Medigap Plan D Overview
Medigap Plan D is a Medicare Supplement Insurance plan that covers some of the gaps of Original Medicare. While, Medigap plan D covers many of the benefits offered by Medicare Supplement plans, it leaves two gaps in coverage.
Remember Medicare Plan D plans are designed to complement Original Medicare Part A and Part B. Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you purchased Medigap Plan D.
Medigap Plan D Benefit Details
|Benefits||Original Medicare Alone||Original Medicare With Medigap Plan D|
|Doctor Network||All Doctors that accept Medicare||All Doctors that accept Medicare|
|Part A Hospital Benefit Period Deductible||You pay $1,364*||You pay $0|
|Hospital days 61-90||You pay $335 per day per day||You pay $0|
|Hospital Days 91-150||You pay $670 per day per day (lifetime reserve days)||You pay $0|
|Beyond Lifetime Reserve Days||You pay 100%||You pay $0 up to an additional 365 hospitalization days.|
|Skilled Nursing Facility Care Days 1-20||You pay $0 (Part A deductible applies)**||You pay $0|
|Skilled Nursing Facility Care Days 21-100||You pay $170.50 per day||You pay $0|
|Hospice Respite Care||You pay 5%||You pay $0|
|First 3 Pints of Blood||You pay 100%||You pay $0|
|Additional Blood||You pay $0||You pay $0|
|Part B Annual Deductible||You pay $185||You pay $185|
|Ambulance||You pay 20% (Part B deductible applies)||You pay $0, after Part B deductible|
|Doctor’s Office Copays/Coinsurance||You pay 20% (Part B deductible applies)||You pay $0, after Part B deductible|
|Durable Medical Equipment||You pay 20% (Part B deductible applies)||You pay $0, after Part B deductible|
|Part B Excess Charges||You pay 100% (Part B deductible applies)||You pay 100%|
|Foreign Travel Emergency||You pay 100%||You pay 20%***|
|Out-Patient Surgery||You pay 20% (Part B deductible applies)||You pay $0, after Part B deductible|
|Urgent Care||You pay 20% (Part B deductible applies)||You pay $0, after Part B deductible|
Next Steps for Medigap Plan D
The fine print of the Medigap Plan D Chart Above
*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,364).
***Foreign Travel Emergency requires a deductible of $250. You will have to have your emergency within the first 60 days of travel, and the plan has a lifetime coverage amount of $50,000.
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