Medigap Plan D Benefits

Medicare Supplement Plan D covers many of the gaps that are not covered by Traditional Medicare Parts A and B.  And, unlike more comprehensive plans like Medigap Plan F and Plan G, Medigap Plan D premiums are much lower.
So, if you don’t mind being responsible for the Medicare Part B deductible and the possible exposure to Medicare Excess charges, this plan might be the one for you.

So, what benefits does Medigap Plan D cover?

  1. 100% of the Medicare Part A hospital deductible - which is $1340 per each 60-day benefit period.
  2. 100% of all Medicare Part A coinsurance and hospital costs - which is the copays for days 61-90 ($335/day) and days 91-150 ($670/day) in hospital; also provides payment in full for 365 additional lifetime days.
  3. Skilled nursing facility care coinsurance - which is $167.50/day from days 21-100 in a skilled nursing facility per each benefit period.
  4. 100% of the Part B Coinsurance - which is the 20% coinsurance for Part B services, such as doctor’s services, laboratory and x-rays, durable medical equipment.  Also covers coinsurance for hospital outpatient services.
  5. 100% of the cost of the first 3 pints of blood.
  6. 100% of the Medicare Part A hospice care coinsurance for respite care and other Part A-covered services.

So, what benefits doesn’t Medigap Plan D cover?

  1. Medicare Part B deductible of $183 in 2018.
  2. Foreign Travel Emergency - which covers 80% of emergency care costs when outside the United States, after annual $250 deductible, up to a maximum lifetime benefit of $50,000.

Medigap Plan D is NOT the same as Medicare Part D (prescription drug coverage)
Although, Medigap Plan D and Medicare Part D sound alike, they are designed to do two completely different things.
Medigap Plan D is one of the eleven Medicare Supplement plans available to Medicare beneficiaries that are “standardized” by the federal government and designed to cover the gaps that Medicare doesn’t cover.
Medicare Part D (prescription drug coverage) helps cover the costs of your prescription drug medications.  These plans are managed by private insurance companies and vary by zip-code.
As you can see, Medicare can be pretty confusing, and most people are overwhelmed with all the information out there.
So, if you’re like most people just trying to figure Medicare out, you may feel like your “spinning-your-wheels” and getting nowhere fast!
If so, you’re not alone . . .

Fortunately, the Medicare insurance specialists at New Jersey Medicare Plan can help - just give us a call at 1 (844) 280-0785 and we’ll do the heavy lifting so you don’t have to.

 

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Plan A | Plan B | Plan C | Plan D | Plan F | Plan G | Plan K | Plan L | Plan M | Plan N


 

Medicare Supplement Insurance Plans (Medigap)
Benefits A B C D F* G K L M N
Part A coinsurance and
hospital costs (up to an
additiona 365 days after
Medicare benefits are used)
100% 100% 100% 100% 100% 100% 100% 100% 100% 100%
Part B coinsurance or
copayment
100% 100% 100% 100% 100% 100% 50% 75% 100% 100%**
Blood (first 3 pints) 100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Part A hospice care
coinsurance or copayment
100% 100% 100% 100% 100% 100% 50% 75% 100% 100%
Skilled nursing facility care
coinsurance
    100% 100% 100% 100% 50% 75% 100% 100%
Part A deductible   100% 100% 100% 100% 100% 50% 75% 50% 100%
Part B deductible     100%   100%          
Part B excess charges         100% 100%        
Foreign travel emergency
(up to plan limits)
    80% 80% 80% 80%     80% 80%
Out-of-pocket limit***
(2018)
            $5240 $2620    

 

* Plan F is also offered as a high- dedutible plan by some issuers in some states. If you choose this option, this means you must pay for Medicare-covered costs (coinsurance, copayments, deductibles) up to the deductible amount of $2240 in 2018 before your policy pays anything.
** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.
*** For Plans K and L, after you meet your out-of-pocket yearly limits and your yearly Part B deductible ($183 for 2018), the Medigap plan pays 100% of covered services for the rest of the calendar year.