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Does prescription drug coverage under a Medigap (or Medicare Supplement) plan H, I or J qualify as creditable coverage for purposes of avoiding the Medicare Part D late enrollment penalty?

Late-Enrollment Penalty (LEP) · updated May 29, 2025

Probably not.  Before the start of the Medicare Part D program, Medicare Supplement "Plan H”, “Plan I”, and “Plan J” were available and included some form of prescription drug coverage.  However, these older Medigap plans that were available before January 1, 2006,  are no longer being sold and the existing "grandfathered" plans may not include "creditable" prescription drug coverage.

As noted by the Centers for Medicare and Medicaid Services (CMS):
"Each Medigap [or Medicare Supplement] issuer is required annually to make the determination of whether its plan is creditable coverage based on the rules set forth in the final Title I regulation.

CMS does not believe that [Medicare Supplement] "Plan H" or "Plan I" will meet the definition of creditable prescription drug coverage, and that it is unlikely that the drug coverage in any "Plan J" will meet the definition."
Please note that anyone who still has one of these older Medigap plans cannot have prescription drug coverage through their Medigap plan and also enroll in a stand-alone Medicare Part D drug plan at the same time.

If you have one of the older Medigap policy that includes prescription drug coverage, and you choose to join a Medicare Part D drug plan (PDP), you should notify your Medigap insurer.

If you choose to keep your Medigap policy for your other health expenses, the insurer will remove the drug coverage from the Medigap policy, and adjust the Medigap premium.  In some cases, the insurer is also required to offer you a different Medigap policy that doesn’t include prescription drugs.

Creditable drug coverage and the Medicare Part D late-enrollment penalty.

If you purchased one of these Medigap policies that included drug coverage before January 1, 2006, and this Medigap drug coverage was not considered "creditable coverage" - and you now decide to join a Medicare Part D drug plan - you may pay a penalty for not joining a Medicare Part D plan when theses plans first became available.  The Medicare Part D late-enrollment penalty is paid in addition to your monthly Medicare Part D premium.  The penalty is permanent and can change year-to-year (usually increasing slightly).

If your Medigap drug coverage was considered "creditable" drug coverage, you will have a 63-day window to leave your Medigap drug coverage and join a Medicare Part D drug plan before accruing a late-enrollment penalty.

For more information about your Medigap drug coverage and your drug plan options, please contact your Medigap plan provider (the Member Services number should be on most of your plan's printed information).


Sources include:
CMS, "Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare"
U.S. Department of Health & Human Services