What Is Medigap Plan D? What You Need to Know

Medigap Plan D is one of 10 Medicare Supplement Insurance plans that cover certain out-of-pocket expenses for people with Original Medicare (Part A and Part B). Plan D covers more than most Medigap plans, but not as much as Medigap Plan F or Plan G.

How it works

After Medicare pays its approved amount for services, Medigap plans help cover what would otherwise be your out-of-pocket costs: copayments, coinsurance and some deductibles. These plans are available only to individuals enrolled in Medicare Part A and/or Part B — not to Medicare Advantage members.

There are 10 standardized Medigap plans available in most states (except Massachusetts, Minnesota and Wisconsin, which use different standards). The plans differ in terms of coverage for services, out-of-pocket limits and premium costs.

What Medigap Plan D covers

Here’s what Medigap Plan D covers, according to Medicare.gov:

• Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.

• Part A deductible.

• Part A hospice care coinsurance or copayment.

• Part B coinsurance or copayment.

• Skilled nursing facility care coinsurance.

• Blood transfusion (first three pints).

• Medically necessary emergency health care service for the first 60 days when traveling outside the U.S. Deductible and limitations apply.

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What Medigap Plan D doesn’t cover

Medigap Plan D covers more than most Medigap plans, but it’s not the most comprehensive option. For example, Plan D doesn’t cover Medicare Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so). Medigap Plan G is an option to consider if you want excess charge coverage on top of everything included in Plan D.

Additionally, all Medigap plans, including Plan D, sold to new Medicare members don’t cover the following:

How much does Medigap Plan D cost?

Medigap Plan D is regulated by the government but sold by private health insurance companies. Prices vary according to factors including age, location and tobacco use.

In Atlanta, a metro area with average costs for Medigap policies, monthly Plan D premiums for a 65-year-old female nonsmoker range from $128 to $304.

A $128 Medigap Plan D policy has the same standardized Medicare coverage as one that costs $304. Companies may add on extra perks like discounted gym memberships, but the core Medicare benefits are the same, so go ahead and compare based on price.

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To get the best price for Medigap Plan D coverage, enroll during your Medigap open enrollment period.

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