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Medicare Supplement Insurance Plan D

Medigap Plan D is one of 10 standardized Medicare Supplement Insurance options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options).

Medicare Supplement Plan D helps cover a number of costs your Original Medicare (Part A and Part B) coverage doesn’t pay for.

 

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What Is Medigap Plan D?

When you use Medicare Part A and Part B , you’re responsible for a number of out-of-pocket costs like deductibles, coinsurance, copayments and more.

A Medigap plan can provide coverage for some these costs.

You’ll use your Medicare insurance as you normally would, and your Medigap plan then picks up some of the extra costs so you pay less out of your pocket for covered care.

Medigap plans are accepted by any provider who accepts Medicare. 

Medicare Plan D vs Part D

Medigap Plan D should not be confused with Medicare Part D (prescription drug coverage).

  • Medicare Part D plans are stand-alone prescription drug plans offered by private insurance companies. Part D plans are available to anyone with Medicare at an additional cost.
  • Medigap Plan D is designed to work alongside Original Medicare by covering some of the out-of-pocket costs that Medicare doesn’t cover. These can include certain deductibles, copays and more.

Medigap Plan D does not provide prescription drug coverage. However, Medicare beneficiaries may have both Medicare Supplement Insurance Plan D and a Medicare Part D prescription drug plan at the same time.

What Does Medigap Plan D Cover?

Medigap Plan D covers 7 out of 9 possible Medigap benefits. See the chart below for a breakdown:

Standard Medicare Supplement Insurance benefits

Plan D

Medicare Part A coinsurance and hospital costs

Medicare Part B coinsurance or copayment

First 3 pints of blood

Part A hospice care coinsurance or copayment

Coinsurance for skilled nursing facility

Medicare Part A deductible

Medicare Part B deductible

 

Medicare Part B excess charges

 

Foreign travel emergency

80%

Medicare Part A Coinsurance

Medicare Part A is known as hospital insurance and it includes cost-sharing measures like coinsurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if they exceed 60 days.

Medigap Plan D fully covers the Part A coinsurance.

Medicare Part B Coinsurance and Copayment

Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% coinsurance in most cases, after you meet the Part B deductible.

Plan D pays the 20% coinsurance or copayment costs.

First 3 Pints of Blood

Original Medicare only covers the fourth pint of blood and beyond.

If you need blood while in the hospital, Medigap Plan D covers the cost of the first 3 pints.

Part A Hospice Care Coinsurance or Copayment

Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires copayments.

These copayments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care.

Medigap Plan D completely covers Part A hospice coinsurance and copay costs.

Coinsurance for Skilled Nursing Facility Care

Medical care provided at skilled nursing care facilities is covered by Medicare Part A, but it requires coinsurance costs of $170.50 per day in 2019 after day 20 of your stay.

Plan D fully covers your Part A skilled nursing facility care coinsurance costs.

Medicare Part A Deductible

Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019. You could potentially have to meet this deductible multiple times in a single year, which can add up quickly.

Medigap Plan D will cover your deductible in full for each benefit period you require.

Foreign Travel Emergency Care Costs

Original Medicare typically doesn’t cover medical care provided outside of the United States.

Medigap Plan D pays for 80% of the costs for your qualified foreign emergency medical care. Coverage is provided after a $250 deductible has been met for the year in 2019.

What Does Plan D Not Cover?

There are just two benefit areas where Plan D does not offer any coverage.

  • The Medicare Part B deductible
    You must first satisfy an annual deductible before your Medicare Part B medical insurance kicks in.

    In 2019, the deductible is $185 for the year. That means you must pay for the first $185 worth of your Part B covered services and items out of your own pocket.

    Part B coverage then kicks in once that deductible has been reached.

  • Medicare Part B excess charges
    Some health care providers don’t accept Medicare assignment, which means that they don’t accept Medicare reimbursement as payment in full for their services or items.

    These providers reserve the right to charge you up to 15% more than the Medicare-approved amount for their services or items. These charges are called Medicare Part B excess charges

Medigap Plan D vs. Plan F and Other Plans

Medigap Plan D is a mid-range benefits plan similar to Plan N

Plan D provides more benefits than basic Plan A and Plan B, but it does not cover the Medicare Part B deductible and Part B excess charges, which are covered by Plan F.

To see the difference between Plan D and the other standardized Medigap plans, please review the chart below.

2019 Medigap plans comparison chart

How Much Does Medigap Plan D Cost? 

The average Medigap Plan D premium in 2018 was $157.33 per month.1

That was slightly higher than the average of all plans in 2018 ($125.93 per month), but was still lower than five other plans, placing it right around the median premium paid for a Medigap plan in 2018.    

It’s important to note that each type of Medigap plan offers a different combination of standardized benefits. Plans with fewer benefits may offer lower premiums.

Other factors such as age, gender, smoking status, health and where you live can also affect Medigap plan rates.

Medigap Plan D Enrollment

In 2017, 160,726 people were enrolled in Medigap Plan D.2

Plan D enrollment is likely to increase in 2020, when Plan F and Plan C are no longer offered to new beneficiaries.

Why Choose Plan D?

Because of recent legislation, anyone who becomes eligible for Medicare on or after January 1, 2020, will not be allowed to enroll in Plan F or Plan C. 

Medicare beneficiaries who become eligible for Medicare before Jan. 1, 2020, will be able to enroll in Plan C or Plan F in 2020 and beyond, but only if either plan is offered in their area. Beneficiaries who already have Plan C or Plan F will be able to keep their plan.

Plan C and Plan F are currently two of the Medigap plans that offer the most comprehensive coverage.

The result of the change in 2020 is that Plan D and Plan G will become the two most comprehensive plans available to new Medicare beneficiaries

The only benefit area missing from Plan D coverage (aside from the Part B deductible) is Medicare Part B excess charges.

Medicare excess charges are easy to avoid. Check with each provider prior to receiving any care to make sure they accept Medicare assignment (meaning they accept the Medicare-approved amount as full payment).

If so, they will not charge you Medicare Part B excess charges.

How Do I Sign up for Plan D?

If Medigap Plan D seems like a good fit, you can request a free Plan D quote online today. Plan D options may be available where you live. 

Call to speak with a licensed insurance agent who can help you compare the plans in your area so that you can find a plan that fits your needs.

 

Find Medigap Plan D in your area.

Find a plan

Or call --ms-tfn-- to speak with a licensed insurance agent.

 

1 TZ Insurance Solutions LLC internal sales data, 2019. This data is based on the Medicare Supplement Insurance policies TZ Insurance Solutions LLC has sold. It is not a comprehensive national average of all available Medicare Supplement Insurance plan premiums.

2 AHIP. The State of Medigap 2019. (May, 2019). Retrieved from www.ahip.org/wp-content/uploads/IB_StateofMedigap2019.pdf.

 

 

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