Medicare Supplement Plan D: Coverage, Cost and Eligibility
What Medigap Plan D covers, what it leaves unpaid and how it compares with Plans G and N
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Medicare Supplement Plan D, also called Medigap Plan D, covers the Part A hospital deductible, hospital and skilled nursing coinsurance, Part B coinsurance, blood, hospice care and 80% of foreign travel emergencies. It does not pay the Part B deductible or Part B excess charges. Unlike Plan C, Plan D is open to anyone eligible for Medigap, including people new to Medicare since 2020. It is not Medicare Part D and does not cover prescription drugs. Most people compare it with Plan G and Plan N.
Reviewed by Charles “Chuck” Lunsford, Life & Health insurance agent licensed in Florida since 1994 and in Alabama (NPN 553216).
Plan D at a Glance
| Feature | Medicare Supplement Plan D |
|---|---|
| Part A hospital deductible | Covered at 100%. $1,736 per benefit period in 2026 |
| Part A hospital coinsurance and 365 extra hospital days | Covered at 100% |
| Skilled nursing facility coinsurance | Covered at 100%. $217 per day for days 21 to 100 in 2026 |
| Part B coinsurance or copayment | Covered at 100% once the Part B deductible is met |
| First three pints of blood | Covered at 100% |
| Part A hospice coinsurance or copayment | Covered at 100% |
| Foreign travel emergency care | 80%, up to plan limits |
| Part B deductible | Not covered. $283 per year in 2026 |
| Part B excess charges | Not covered |
| Plan copays for office or emergency room visits | None |
| Annual out-of-pocket limit | None |
| Restriction based on when you became eligible for Medicare | None |
Dollar amounts on this page are the 2026 Medicare figures published by CMS. They change each year.
Once the annual Part B deductible is met, Plan D leaves no deductibles, coinsurance or copays for Medicare-covered care in the United States from providers who accept assignment. What remains is the Part B deductible itself, excess charges from providers who do not accept assignment and part of any foreign emergency care.
Like every Medigap policy, Plan D works alongside Original Medicare and is sold by private insurance companies. Benefits are standardized, so Plan D from one carrier covers the same things as Plan D from another.
What Does Medicare Supplement Plan D Cover?
Plan D covers seven of the nine standardized Medigap benefits: six at 100% and foreign travel emergencies at 80%.
| Benefit | What Original Medicare leaves you owing | What Plan D pays |
|---|---|---|
| Part A hospital deductible | $1,736 for each benefit period in 2026 | The full deductible, every benefit period |
| Part A hospital coinsurance | A daily charge for hospital days 61 to 90 ($434 in 2026) and for lifetime reserve days ($868 in 2026) | The full daily coinsurance, plus Medicare-eligible hospital costs for up to 365 additional days over your lifetime once Medicare hospital benefits are used up |
| Skilled nursing facility coinsurance | $217 per day for days 21 to 100 of a covered stay in 2026 | The full daily coinsurance |
| Part B coinsurance or copayment | Generally 20% of the Medicare-approved amount for doctor visits, outpatient care and durable medical equipment | The full coinsurance or copayment after you meet the Part B deductible |
| Blood | The first three pints in a calendar year | All three pints |
| Part A hospice care | Copayments for outpatient drugs and coinsurance for inpatient respite care | The full hospice coinsurance or copayment |
| Foreign travel emergency care | Original Medicare generally pays nothing outside the United States | 80% of emergency care, up to plan limits |
Plan D’s hospital and skilled nursing coverage is the same as Plan G’s. A hospital admission followed by a rehabilitation stay in a skilled nursing facility adds no Part A cost sharing for a Plan D policyholder.
Unlike Plan N, Plan D charges no copays for office or emergency room visits. After the Part B deductible, Part B services from providers who accept assignment cost nothing more.
What Doesn’t Plan D Cover?
Plan D does not cover the Part B deductible or Part B excess charges, and it pays only part of foreign emergency care.
The Part B Deductible
You pay the first $283 of Medicare-approved Part B costs each year in 2026. No Medigap plan sold to people who became eligible for Medicare on or after January 1, 2020 covers it, so this gap is shared with Plans G and N.
Part B Excess Charges
A provider who does not accept Medicare assignment may bill up to 15% above the Medicare-approved amount, and Plan D does not pay the difference. Excess charges are the one benefit that separates Plan D from Plan G. You can avoid them by asking whether a provider accepts assignment before you receive care.
Foreign Travel Emergencies
Plan D pays 80% of emergency care during foreign travel, up to plan limits. You pay the remaining 20% and any amount above those limits.
Plan D also does not cover prescription drugs, despite sharing a letter with Medicare Part D. Drug coverage comes from a separate Part D plan. Like all Medigap plans, Plan D does not cover dental care, vision care, hearing aids or long-term custodial care.
What Could You Pay With Plan D?
With Plan D you pay the monthly premium and the annual Part B deductible. You also pay any excess charges or foreign emergency costs you incur. The plan has no annual out-of-pocket limit, but the costs it leaves open are narrow.
| Cost you keep | When it applies | 2026 amount |
|---|---|---|
| Part B deductible | Once per calendar year | $283 |
| Part B excess charges | Only when a provider does not accept Medicare assignment | Up to 15% above the Medicare-approved amount |
| Emergency care outside the United States | Travel abroad | 20% of covered emergency care, plus any amount above plan limits |
If you use providers that accept assignment and receive care in the United States, the Part B deductible is the only Medicare cost sharing Plan D leaves you in a year, whatever happens with hospital or skilled nursing care.
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What Does Plan D Cost?
There is no single price for Plan D. Plan D benefits are identical from carrier to carrier, but each insurance company sets its own premium.
Premiums can vary by:
- The insurance company
- Your age when you buy the policy
- Your ZIP code
- Tobacco use
- Gender, with some carriers
- Household or other discounts a carrier offers
- Your enrollment situation: open enrollment, a guaranteed-issue right or medical underwriting
Plan D sits between two plans that differ from it by one feature each, which makes premium comparisons straightforward.
Plan D vs. Plan G: weigh the premium gap against excess charges. Plan G adds only Part B excess charge coverage. If the providers you use accept Medicare assignment, excess charges are unlikely, and the question is whether Plan G’s extra premium is worth that protection.
Plan D vs. Plan N: weigh the premium gap against copays. Plan N has the same benefits as Plan D but charges copays of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to an admission. If Plan N costs less, compare the yearly savings with the copays you expect to pay.
Not every carrier sells Plan D. Federal rules require insurers to offer Plan A, and Plan D is optional, so ask which carriers sell it in your ZIP code.
This page does not list Plan D premium ranges. A range without a date, ZIP code, age and carrier list is not a useful comparison. A quote for your own age and ZIP code is.
Who Might Consider Plan D?
Plan D may be worth considering if you want hospital, skilled nursing and doctor costs covered after the Part B deductible, without copays, and you are comfortable without excess charge coverage.
It may appeal to someone who:
- Became eligible for Medicare in 2020 or later and wants coverage close to Plan C
- Prefers not to pay the office and emergency room copays that Plan N charges
- Sees providers who accept Medicare assignment, so excess charges are unlikely
- Wants skilled nursing coinsurance and foreign travel emergencies covered
- Finds that a carrier prices Plan D below Plan G by more than the excess charge protection is worth to them
Plan G may be worth comparing if you see specialists who do not accept assignment. Plan N may be worth comparing if you visit doctors rarely and its premium is lower.
Timing matters too. Moving from Plan D to another plan later is not guaranteed. Outside open enrollment or a guaranteed-issue situation, a carrier can review your health history before approving the change.
How Plan D Compares With Plan G and Plan N
Plan G is Plan D plus excess charge coverage. Plan N is Plan D with copays.
| Benefit | Plan N | Plan D | Plan G |
|---|---|---|---|
| Part A deductible, hospital coinsurance, skilled nursing, blood, hospice | Yes | Yes | Yes |
| Part B coinsurance | Yes, minus copays | Yes | Yes |
| Office and emergency room copays | Up to $20 per office visit and up to $50 per ER visit without admission | None | None |
| Foreign travel emergency care | 80% | 80% | 80% |
| Part B excess charges | No | No | Yes |
| Part B deductible | No | No | No |
| Who can buy it | Anyone eligible for Medigap | Anyone eligible for Medigap | Anyone eligible for Medigap |
Plan D vs. Plan G. The only difference is Part B excess charges. Compare the premium gap with how likely you are to see providers who do not accept assignment. See Medicare Supplement Plan G.
Plan D vs. Plan N. The only difference is Plan N’s copays. Compare the premium gap with how often you expect office and emergency room visits. See Medicare Supplement Plan N.
If you were eligible for Medicare before 2020, Medicare Supplement Plan C is Plan D plus the Part B deductible. To see every lettered plan side by side, compare all Medicare Supplement plans.
Enrollment, Availability and Underwriting
Plan D has no eligibility-date restriction. Whether a carrier can ask health questions depends on when and why you apply.
Medicare Supplement Open Enrollment. This six-month period begins the first month you are 65 or older and enrolled in Medicare Part B. During it, a carrier that sells Plan D cannot use your health history to decline your application or charge you more.
Under age 65. Rules for people under 65 vary by state. Some states require carriers to offer Medicare Supplement coverage to people who qualify for Medicare through disability or end-stage renal disease, often with an open enrollment period. Ask what applies where you live.
Guaranteed-issue situations. Certain events, such as losing employer group coverage or a Medicare Advantage plan leaving your area, can create a right to buy specific Medigap plans without underwriting for a limited time. Plan D is one of those plans. For people new to Medicare since 2020, Plan D and Plan G take the place of Plan C and Plan F in that list. The application window generally closes 63 days after the earlier coverage ends.
Applications outside those periods. A carrier may use medical underwriting. It can accept the application, decline it or offer a different premium based on your health history.
Medicare Supplement Plan D FAQs
Is Medicare Supplement Plan D the same as Medicare Part D?
No. Medicare Part D is prescription drug coverage. Medicare Supplement Plan D is a Medigap policy that helps pay costs Original Medicare leaves behind, and it does not cover prescription drugs. Drug coverage comes from a separate Part D plan.
What is the difference between Plan D and Plan G?
One benefit. Plan G pays Part B excess charges and Plan D does not. Their other benefits are identical.
What is the difference between Plan D and Plan N?
Plan N charges copays of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to an admission. Plan D has no copays. Their other benefits are identical.
Can I buy Plan D if I became eligible for Medicare after January 1, 2020?
Yes. Plan D has no eligibility-date restriction. It is one of the plans people new to Medicare since 2020 have the right to buy in guaranteed-issue situations.
Does Plan D cover the Part B deductible?
No. You pay the Part B deductible, which is $283 in 2026, before Plan D pays Part B coinsurance. Only Plans C and F cover it, and they are limited to people eligible for Medicare before 2020.
Does Plan D cover a skilled nursing facility stay?
Yes. Plan D pays the daily coinsurance for days 21 to 100 of a covered skilled nursing facility stay. Medicare pays days 1 to 20 in full.
Does Plan D cover medical emergencies abroad?
Yes, partly. Plan D pays 80% of emergency care during foreign travel, up to plan limits. Original Medicare generally does not pay for care outside the United States.
Does every insurance company sell Plan D?
No. Federal rules require insurers that sell Medigap policies to offer Plan A, but Plan D is optional. Availability depends on the carrier and your ZIP code.
Can I switch from Plan D to Plan G later?
You can apply at any time, but approval is not automatic. Outside your open enrollment period or a guaranteed-issue situation, the carrier may review your health history and can decline the application.
Compare Plan D for Your ZIP Code
A Plan D decision usually comes down to how its premium compares with Plan G and Plan N from the carriers that sell them in your ZIP code. We can run that comparison for your age and location.
Prefer to keep reading first? Compare all Medicare Supplement plans.
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Content Review
Content reviewed by Charles “Chuck” Lunsford, Licensed Life & Health Agent, Florida License A169316 and Alabama, NPN 553216