Medigap plans do not cover maintenance medications, aka drugs that treat chronic health conditions. All lettered Medigap Plans: A, B, C, D, F, G, K, L, M, and N do not cover prescription drugs. However, your Medigap Plan will cover drugs while an inpatient in a hospital under Part A. Furthermore, your Medigap may pay for drugs administered in your doctor’s office under Part B.
For example, Medicare Part B covers Humira injections when administered by a licensed medical provider. Discover how MedicareBob’s advice results in a Medigap client getting FREE Humira injections.
What are maintenance medications?
Maintenance medications are the everyday drugs you take to treat chronic health conditions. For example, Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease that obstructs airflow to your lungs. Most people with COPD use bronchodilator inhalers. This medication makes breathing easier by relaxing your airways. For people with Medigap Plans, you will need a separate Part D plan to cover maintenance medications.
A Brief History of Medicare Part D
The Medicare Prescription Drug, Improvement, and Modernization Act of 2013 adds a new Part D drug benefit program effective January 1, 2006. The act adds prescription drug coverage to Medicare Advantage plans. Furthermore, this public law allows beneficiaries with Part A or Part B to join Medicare Part D stand-alone Prescription Drug Plan (PDP). Thus, Medigap Plans sold after January 1, 2006, are not allowed to include prescription drug coverage.
Medicare Part D Plan
You can enroll or change your Medicare Part D Plan during the Annual Election Period (AEP) every year between October 15 and December 7. Furthermore, you can sign up for a Part D plan during your initial Medicare enrollment period. Moreover, you can avoid a late enrollment penalty by enrolling when you are first eligible.
Medicare Advantage Plan
You can enroll or change your Medicare Advantage Plan during the Annual Election Period (AEP) once a year between October 15 and December 7. Furthermore, you can switch Advantage plans or enroll in a Medigap plan during Medicare Advantage Open Enrollment.