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25. What happens if I have Medigap?

Since January 1, 2006, new Medigap policies have been prohibited from offering prescription drug coverage. If you are currently in a Medigap plan, other than Plans H, I or J, you should consider signing up for a Part D plan to obtain drug coverage.

If you currently have Medigap Plans H, I or J, you are allowed to renew your plan and keep your drug coverage. However, not all of these plans provide creditable coverage, that is, some are not as good as Medicare. In these cases, if you keep your Medigap plan and its drug coverage and later decide to switch to Part D, you will pay the late enrollment penalty.

Premiums for Medigap policies with drug coverage will likely increase faster than Medigap policies that never offered drug coverage, so they can be expected to become uneconomical fairly quickly. If you have a Medigap H, I or J policy, you have a number of options.

You can cancel your existing Medigap policy and replace it with another Medigap policy that does not cover drugs, plus enroll in Part D.

If you select this option, in most cases, you cannot be charged more because of health issues and you cannot be excluded because of a pre-existing condition if your new Medigap policy is offered by the same company as your previous policy. Check with your state insurance office for information specific to your plan. You can find contact information for your state insurance office at

In addition, you can keep your current policy but without the drug coverage and enroll in Part D, or you can cancel your Medigap policy and enroll in a managed care plan. In this case, you will not need your Medigap policy because it cannot pay premiums or coinsurance for managed care plans. Finally, you can continue to receive drug coverage through your current Medigap policy, but you should find out if the drug coverage is considered creditable.


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