What Is Medigap Plan D?
Key Takeaways
- Medigap Plan D is a supplemental Medicare plan offering high coverage for out-of-pocket expenses like deductibles, copays, and coinsurance, though it comes with higher monthly premiums.
- Medigap Plan D covers 100% of the Part A deductible, Part B copays and coinsurance, hospice care, skilled nursing facility coinsurance, and 80% of foreign travel emergencies.
- Beneficiaries pay monthly premiums to private insurers, along with Medicare Part B premiums, but Plan D can significantly reduce out-of-pocket costs for hospital stays, doctor visits, and other services.
Medigap At a Glance
Medigap, also known as Medicare Supplement Insurance, helps consumers pay for their out-of-pocket healthcare costs. Medigap plans are only available to people with Original Medicare, not Medicare Advantage.
Medigap plans do not provide any additional health coverage, but they help cover your portion of your healthcare bills. When you receive care under Medicare, you may still have to pay a copay or coinsurance. If Medicare pays for 80% of your service, you would owe the remaining 20%. A Medigap plan may cover that 20%. Some plans also pay for your Part A deductible.
Each Medigap plan is labeled with a letter. These plans are standardized, meaning that price is the only difference between two plans with the same letter. However, your options will vary depending on your location. Each plan offers different levels of benefits, and Medigap Plan D has some of the highest coverage.
Ready for a new Medicare Advantage plan?
Understanding Medigap Plan D
Medigap Plan D might seem a bit confusing since its name sounds similar to Medicare Part D, which refers to prescription drug coverage sold by private insurance companies. But these two products aren’t related; Medigap Plan D doesn’t include any prescription drug features. In the following sections, we’ll explore what this plan does cover.
Key Features of Medigap Plan D
- High coverage. Medigap Plan D provides more benefits than most Medigap plans.
- Higher premium. Increased benefits may result in a higher monthly cost.
- Replacement for Medigap Plan C. People who joined Medicare in 2020 or later can no longer purchase Medigap Plan C. Medigap Plan D offers the same benefits, except for the Part B deductible.
What Does Medigap Plan D Cover?
Medigap Plan D does not provide any extra coverage for health conditions or treatments. It only lowers your out-of-pocket costs. When you receive care, Medicare pays its part first, then your Medigap plan kicks in to cover your part of the bill.
Like all Medigap plans, Medigap Plan D pays for 100% of your Part A coinsurance and hospital costs, for up to one year after your Medicare benefits have been used. Medigap Plan D also pays for:
Here’s what Medigap Plan A also covers:
- 100% of your Part A deductible
- 100% of your Part A hospice care copay or coinsurance
- 100% of your Medicare Part B copay or coinsurance
- 100% of your skilled nursing facility coinsurance
- 80% of foreign travel emergency expenses
- Blood benefit (first three pints of blood)
Costs For Medigap Plan D
When deciding whether Medigap Plan D works for you, take all of the following costs into consideration.- Premiums: You’ll pay a monthly premium to a private insurance company to keep your Medigap plan active. This is in addition to your Part B premium.
- Deductibles: Generally, you have to hit your Part A or Part B deductible before Medicare starts to pay. However, Medigap Plan D covers your Part A deductible entirely, so you won’t have to pay right away.
- Copays: Copays are a set price you pay for services or prescription drugs, like a $20 routine doctor visit. Medigap fully covers your copays for Part B and hospice care.
- Coinsurance: Sometimes, you’ll need to pay a coinsurance, or a percentage of the total cost for your care. However, Medigap Plan D covers most of your coinsurance costs.
See It In Action
To understand how Medigap Plan D works, let’s look at an example. In this scenario, let’s say that you’ve sustained an injury that requires hospitalization. As long as the hospital accepts Medicare, your stay will be covered for up to 60 days.
However, before Medicare starts to pay, you have to meet your deductible, which is $1,676 per benefit period in 2025. You could quickly meet that deductible with a few days in the hospital, and your Medicare benefits would kick in.
Since Medigap Plan D covers 100% of your Part A deductible, coinsurance, and hospital costs, you wouldn’t have to pay anything out of pocket.
How Medigap Plan D Compares With Other High-Coverage Medigap Plans
| Benefits | Plan D | Plan G | Plan C |
|---|---|---|---|
| Available to those who became eligible for Medicare in or after 2020? | Yes | Yes | No |
| Part A coinsurance and hospital costs for up to 365 additional days after Medicare benefits are disbursed | Yes | Yes | Yes |
| Part B coinsurance or copayment | Yes | Yes | Yes |
| Part A hospice care coinsurance or copayment | Yes | Yes | Yes |
| Part A deductible | Yes | Yes | Yes |
| Part B deductible | Not covered | Not covered | Yes |
| Part B excess charge | Not covered | Yes | Not covered |
| Out-of-pocket limit | N/A | N/A | N/A |
| Blood (first three pints) | Yes | Yes | Yes |
| Skilled nursing facility care coinsurance | Yes | Yes | Yes |
| Foreign travel exchange up to plan limits | 80% | 80% | 80% |
How to Choose a Medigap Plan
To find the right Medigap plan, consider your current and expected healthcare needs. If you visit the doctor frequently or want to prepare for potential hospital stays, Medigap Plan D could be a good fit. While Medigap Plan D may have a higher monthly premium than other Medigap plans, that investment may pay off in the long run.
Next, compare prices at different insurance companies. Since all Medigap plans with the same letter offer the same benefits, you can save money by shopping around. You can also take the insurance company’s reputation and history into account.
Once you’ve chosen your Medigap plan, it’s time to enroll. The easiest time to purchase a plan is during the Medigap Open Enrollment Period, which lasts for 6 months after you get Part B. During this period, you can enroll in any plan in your state without medical underwriting, and you may get a lower premium. You can still purchase a Medigap plan after this period, but your options may be more limited.
How to Enroll in Medicare Supplement Plan D
When you’re ready to enroll, follow the steps below.
- Find insurance companies that sell Medigap Plan D. Use Medicare’s website or work with a licensed insurance agent to identify your options.
- Compare pricing. Contact multiple companies to gather quotes.
- Apply. Insurance companies can cancel your Medigap policy if they discover you were dishonest on your application, so be as thorough as possible.
- Start your Medigap policy. Your benefits start the month after you apply. As long as you keep paying your premium, your Medigap plan will renew automatically.
Putting It All Together
Medigap Plan D provides more benefits than most Medigap plans, but it isn’t the highest-coverage option. It covers your Part A deductible and your portion of the bill for hospital, hospice and skilled nursing facility care. It also pays for your Part B copays and coinsurance, first three pints of blood, and some foreign travel emergency expenses. To understand whether Medigap Plan D is right for you, consider working with a licensed insurance agent or broker.
Get real Medicare answers and guidance – no strings attached.
Sources
A Snapshot of Sources of Coverage Among Medicare Beneficiaries. KFF.
Procedure Price Lookup. Medicare.gov