Does Medigap Cover Drugs

 

Discover the one drug covered by Medigap plans that saves Medicare beneficiaries millions of dollars per month.

David Minaya
September 13, 2023

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An estimated 1.5 million  Medicare beneficiaries who used insulin in 2020 would have saved $27 million with the $35 monthly cap on insulin costs.  Learn about Medigap drug coverage. 

Medigap Drug Coverage FAQs

What Medigap Policies may include drug coverage?

Medigap plans sold before 2005 may include outpatient prescription  drugs. 

Do Medigap plans sold today include drug coverage?

No, Medigap plans sold after 2005 do not include  prescription drug coverage with the exception of insulin.  

How do I get drug coverage with Medigap plan?

You can get prescription drug coverage with a Medigap plan by joining a separate  Medicare drug plan (Part D).  

When can I join a separate Medicare Part D plan?

You can join a stand-alone Medicare Part D drug plan during the following periods: 

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Your 7-month initial Medicare enrollment period

Medigap and Medicare Prescription Drug Coverage

Since today’s Medicare Supplement (Medigap) plans, do not include prescription drug coverage (except insulin ), you may need a separate Medicare Part D plan. If you delay purchasing a Part D drug plan, you could incur monthly late enrollment penalties.   

Future Medigap Drug Coverage

Effective in 2026 , Medicare will be able to negotiate the price directly with drug manufacturers on the following brand-name Part B (Medigap) and Part D drugs:

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Eliquis 
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Jardiance
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Xarelto
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Januvia 
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Farxiga
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Entresto
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Enbrel 
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Imbruvica
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Stelara
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Fiasp; Fiasp FlexTouch; Fiasp PenFill; NovoLog; NovoLog FlexPen; NovoLog PenFill

Furthermore, Medicare will select and negotiate costs on additional Part B and Part D drugs, including: 

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15 Part D drugs in 2025 
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15 Part B and Part D drugs in 2026
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20 Part B and Part D drugs in 2027
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20 Part B and Part D drugs in 2028 and every year after 

Medigap Plans That Cover Insulin Costs

Effective January 1, 2023 , beneficiaries with Medicare Part B and a Medigap plan that pays Part B coinsurance now cover the $35 (or less) cost of insulin with an insulin pump .  Furthermore, you don’t have to pay the Part B deductible for insulin.   However, Part B does not cover insulin pens or insulin related supplies including:  

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Syringes
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Needles
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Alcohol swabs 
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Gauze

All Medicare Supplement plans cover 100% of Part B coinsurance except Plan K (50%) and Plan L (75%).  To shop Medigap plans, call Senior Healthcare Direct at 1-833-463-3262 and speak with a licensed agent. You can also get a quote.  

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