Medigap Plan D

Plan D is a Medicare Plan option with similar benefits to Plan B in addtion to foriegn travel emergency & skilled nursing care coverage.

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Maybe you’ve heard some information about Medigap Plan D from friends & family but what exactly are Plan D anyway & how does it fit within Medicare Insurance benefits? We consolidated & simplified all the important details for you by answering common questions to help save you time, money & energy!

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Last Updated: 10/8/2019

What is Medigap Plan D?

Plan D is a unique Medigap Plan because although it doesn’t quite beat Plan C in terms of comprehensive coverage (going in alphabetical order) it is a step above Plan B. If Foriegn travel coverage and Skilled Nursing Facility coverage are important to you while wanting to keep your costs down, this option may be a good fit for you. Plan D should not be confused with Part D which is a standalone prescription drug plan (PDP).

Did you know, Plan D also includes all the benefits of its predecessor plan, Plan C, with the exception of;

  1. The Part B Deductible

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What does Medigap Plan D cover?

Plan D covers;

  • 100% Medicare Part A coinsurance.
  • 100% Medicare Part B coinsurance.
  • 100% first three (3) pints of blood.
  • 100% Part A hospice coinsurance
  • 100% Skilled Nursing Facility Care coinsurance.
  • 100% Part A deductible.
  • 80% Foreign Travel Emergency.

The National Association of Insurance Commissioners (NAIC), standardized all Medigap Plans which must adhere to the following guidelines;

  • Must cover costs for both Original Medicare Part A & Part B.
  • Must reflect statutory changes in Medicare.
  • Cannot deny pre-existing conditions after a policy has been active for 6-months.
  • Must include a 30-day lookback period.

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What does Medigap Plan D not cover?

Medigap Plan D does not cover the following items which are included in other Medigap Plans;

  • No Medicare Part B Deductible.

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How do I compare Medigap Plan D?

Comparing Medigap policies can be confusing and time consuming when vetting multiple carriers. It takes more than reading a 2019 Medigap PDF Guide to get the FAQs! Simplify the process by speaking with a Bridge Agent who can answer your questions & run all your Medigap comparisons for you at no cost.

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2019 Medigap Guide

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Is Medigap Plan D worth buying?

Plan D is a good Medigap Plan option among seniors clients because of its comprehensive coverage compared to plans such as Plan A & Plan B. We recommend speaking with a Bridge Agent to review your options and get a comparison quote to fit your needs.

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How much does Medigap Plan D cost?

As with all Medigap Plans, since they are federally standardized the only differentiating factor is based on the price you pay. Since Medigap plans vary in price, availability and carrier. Contact a Bridge Agent for a hassle-free quote!

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How do I enroll in Medigap Plan D?

Enrolling in Plan D is pretty straightforward. Once you have enrolled in Original Medicare, you can contact a Bridge Agent to find plans in your service area.

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How does Medigap Plan D compare with Part C Medicare Advantage (MA)?

In comparison, Plan D is only a subset of a health insurance plan. Since Medicare Advantage (Part C) is a compete health plan, it actually contains a drug plan within it called MA-PD vs. PDP which is a stand alone drug plan. Comparing Medigap vs Medicare Advantage Plans can be difficult going at it alone. Afterall, they are similar in that both are considered private health plans but you cannot be enrolled in both Original Medicare and a Medicare Advantage at the same time. Read about comparing Original Medicare vs Medicare Advanatage

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Although, Medicare Advantage Plans are appealing based on price, they can also come with a few medicare pitfalls that may have you reconsider the real “advantage”. For example;

  1. Prices have been historically unstable.
  2. Your coverage will change annually.
  3. You could be locked-in without the future option for a Medigap Plan
  4. You’re responsible for out-of-network, Physician costs.
  5. No coverage beyond your service area.
  6. Must use in-network providers.
  7. No travel coverage.
  8. May need a referral to see a specilist.

Additionally, If you have a MA plan & diagnosed with a critical illness such as cancer, heart attack or stroke, costs for treatment if the hospital is out-of-network may not be covered in your plan. The max out-of-pocket only applies to covered services and could require a specialist referral. People with MA plans, think they have more coverage than they actually do unlike Medigap plans, which is considered more comprehensive senior health coverage plan.

CONSULTANT TIP

Starting January 1, 2020, Medigap plans for seniors new to Medicare will not be able to cover the Part B deductible. As such, Plans C & F will no longer be available to new Medicare enrollees on or after January 1, 2020.

How does Medigap Plan D work with Medicare Part D Prescription drug coverage?

Since Plan D is compatible with Original Medicare, enrollees who choose this plan will also need to enroll separately in a Part D drug plan. However, drugs administered in a Hospital setting are generally covered under your Medicare Part A. Enrollees have a guaranteed eligibility for a Part D plan when they enroll in Plan D (on-time). It’s best to avoid the Part D Enrollment Penalty by enrolling during your initial enrollment period (also known as, IEP). For more information on enrollments, visit the Medicare Enrollment Periods page. More information on this topic below under the question: “What is the difference between Part D and Plan D?”

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How does Dental, Vision & Hearing Insurance (DVH) work with Medigap Plan D?

Good news! Plan D is compatible with DVH plans however since they are considered standalone plans, DVH’s would need to be purchased separately. By working with a Bridge Agent, we can help you find an affordable DVH insurance plan to fit your needs.

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How does Medigap Plan D work with a Critical Illness Insurance for cancer, heart-attack & stroke coverage (CHAS)?

Luckly, Plan D is compatible with CHAS insurance / cancer plans however since they are considered standalone plans, they would need to be purchased separately. By working with a Bridge Agent, we can help you find an CHAS and/or affordable critical illness insurance plans to fit your needs.

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How does Medigap Plan D work with a Long Term Care Insurance (LTC)?

Medigap Plan D is compatible with LTC plans however, since they are considered standalone plans, they would need to be purchased separately. There is talk about developing a new Medigap plan to include LTC coverage. By working with a Bridge Agent, we can help you find an affordable LTC insurance plan to fit your needs(LTC).

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How does Plan D work with a Health Savings Account (HSA)?

As with all Medigap Plans, Medigap Plan D is not considered a qualified expense to pay out of your Health Savings Account (HSA). However, your HSA can pay for Medicare Parts A, B, C & D. Once enrolled in Medicare, enrollees are no longer able to contribute to their Health Savings Account. However, the funds can be used to pay for qualified Medicare costs stated above. If one postpones Medicare enrollment they may still contribute to their Health Savings but enrolling late will also be subject to a Medicare Late Enrollment Penalty which is a percentage increase of costs per year. Speak with your Financial Advisor to determine what works best for you!

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What is the difference between Part D and Plan D?

Most people can get confused between the two since they have very similar naming conventions but “Parts” and “Plans” are not the same! Although we answered this question above (How does Medigap Plan D work with Medicare Part D Prescription drug coverage?, it might be worth futher explination. Medicare Part D, also called, “Prescription Drug Plan” (PDP) is a stand-alone drug plan that works alongside Original Medicare (Parts A & B) AND works with PLAN D. However, the two are different in that they are not separate products. Plan D is a supplemental health insurance plan, Part D is a standalone drug plan. Although, both works alongside Original Medicare, Plan D serves Hospital & Medical insurance coverage, not drug coverage. To better explain this topic, we created a page called, “Medicare Options Redefined” to better help explain Medicare from a “Complete Health Plan Perspective”. To help clarify, refer to the page, “Medicare Options Redefined” for more information.

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In Conclusion

To summarize, Plan D is “step-up” in coverage from Plan B with the highlighted benefits of skilled nursing facility care coinsurance & foreign travel emergency coverage. The cost of Plan D is dependant upon carrier & availability. All carriers who sell Plan D must adhere to standardized federal guidelines. Plan D is private insurance that “supplements” Original Medicare. The cost of Plan C is dependant upon carrier & availability. All carriers who sell Plan C must adhere to standardized federal guidelines. Comparing Medigap Policies can be confusing and time consuming! If you would like to speak with a licensed Bridge Agent about Plan C options, please contact us today for a free, no-obligation, comparison quote today!

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