Medicare Supplement Insurance (Medigap) Plan D is a mid-range plan that covers 7 of 9 basic benefits. Learn more about benefits, availability, and enrollment.
Medigap Plan D (sometime incorrectly known as Medigap Part D) is one of the standardized Medicare Supplement Insurance options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options).
Medicare Supplement Plan D helps cover a number of costs your Original Medicare (Part A and Part B) coverage doesn't pay for.
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When you use Medicare Part A and Part B , you’re responsible for a number of out-of-pocket costs like deductibles, coinsurance, copayments and more.
A Medigap plan can provide coverage for some these costs.
You’ll use your Medicare insurance as you normally would, and your Medigap plan then picks up some of the extra costs so you pay less out of your pocket for covered care.
Medigap plans are accepted by any provider who accepts Medicare.
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Medigap Plan D should not be confused with Medicare Part D (prescription drug coverage).
Medigap Plan D does not provide prescription drug coverage. However, Medicare beneficiaries may have both Medicare Supplement Insurance Plan D and a Medicare Part D prescription drug plan at the same time.
Medigap Plan D covers 7 out of 9 possible Medigap benefits. See the chart below for a breakdown:
|
Standard Medicare Supplement Insurance benefits |
Plan D |
|---|---|
|
Medicare Part A coinsurance and hospital costs |
✓ |
|
Medicare Part B coinsurance or copayment |
✓ |
|
First 3 pints of blood |
✓ |
|
Part A hospice care coinsurance or copayment |
✓ |
|
Coinsurance for skilled nursing facility |
✓ |
|
Medicare Part A deductible |
✓ |
|
Medicare Part B deductible |
|
|
Medicare Part B excess charges |
|
|
Foreign travel emergency |
80% |
Medicare Part A is known as hospital insurance and it includes cost-sharing measures like coinsurance. Inpatient hospital stays covered by Medicare Part A require coinsurance fees if they exceed 60 days.
Medicare Supplement Plan D fully covers the Part A coinsurance.
Medicare Part B usually charges a coinsurance and copayments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% coinsurance in most cases, after you meet the Part B deductible.
Plan D pays the 20% coinsurance or copayment costs.
Original Medicare only covers the fourth pint of blood and beyond.
If you need blood while in the hospital, Medigap Plan D covers the cost of the first 3 pints.
Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires copayments.
These copayments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care.
Medigap Plan D completely covers Part A hospice coinsurance and copay costs.
Medical care provided at skilled nursing care facilities is covered by Medicare Part A, but it requires coinsurance costs of $200 per day in 2023 after day 20 of your stay.
Plan D fully covers your Part A skilled nursing facility care coinsurance costs.
Medicare Part A comes with a deductible, which is $1,600 per benefit period in 2023. You could potentially have to meet this deductible multiple times in a single year, which can add up quickly.
Medigap Plan D will cover your deductible in full for each benefit period you require.
Original Medicare typically doesn't cover medical care provided outside of the United States.
Medigap Plan D pays for 80% of the costs for your qualified foreign emergency medical care.
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There are just two benefit areas where Plan D does not offer any coverage.
Medigap Plan D is a mid-range benefits plan similar to Plan N.
Plan D provides more benefits than basic Plan A and Plan B, but it does not cover the Medicare Part B deductible and Part B excess charges, which are covered by Plan F.
To see the difference between Plan D and the other standardized Medigap plans, please review the chart below. Use the scroll bar at the bottom to view all plans and information.
The average Medigap Plan D premium in 2022 was around $157 per month.1
It’s important to note that factors such as age, gender, smoking status, health and where you live can affect Medigap plan rates.
Only 1% of Medicare beneficiaries are enrolled in Medigap Plan D.2
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Because of recent legislation, anyone who becomes eligible for Medicare on or after January 1, 2020, will not be allowed to enroll in Plan F or Plan C.
Medicare beneficiaries who became eligible for Medicare before Jan. 1, 2020, are able to enroll in Plan C or Plan F, but only if either plan is offered in their area. Beneficiaries who already had Plan C or Plan F can keep their plan.
The result of the change in 2020 is that Plan D and Plan G will become the two most comprehensive plans available to new Medicare beneficiaries.
The only benefit area missing from Plan D coverage (aside from the Part B deductible) is Medicare Part B excess charges.
Medicare excess charges are easy to avoid. Check with each provider prior to receiving any care to make sure they accept Medicare assignment (meaning they accept the Medicare-approved amount as full payment).
If so, they will not charge you Medicare Part B excess charges.
If Medigap Plan D seems like a good fit, you can request a free Plan D quote online today. Plan D options may be available where you live.
Call to speak with a licensed insurance agent who can help you compare the plans in your area so that you can find a plan that fits your needs.
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