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What Is Medigap Plan D? What You Need to Know

Dec 21, 2021 | Medicare, Medicare Supplement

Medigap Plan D is one of 10 Medicare Supplement Insurance plans that cover some out-of-pocket expenses for individuals enrolled in Medicare Part A and Part B, also known as Original Medicare

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 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 deductible.
  • Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
  • Part A hospice care coinsurance or copayment.
  • Part B coinsurance or copayment.
  • Skilled nursing facility care coinsurance.
  • Blood transfusion (first three pints).
  • Emergency health care service for the first 60 days when traveling outside the U.S.

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 (when a provider charges you more than Medicare’s approved amount). Medigap Plan G is an option to consider if you want excess charge coverage on top of everything included in Plan D.

There are also costs that, in general, Medigap plans sold to new Medicare enrollees don’t cover:

  • Part B deductible (starting in 2020, new Medicare members can’t buy any plan that covers the Part B deductible).
  • Prescription drugs.
  • Long-term care.
  • Dental care.
  • Vision care.
  • Private-duty nursing.

How much does Medigap Plan D cost?

Medigap Plan D is regulated by the government but sold by private insurers. Prices vary according to factors including age, location and tobacco use. In a representative California ZIP code (92589) in 2022, monthly premiums for a 65-year-old nonsmoker range from $124 to $230.

To find out what a Medigap Plan D plan would cost you, visit Medicare.gov.

To get the best price for Medigap Plan D coverage, enroll during your Medigap open enrollment period — which happens only once. It starts when you turn 65 and enroll in Medicare Part B, and lasts for six months.

Medigap policies are cheapest and easiest to get during this open enrollment period because companies aren’t allowed to factor your health or medical history into your price. After the period ends, the prices may go up or you may be denied coverage due to your health status or medical history.