Understanding Medicare Supplement Plan D
Medicare Supplement Plan D (sometimes referred to as Medigap Plan D) can be characterized as the “middle ground” of plans in terms of coverage among the eight standardized Medicare Supplement Insurance plans available for purchase in most states. Massachusetts, Minnesota, and Wisconsin have their own standardized Medigap plans. Medicare Plan D is designed to work alongside Original Medicare Parts A and B to cover some of Original Medicare’s out-of-pocket costs like copayments, coinsurance and deductibles.
What does Medicare Supplement Plan D cover?
Medigap Plan D is not the most comprehensive Medicare Supplement Insurance plan available but it does offer a good amount of coverage and the monthly premiums for Medicare Supplement Plan D are typically less than some of the other Supplement Plans available.
Covered
Hospital Expenses: 100% of Original Medicare Part A coinsurance and hospital costs up to 365 days.
Hospital Expenses
100% of Original Medicare Part A coinsurance and hospital costs up to 365 days.
Medical Expenses: Pays Original Medicare Part B coinsurance or copayment (20% of Medicare-approved expenses).
Medical Expenses
Pays Original Medicare Part B coinsurance or copayment (20% of Medicare-approved expenses).
Transfusions: Pays for the first three pints of blood you receive (max 3 per year).
Transfusions
Pays for the first three pints of blood you receive (max 3 per year).
Hospice Care: Pays Original Medicare Part A coinsurance or copayment.
Hospice Care
Pays Original Medicare Part A coinsurance or copayment.
Skilled Nursing: Pays for facility care coinsurance.
Skilled Nursing
Pays for facility care coinsurance.
Foreign Travel Medical Emergencies: Pays travel-abroad medical emergency expenses (80% of approved costs up to plan limits).
Foreign Travel Medical Emergencies
Pays travel-abroad medical emergency expenses (80% of approved costs up to plan limits).
Additional Hospitalization Expenses: Pays Original Medicare Part A deductible.
Additional Hospitalization Expenses
Pays Original Medicare Part A deductible.
Not covered
Part B Deductible: The Medicare Part B deductible for 2023 is $226. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Part B Deductible
The Medicare Part B deductible for 2023 is $226. After the deductible is met, you pay 20% of the Medicare-Approved Amount (this is the amount a doctor or supplier that accepts assignment can be paid in Original Medicare) for most doctor services, outpatient therapy and durable medical equipment.1
Part B Excess Charges: Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Part B Excess Charges
Providers who don’t accept Medicare assignment may charge up to 15 percent more than what Medicare is willing to pay, known as Part B excess charges. Medicare assignment is the Medicare approved cost for a particular medical service. Medicare assignment is accepted by Medicare-approved providers.
Prescription Drugs: Medigap Plan D does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Prescription Drugs
Medigap Plan D does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs.
Who can benefit from this type of supplement plan?
Medicare Supplement Plan D is a great option for someone who wants more comprehensive coverage than Medicare Supplement Plan A and Plan B, but not as much as Plans C and F. Medicare Supplement Plan D offers a good amount of coverage and lower monthly premiums in comparison to other Supplement Plans.
Meet Angela, A Medicare Supplement Plan D User
Angela recently retired from her career as an ice-skating instructor and lost her full time health insurance. She did a lot of research to choose the right Medicare plan. She’s fit and in good health, but she’s realistic—she’s not getting any younger and she wants to be prepared should her healthcare needs change.
When Angela was researching Medigap plans, it was important for her to find a plan that would offer good coverage, but would also allow her to pay lower premiums.
In other words, she was searching for a supplement plan that would fill the gap in her standard Medicare coverage in a way that provided a good balance between coverage and cost.
For these reasons, Angela chose Medicare Supplement Plan D.
Advantages to Medicare Plan D
- Monthly premiums are typically less than some of the other Supplement Plans available.
- Offers more coverage than Plans A and B.
Drawbacks to Medicare Plan D
- Plan D offers more coverage than Plans A & B, but not as much as Plans C & F.
- Does not cover the Original Medicare Part B deductible.
- Does not cover Part B excess charges (these are physician charges which could be up to 15% above the Medicare-approved amount).
How much does Medicare Supplement Plan D cost?
Monthly premiums are set by the private insurance companies who offer Medicare Supplement Insurance plans and are based on age, health status, gender and various other factors. Depending on these factors including location, insurance companies may charge different premiums for the same Medicare Supplement Plan D. Monthly premiums for Plan D are typically less than some of the other Supplement Plans available. Companies may not cancel your coverage unless you don’t pay the plan premium, you weren’t truthful on the application, or the Medigap insurance company becomes bankrupt or insolvent.
How Pricing Works For This Plan
Pricing for Medicare Supplement Plan D varies by company. Medigap policies can be priced in 3 ways: community-rated, issue-age-rated, and attained-age-rated.
- Community-rated: Generally, the same monthly premium is charged to everyone who has the Medigap plan, regardless of age. Premiums may go up because of inflation and other factors, but not because of your age.
- Issue-age-rated: The premium is based on the age you were when you bought the Medigap plan. Premiums are lowered for people who buy at a younger age and won’t change when you get older. Premiums may go up because of inflation and other factors, but not because of your age.
- Attained-age-rated: The premium is based on your current age, increasing your premium as you get older. Premiums are lower when you are younger, but continually increase as you age. Premiums may also increase because of inflation or other factors.2
When to Enroll in Medicare Supplement Plans
When you’re first eligible: The best time to enroll in a Medicare Supplement plan is when you’re first eligible. You are eligible to purchase a Medicare Supplement policy (Medigap) on the first day of the month in which you turn 65. This marks the beginning of your Medigap Open Enrollment Period which lasts for six months.
You must already be enrolled in Medicare Part A and Part B. During this enrollment period, you can buy any Medigap policy sold in your state, regardless of any health problems. You will generally see better prices and more choices among Medigap policies during this period.
Outside open enrollment: While it’s often better to get coverage when you’re first eligible, you can still apply for Medigap coverage after your initial enrollment period. However, if you apply for coverage after your initial enrollment period, there’s no guarantee that an insurance company will sell you a policy if you don’t meet the medical underwriting requirements.
FAQs About Medicare Supplement Plan D
Below are answers to common questions about Medicare Supplement Plan D:
Is Medicare Supplement Plan D the same as Medicare Part D?
Medicare Supplement Plan D is not the same as Medicare Part D. Medicare Part D, also referred to as Medicare Prescription Drug Plans, helps cover the cost of prescription medications.
Do Medicare Supplement plans cover pre-existing conditions?
While insurance companies can’t make you wait for your coverage to start, they may make you wait for coverage for a pre-existing condition. Coverage for pre-existing conditions can be excluded if the condition was treated or diagnosed within 6 months before the coverage starts under the Medicare Supplement plan.
After the 6-month period, the Medicare Supplement plan will cover the condition that was excluded. However, it is possible to avoid or shorten the waiting period for a pre-existing condition if you buy a Medicare Supplement plan during your Medigap open enrollment period to replace “creditable coverage” Medigap plan.3
Do Medigap plans vary by state?
Medigap plans are standardized, meaning they offer the same benefits, across most of the states, except for Wisconsin Medicare Supplement Plans, Minnesota Medicare Supplement Plans, and Massachusetts Supplement Plans.
How can I lower the costs of my Medigap Plan D?
It’s possible to reduce your Medigap costs for the same exact coverage by shopping around and seeing what your available options for Medicare coverage are. Although Medigap plans are standardized, costs vary widely between companies.
Compare Medicare Supplement Plans
There are a variety of Medicare Supplement plans available and the best way to figure out which could be right for you is by comparing the advantages and drawbacks. Learn more about the Medicare Supplement plan options below.
Find the Right Medicare Supplement Plan For You With SelectQuote
As your advocate, we can help you navigate your Medicare Supplement plan options, helping you understand the costs and answering any questions you may have. At SelectQuote, we’ll make sure you find a plan that meets your needs and budget.
