Medicare Supplement Insurance Plan D
Medicare Supplement (Medigap) insurance Plan D is one of the 10 standardized Medigap plans available in most states (Wisconsin, Minnesota and Massachusetts have their own standardized Medigap plans).
Medicare Supplement insurance is designed to work alongside your Original Medicare (Part A and Part B). Medigap covers some of Original Medicare’s out-of-pocket costs, like coinsurance, copayments, and deductibles. Each of the 10 standardized Medigap plans covers a different portion of these costs.
Note that Medigap Plan D is not the same thing as Medicare Part D, which is prescription drug coverage. In fact, none of the Medigap plans sold today includes prescription drug coverage, but you can optionally purchase a separate, stand-alone Medicare Part D Prescription Drug Plan that can exist alongside your Medicare Part A and Part B coverage and your Medicare Supplement insurance.
Each Medigap Plan D policy offers the following standard set of benefits:
- Medicare Part A hospital and coinsurance costs up to 365 days after Original Medicare benefits are used up
- Medicare Part A deductible
- Medicare Part A hospice care coinsurance and copayments
- Medicare Part B coinsurance and copayments
- First three pints of blood used in a medical procedure
- Skilled Nursing Facility care coinsurance
- Foreign travel emergency care (80% of approved costs up to plan limits)
Medigap Plan D is about midway between the least and most comprehensive Medicare Supplement insurance plans. Medigap Plan D covers many out-of-pocket costs associated with Original Medicare, but does not cover the Part B deductible or Part B excess charges.
Medigap insurance plans are offered through private insurance companies, so costs and availability may differ. Some insurance companies might not offer Medicare Supplement insurance Plan D policies. However, each lettered plan must provide the same, standardized basic benefits; that is, Medigap Plan D includes the same basic benefits no matter where you purchase it.
Medicare Supplement insurance Plan D costs
Private insurance companies may set their own premiums based on three different rating systems: community-rated, issue-age-rated, and attained-age-rated. Therefore, although Medigap Plan D policies must offer the same standard set of basic benefits, the costs associated with each plan may vary widely. Some companies may offer premiums that do not increase as you age while others may offer premiums that do, so it may be a good idea to shop around in your area to find that plan that may suit your individual needs.
When to purchase
To be eligible to purchase in a Medicare Supplemental Plan D policy, you must be enrolled in Original Medicare (Part A and Part B) and live in the plan’s network. The best time to purchase a Medigap Plan D policy is usually during your six-month Medigap Open Enrollment Period (OEP), which starts the month you’re age 65 or older and enrolled in Medicare Part B. During this period, you have a guaranteed issue right to purchase a Medigap policy of your choosing, meaning that companies may not use medical underwriting to deny you coverage. If you apply for a Medigap plan outside this six-month period, you might be subject to medical underwriting and may be denied coverage if you have a pre-existing health condition*. However, there are some situations when you might have guaranteed issue rights to Medigap coverage outside your Medigap OEP.
*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.
This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.
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