Medicare Supplement (Medigap) Plan D is easy to confuse with Medicare Part D, but take care not to mix them up. Medigap Plan D is one of the standardized Medicare Supplement plans that private insurers offer to cover the gaps in your Original Medicare coverage. Medicare Part D, on the other hand, is your prescription drug coverage.
What Does Medicare Supplement Plan D Cover?
Medicare Supplement Plan D pays many of the costs you’re responsible for with Original Medicare alone. Plan D covers the following expenses:
- Medicare Part A coinsurance and hospital costs
- Medicare Part B coinsurance and copayment
- Blood (first three pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance
- Medicare Part A deductible (1,408 in 2020)
- Foreign Travel emergency
Medicare Part A and Part B (your inpatient and outpatient coverage) typically require you to pay 20% coinsurance. There’s no cap to how much you could have to pay out of pocket, but with Medigap Plan D, you wouldn’t have to worry about it. As long as Medicare pays for a service, Plan D will pay the coinsurance, as well its portion of the other charges as charges listed above. A supplemental plan like Plan D can save you thousands of dollars in medical bills.
What Doesn’t Medicare Supplement Plan D Cover?
Medicare Supplement Plan D offers protection from most of your out-of-pocket costs with Medicare, but not all of them.
Plan D doesn’t cover the following:
- The Medicare Part B deductible ($198 in 2020)
- Excess charges
Medicare Part B covers your outpatient services, such as your annual wellness exams. When you see the doctor, you’ll have to pay your bills until you’ve spent $189 for the outpatient services, and then Medicare and Medigap Plan D will begin paying their portion. The deductible resets annually, and the amount may be adjusted from year-to-year.
The cost of excess charges can be more challenging to predict, but fortunately, providers usually don’t charge them. Most healthcare providers accept Medicare assignment, which is the amount that Medicare agrees to pay for a particular service. If they don’t accept Medicare assignment, they can choose to add an excess charge, which can be up to an additional 15% of the bill. If you have Medigap Plan D, you’d be responsible for paying that fee yourself.
Is Medicare Supplement Plan D Right for Me?
While Medicare Supplement Plan D offers a fair amount of coverage, it isn’t widely offered by insurance carriers. If you’re looking for a plan that has similar coverage, you may want to consider Medigap Plan G or Plan N instead. Choosing a plan can be intimidating at first, but the right coverage can give you peace-of-mind about your future.
Nothing on this 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.