Getting Care in Emergencies: What You Should Know
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Medicare Supplement Plan D
What is Medicare Supplement Plan D?
Please note that Medicare Supplement Plan D should not be confused with Medicare Part D, which is Medicare prescription drug coverage.
Plan D is supplemental insurance that fills some coverage gaps in Original Medicare.
Medigap Plan D provides the following benefits:
- Part A hospital coinsurance and hospital costs up to an extra 365 days after Original Medicare benefits are exhausted
- Part A hospice care coinsurance payment or copayment
- Part A deductible
- Part B copayment or coinsurance payment
- First three pints of blood for a medical procedure
- Skilled nursing facility (SNF) care coinsurance
- 80% of foreign travel emergency costs (up to plan limits)
Plan D does not cover Medicare Part B deductible payments or Part B excess charges.
Medicare Part B excess charges may occur if a doctor doesn’t accept an assignment, meaning they charge above the amount that Medicare will pay for the service. The difference between what your doctor charges and the Medicare-approved amount for a health-care service is known as an excess charge. Doctors who do not accept assignments are allowed to charge up to 15% above the Medicare-approved amount. Beneficiaries are typically responsible for paying these charges out of pocket. Plan D doesn’t cover excess charges, but Plans F and G do cover these costs.
The best time for a beneficiary to enroll in a Medigap plan is during their Medicare Supplement Open Enrollment Period. This period begins on the first day of the first month that you are both age 65 or older and enrolled in Medicare Part B, and lasts for six months. During this time, private insurance carriers may not use medical underwriting to assess a beneficiary’s health condition.
This means that if you’re enrolled in Medicare Part A and Part B and live within a Medigap plan’s service area, you can enroll in that Medigap plan without fear of being denied coverage or charged higher premiums based on a pre-existing health condition (although waiting periods may apply).
Medigap plans do not include prescription drug benefits; if you’re enrolled in Original Medicare and want coverage for your medications, you should enroll in a stand-alone Medicare Prescription Drug Plan.
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