Medicare Supplement Plan D

Medicare Supplement (Medigap) plans are designed to help with certain healthcare expenses that the Original Medicare insurance cannot cover. The federal government created these programs because it simply cannot shoulder all of the costs related to senior health care, in addition to the other costs it needs to shoulder for the rest of the citizenry’s other care needs.

There are currently 10 Medigap plans that are standardized to ensure that the basic benefits are delivered to anybody who avails it, regardless of their location. While Medicare Supplements are provided and sold through private insurance agencies, the standard inclusions are regulated by the government, so all senior can rest assured that they are taken care of. The 10 plans are labelled alphabetically, each providing a different mix of benefits, with varying monthly premium fees. These are Plans A, B, C, D, F, G, K, L, M and N.

Plan D Medicare Supplement is considered to be the midpoint of the plans, in terms of what it covers and its cost. It offers more benefits compared to Plan A and Plan B, but there are benefits in Plan C and F that it does not include. Note that Plan D Medicare Supplement is not the same as Medicare Part D, which a prescription drug insurance coverage. Plan D is a Medigap program that fills in some of the benefits that Original Medicare does not cover—and prescription drugs are not included (and need to be purchased separately).

Plan D Medicare Supplement Inclusions

Medigap Plan D cover the following benefits:

Plan D Medigap does not cover Part B excess charge, which may happen if your doctor does not accept assignments or charges fees that are more than the amount that Medicare is willing to shoulder for the service. The difference between the two amounts is referred as an “excess charge.”

Doctors who do not accept Medicare assignments are legally allowed to charge up to a maximum of 15% more than the Medicare-approved fee. This will be paid out of pocket. If you are concerned about excess charges, Medigap Plan F and Plan G have it as part of their benefits, though this means that the monthly premium will be higher than Plan D.

Applying for Plan D Medicare Supplement

The best time to apply for a Plan D Medicare Supplement is during your Open Enrollment period. This is your one-time-only, six-month period when the federal government allows you to purchase any Medigap policy you want, as long as it is available in your state.

The Open Enrollment period begins on the first day of the month that you turn 65 years old. During this six-month window, insurance providers are required to sell you any policy you want and are not allowed to charge more because of a past or current health issue.

If you miss this window, you will no longer have the protection and might be asked to pay a higher monthly premium for the Medigap policy of your choice. Missing your Open Enrollment period also means that your insurer can deny your application as it sees fit.

Important Things To Remember About Plan D In 2020

Note that in the year 2020, Plan D Medicare Supplement will become a Guaranteed Issue Plan for those who meet the rules.

Guaranteed Issue Rights are rights you have in certain instances when insurance companies are required to offer you specific Medigap plans even if it’s not your Open Enrollment period. During such instance, the insurer must do the following:

• Sell you a Medigap plan
• Cover all your pre-existing health conditions
• Cannot charge a higher fee for your chosen plan even if you have past or present health issues

Examples of situations that give you guaranteed issue rights are the following:

• When your Medigap insurance company shuts down (or goes bankrupt) and you lose your coverage as a result
• You decide to leave a Medigap plan or Medicare Advantage plan because the insurance company either misled you or did not follow the rules
• You have a Medicare Advantage plan and that plan is leaving Medicare or stops giving services in your area (or you move out of the plan’s area of service)
• You have Original Medicare and are part of a group plan by your employer and that plan is ending
• You dropped a Medigap plan to join a Medicare Advantage plan for the first time and you want to switch back (provided that you’ve been in the MA plan for less than one year)

Take note that there are certain U.S. states that have slightly different rules when it comes to guaranteed issue rights. Some may even provide additional ways to access. So be sure to find out what’s available for your area so you can avail of maximum benefits.

Tips on Choosing The Right Medigap Plan For You

You can buy a Plan D Medigap policy (or any policy you want) even if you lose your previous health care coverage. This is because you have guaranteed issue rights. To be able to make the change seamlessly, you must have the following:

A copy of any emails, letters, notices or claim denials that bear your name on them as proof that your previous coverage has been terminated, and

The postmarked envelope these documents came in as proof that it was mailed through proper channels.

You might be asked to send a copy of these with your Medigap application form to prove that you have a guaranteed issue right.

If you have more questions or want to understand more about Plan D Medicare Supplements and guaranteed issue rights, you may contact our team of expert Medigap advisors, who will gladly walk you through the entire process.