Medigap Plan D Benefits
Plan D covers the most important items and services, including:
- Medicare Part A copayments for inpatient hospital care — up to an additional 365 days after Medicare benefits are used up
- Medicare Part B copayment
- First 3 pints of blood
- Part A hospice care copayment
- Medicare Part A deductible
- Skilled nursing facility coinsurance
- Foreign Travel Emergency — up to plan limits
What Costs Are You Responsible for?
A Plan D policy covers most of the Medicare gaps for you, except for the Part B deductible and any excess charges. So, you’ll pay out of pocket for these items if you buy a Plan D.
An excess charge is an extra amount you’ll pay if a doctor charges more than the Medicare-allowed amount.
Plan D Eligibility and Enrollment
There are certain eligibility rules with buying a Medigap plan:
- You must have Original Medicare A and B, and you can’t have Medigap and Medicare Advantage.
- A Medigap policy covers one person only. So, your spouse will need to buy a seprate policy.
- Insurers aren’t legally required to sell Medigap plans to folks under 65. If you’re under 65 and on Original Medicare, you may not be able to buy the policy you want.
If you’re interested in Medigap, you can first enroll during Medigap Initial Enrollment — a six-month period that begins when you turn 65 and enroll in Medicare Part B. If you don’t sign up during this time, you may not be able to get the plan you want or it might cost more.
How the Companies Charge You
Every Medigap policy has a monthly premium. The exact amount may vary by individual plan. Insurers can set monthly premiums for their policies in three ways:
- Community rated — Everybody who buys the plan pays the same monthly amount no matter their age.
- Issue-age rated — Monthly premiums are based on the age when you first buy a plan. Younger buyers will have lower premiums, and the premiums don’t go up as you get older.
- Attained-age rated — Monthly premiums are based on your CURRENT age. So, your premium will increase as you get older.
Is Plan D Right for You?
If you’re considering enrolling in a Medigap plan, you’ll want to compare multiple policies offered near you. This can help you know how premiums are set and give you an idea of what you’ll pay for the insurance policy.
It would also be a good idea to compare rates for Plan D to rates for Plans F and G. Some people don’t mind paying more for their supplemental insurance if they have certainty that all the gaps will be taken care of. Others are okay with some cost-sharing to pay lower monthly premiums. It’s entirely your choice.