Medigap Plan D is one of 10 Medicare Supplement Insurance plans that cover some out-of-pocket drug costs 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. Medigap helps you “close the gap” between what your insurance is able to cover, and the actual cost for medial care. Even with good insurance, real, proper medical care can be really expensive. Especially if you are someone who uses medical care commonly, the costs surrounding medical care can start to become difficult to deal with despite the face that you are already covered by insurance. These plans are available only to individuals enrolled in Medicare Part A and Part B — not to Medicare Advantage members. It is important to understand exactly what your Medicare plan covers so that you know what you can apply for before making a decision like this.
Medigap offers a large variety of different plans so that you can find the one that best fits your income and lifestyle. The dynamic nature of the plans allows you to more easily use the plan that you will get the most out of. 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. Make sure that you understand the details of the plans and what they cover before deciding which plan is the right one for you. If you have any questions, we are more than happy to help you figure out the best plan to fit your lifestyle.
What Medigap Plan D covers
Here’s what Medigap Plan D covers:
Medigap Plan D is an insurance plan designed to protect you from high prescription drug costs. Anything outside of drug coverage does not fall under the coverage plan of Medigap Plan D.
Understanding the specifics of what the plan covers is the most important step to figuring out if the plan will work for you. If you pick a plan thinking that it covers something that it does not, you may be stuck with a plan that you don’t like for a very long time.
What Medigap Plan D doesn’t cover
Medigap Plan D is 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. Checking the different medigap plan will allow you to make sure that you get a plan that covers everything that you need it to cover.
Be sure to review what the Medigap D plan doesn’t cover before choosing your plan. It is important to understand the ins and outs of the plan completely before you commit to it. Getting stuck with a plan that doesn’t provide services that you need can be a massive problem when it comes to choosing insurance.
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.
Understanding and determining the costs and savings of a medigap plan is essential to figuring out whether it is right for you. If you can gage the costs of the plan, you will know that the plan will be likely to save you money in the long run. If you need help determining the benefits and costs of a certain plan, we are always ready to help. It is important to us that you get the best possible plan for your lifestyle.