Medigap Plan D is a standardized Medicare Supplement insurance plan that helps cover certain out-of-pocket costs not covered by Original Medicare (Part A and Part B). While it offers comprehensive coverage, it does not cover the Medicare Part B deductible.
Medigap Plan D typically provides coverage for Medicare Part A coinsurance and hospital costs, including an additional 365 days of hospital coverage after Original Medicare benefits are exhausted. It also covers Part B coinsurance or copayments, as well as the first three pints of blood needed for a medical procedure. In addition, Medigap Plan D includes coverage for skilled nursing facility coinsurance and provides coverage for emergency medical care during foreign travel, up to plan limits. However, it does not cover the Medicare Part B deductible or excess charges.
Medigap Plan D may be a suitable option for individuals who are willing to pay the Medicare Part B deductible out of pocket. This plan offers a good balance of coverage and cost savings compared to some other Medigap plans. It's crucial to review and compare the available options based on your individual healthcare needs and budget.
Below is a comprehensive list of the covered services provided by Medicare Supplement Plan D, which include benefits under Medicare Part A, Medicare Part B, and other areas:
Service | Who pays what? |
---|---|
First 60 days | Medicare pays: All cost but $1,632 Plan pays: $1,632 (Part A Deductible) Member pays: Nothing |
61st thru 90th day | Medicare pays: All cost but $408/day Plan pays: $408/day Member pays: Nothing |
91st day and after (While using 60 lifetime reserve days) | Medicare pays: All cost but $816/day
Plan pays: $816/day Member pays: Nothing |
Once lifetime reserve days are used; additional 365 days | Medicare pays: Nothing Plan pays: 100% of Medicare-eligible expenses Member pays: Nothing |
Beyond the additional 365 days | Medicare pays: Nothing
Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First 20 days | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
21st thru 100th day | Medicare pays: All but $204/day Plan pays: Up to $204/day Member pays: Nothing |
101st day and after | Medicare pays: Nothing Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: Nothing Plan pays: All cost Member pays: Nothing |
Additional amount | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
Hospice Care | Medicare pays: All but very limited
copayment/ coinsurance for outpatient drugs and inpatient respite care Plan pays: Medicare copayment and coinsurance Member pays: Nothing |
Service | Who pays what? |
---|---|
Part B Deductible | Medicare pays: Nothing Plan pays: Nothing Member pays: $240 (Part B Deductible) |
Part B Coinsurance | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Part B Excess Charges
(above Medicare approved amounts) | Medicare pays: Nothing Plan pays: All cost Member pays: Nothing |
Service | Who pays what? |
---|---|
Test for diagnostic lab services | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Additional amount (First $226 of
Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays: $240 (Part B deductible) |
Remainder of Medicare approved amounts | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who pays what? |
---|---|
Medically necessary skilled care
services and medical supplies/ Durable medical equipment (First $226 of Medicare approved amounts) | Medicare pays: Nothing Plan pays: Nothing Member pays: $240 (Part B deductible) |
61st thru 90th day | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who pays what? |
---|---|
First $250 each calendar year/Remainder of charges | Medicare pays: Nothing (exccept under limited circumstances) Plan pays: $0/80% to a lifetime maximum of $50,000 Member pays: $250/20% and amounts over the $50,000 lifetime maximum |
Medicare Part D Prescription Drug Plan (PDP) and Medicare Supplement (Medigap) Plan D are distinct from each other. Medicare Part D is specifically designed to provide coverage for prescription drugs, whereas Medicare Supplement (Medigap) Plan D is an insurance policy that offers a comprehensive range of benefits, including those covered under Original Medicare Parts A and B.
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