• Higher-income enrollees pay an IRMAA surcharge on top of their Part D premium. For 2026, IRMAA starts above $109,000 in income for a single filer (based on your tax return from two years earlier).

Enrollment windows to circle on the calendar

• Initial Enrollment Period: the seven months around your 65th birthday. This is when most people first sign up for Part D.
• Annual Enrollment Period: Oct. 15 – Dec. 7 each year. This is when you can join, switch or drop a Part D plan for the following year.
• Special Enrollment Periods: triggered by life events, such as moving or losing employer drug coverage.

Medigap has its own timing. Your best chance to buy a Medigap policy without medical underwriting is your six-month Medigap Open Enrollment Period, which starts the month you are 65 or older and enrolled in Part B. New Jersey has some additional state protections; SHIP counselors can walk you through them.

How to decide, step by step

1. Confirm you want Original Medicare rather than a Medicare Advantage plan. That is the path where Medigap plus Part D makes sense. 2. Shop Medigap during your Medigap Open Enrollment Period, when insurers cannot turn you down or charge more based on health. 3. Separately, use the Plan Finder at medicare.gov to compare stand-alone Part D plans available in Camden County. Enter the drugs you actually take and your preferred pharmacy. 4. Enroll in Part D on time — during your Initial Enrollment Period, or within 63 days of losing other creditable coverage. 5. Review your Part D choice each year during Oct. 15 – Dec. 7. Formularies, pharmacy networks and premiums change annually.