Medigap Plan D is one of 10 Medicare supplement plans that cover out-of-pocket costs remaining after Medicare coverage applies. This plan offers broad coverage but doesn’t cover the Part B deductible, excess charges, or the costs of uncovered services.
Medicare supplemental insurance, also known as Medigap, helps cover costs left over after Original Medicare (Parts A and B) kicks in, such as some deductibles, copayments, and coinsurance.
If you qualify for Medicare, you may choose to enroll in Medigap to reduce your out-of-pocket expenses. You can choose among 10 Medigap plan options with varying levels of coverage and premiums, which can differ by location, including Medigap Plan D. Read on to learn what Medigap Plan D covers and what it might cost for you.
Plans versus parts
Medicare is a government-funded health insurance program that provides medical coverage for people ages 65 and over and some people under age 65.
Original Medicare is divided into Medicare Part A and Medicare Part B. Medicare Advantage (Part C) is an alternative Medicare plan that offers the same coverage as Original Medicare, and Medicare Part D covers prescription drugs.
Only these Medicare components are referred to as parts. Medigap plans are subdivided into plans. Medigap Plan D should not be confused with Medicare Part D.
Medigap plans are not medical plans. Instead of covering medical care directly, these plans pay for your remaining out-of-pocket costs once Original Medicare coverage kicks in.
Every Plan D has the same level of coverage in every state except in Massachusetts, Minnesota, and Wisconsin. Medigap Plan D covers the following costs:
The following chart summarizes the coverage of Medigap Plan D in every state except these three.
| Benefit Covered by Medigap Plan D | Coverage Percentage |
|---|---|
| Part A coinsurance and hospital costs (up to an additional 365 days after medicare benefits are used) | 100% |
| Part A hospice care coinsurance or copayment | 100% |
| Blood benefit (first 3 pints) | 100% |
| Skilled nursing facility care coinsurance | 100% |
| Part B coinsurance or copayment | 100% |
| Part A deductible | 100% |
| Foreign travel emergency (up to plan limits) | 80% |
Plan D doesn’t cover the Part B deductible or the Part B excess charge.
Most Medigap plans don’t have their own deductibles, copays, or coinsurance. Instead, you pay a monthly premium that varies by state.
Medigap premiums are priced in three main ways:
- Issue-age rated: Based on your age when you buy the policy—buying younger means lower rates.
- Community rated: Everyone pays the same premium, regardless of age.
- Attained-age rated: Based on your current age, with rates that generally rise as you get older.
The following are some sample expected premium ranges in different states in 2026.
| Indiana | Texas | Rhode Island | California | |
|---|---|---|---|---|
| Plan D premium range (monthly) | $134-$718 | $121-$560 | $154-$478 | $161-$586 |
Just keep in mind that your Medigap premiums may also depend on other factors, such as:
- your health status
- your gender
- when you buy your plan
- tobacco use
You can sign up for Medigap Plan D during your open enrollment period if:
- You qualify for Medicare
- The plan is offered in your area
- You’re enrolled in both Medicare Part A and Part B
Once you have Plan D, it can’t be canceled due to pre-existing conditions as long as you keep paying your premiums.
Plan D is offered by private insurance companies approved by Medicare. Your best time to buy is during the 6-month open enrollment period, which begins the month you turn 65 and enroll in Part B. During this window, it’s easier to get coverage, even with preexisting conditions. If you apply later, you might pay more or be denied coverage.
On the Medicare website, you can compare available Medigap plans and prices by entering your ZIP code, age, gender, and smoking status. Since costs vary by insurer, it’s worth comparing several options before choosing.
You might consider enrolling in Medigap Plan D over the other Medigap plans for a number of reasons, as follows:
- Availability: Since 2020, if you’ve recently enrolled in Medicare, you can’t enroll in Medigap Plan C or Plan F, which used to offer the most coverage, unless you were eligible to enroll in Medicare prior to January 1, 2020. Plan D is one of the closest alternatives, after Medigap Plan G.
- Strong overall coverage: Plan D pays 100% of most Medicare out-of-pocket costs, so after you pay the Part B deductible, you’ll have little to no out-of-pocket costs for most Medicare-approved services.
- Travel protection: Plan D includes foreign travel emergency coverage, paying 80% of emergency medical costs abroad (up to plan limits).
What are the disadvantages of Medigap Plan D?
That said, if you want full protection against higher doctor fees, you may prefer Medigap Plan G, which covers everything Plan D does plus the Part B excess charges.
So, for example, if you receive services from a doctor or provider who does not “accept assignment,” you may be responsible for paying 15% above the Medicare-approved amount that the provider may charge.
In addition, unlike Plan K and Plan L, Plan D doesn’t have a mandated annual spending maximum, after which the plan would cover 100% of all remaining out-of-pocket costs.
So, after you pay the Part B deductible, while Plan D will cover 100% of most major out-of-pocket costs, you’ll still be responsible for the Part B excess charges, your monthly premiums, and the costs of any services Medicare doesn’t cover.
Medigap Plan D is one of 10 Medicare supplement options that help pay out-of-pocket expenses left after Original Medicare coverage kicks in. It offers broad protection but doesn’t cover the Part B deductible, excess charges, or services not covered by Medicare.
Most Medigap plans don’t have their own deductibles, copays, or coinsurance. You simply pay a monthly premium, which varies by state and may also depend on factors like your health, gender, tobacco use, and when you sign up.
You can enroll in Plan D during your open enrollment period if you qualify for Medicare, the plan is available in your area, and you’re enrolled in Original Medicare.
Resources:
Compare Medigap plan benefits. (n.d.). https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
Get Medigap basics. (n.d.). https://www.medicare.gov/health-drug-plans/medigap/basics
Your Medicare benefits. (2025). https://www.medicare.gov/publications/10116-your-medicare-benefits.pdf
When can I buy a Medigap policy? (n.d.). https://www.medicare.gov/health-drug-plans/medigap/ready-to-buy/when