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Medigap Plan D is one of 10 Medicare Supplement Insurance plans that cover certain 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 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.
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 a representative North Carolina ZIP code (27406), monthly premiums for a 65-year-old nonsmoker range from $110 to $340.
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.
This period happens only once. It starts once you’re 65 and enrolled in Medicare Part B, and lasts for six months. (If you're still working after 65 and covered by a group employer plan that is deemed creditable coverage, your six-month period starts after you’ve ended active employment or no longer have that insurance.)
Medigap policies are cheapest and easiest to get during this open enrollment period because insurance 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.
If you have questions about Medicare, visit Medicare.gov or call 800-633-4227 (TTY: 877-486-2048).
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