Medicare is one of the largest federal programs in America and assists millions of senior citizens in paying for hospital and medical bills, While it continues to be a valuable program, there are essential services that are not covered. Gaps in coverage create massive healthcare bills that can become a burden when a person is sick. Medicare Supplement Plan D, also called Medigap Plan D, was designed to fill those gaps. It provides essential services that many aging Americans might not be able to pay for otherwise.
What is Medicare Plan D?
As with all Medigap plans, Medicare Plan D coverage offer auxiliary healthcare services that are not offered by Medicare Parts A and Part B. Although they are not affiliated with the government, all Medigap plans adhere to standardized regulations in every state except Wisconsin, Minnesota, and Massachusetts.
Medicare Supplemental Plan D is not the most comprehensive of the 10 Medigap plans but it does cover many necessary services. Medigap Plans D offers more benefits than Plans A and B, but less coverage than Plans C and F. It is important to keep in mind that Medicare Plan D is not the same as Medicare Part D.
What Does Medicare Supplemental Plan D Cover?
The cost of hospital and medical care continually increases every year. The main benefit of Medigap Plan D is that it covers several expenses that are not covered under original Medicare. These costs can become exorbitant and place a large financial burden and significant stress on seniors citizens who should be focusing on self-care.
Medicare Plan D was created to ease that weight by providing the following benefits:
- Medicare Part A hospital care and coinsurance for costs up to 365 days after Part A benefits are at capacity
- Medicare Part A deductible
- Medicare Part B coinsurance or copayment
- Skilled nursing facility with coinsurance
- First three pints of blood
- Emergency medical foreign travel (up to 80% of costs)
- Medicare Part A hospice care copayment or coinsurance
Medicare Supplemental Plan D was created to work in conjunction with Medicare Parts A and B. Medigap Plan D coverage allows individuals to use any premiere doctor or hospital within the United States as long as they accept Medicare. The added advantage to this non-restrictive policy is that Medicare Plan D allows access to these doctors and hospitals without a referral.
What Doesn't Medicare Plan D Cover?
Although Medicare Supplemental Plan D covers a variety of expenses, there are few things that are left out. The most noticeable issue with Medicare Plan D coverage might be the excess charges from Part B. When you visit a doctor or receive medical treatment at a hospital, there's a pre-approved amount that Medicare will cover. The doctor can only charge up to to 15% of what Medicare will pay. Consequently, under Medicare Plan D, the patient will have to pay the difference.
In addition to the excess charges, Medicare Supplement Plan D doesn't cover the Medicare Part B deductible or the coinsurance payment for preventative care. None of the Medigap policies have a prescription drug plan, however, you do have the option to purchase the stand-alone Medicare Part D Prescription Drug Plan.
Medicare Supplement Plan D Cost
The private insurance companies that provide Medicare Supplemental Plan D services set their own prices. They determine their premiums based on a rating system that falls into 3 categories:
- Community-Based
- Issue-Age-Rated
- Attained-Age-Rate System
The community-rated system doesn't factor in age, and everyone is charged the same rate. In contrast, the issue-age rating bases its price on the age of the policyholder when they first purchased the plan. However, the attained-age rating might be considered the least attractive metric because the premium increases as the policyholder ages. These factors can impact how much insurance companies charge for Medicare Plan D coverage.
Medigap Plan D offers standardized coverage in most states, however, depending on which rating system is used, the prices can vary quite a bit. Insurance company premiums can also differ based on other metrics such as discounts for non-smokers or women, and for holders of multiple policies, all of which can affect the cost of Medicare Plan D coverage.
Who Should Consider Medicare Plan D?
If you are nearing 65 years of age, it would be beneficial to consider Medigap Plan D as an option for filling gaps in coverage associated with Medicare Parts A and B.
Seniors who regularly find themselves paying out of pocket for necessary medical procedures and care will benefit tremendously from Medicare Supplement Plan D. In addition, individuals who plan to be frequent travelers during retirement can find comfort in knowing that up to 80% of emergency medical expenses will be covered through Medicare Plan D.
Medicare Plan D has a 6-month Open Enrollment Period that begins during the month you turn 65 years of age. You cannot be penalized for pre-existing conditions during this time. It's a given that as we age, we all will inevitably spend more on healthcare. Medicare Supplement Plan D is an excellent plan that can provide a safeguard against the draining cost of medical expenses and provide peace of mind during retirement.
