Medigap Plan D: What It Covers, What It Costs, and Who It's For in 2026

First, clear up the name: Plan D is not Part D

Two of the most confused terms in Medicare share the letter D. "Medigap Plan D" is a Medicare Supplement insurance policy sold by private insurers that helps pay your share of Original Medicare costs. "Medicare Part D" is separate prescription drug coverage. They are not the same product, and one does not include the other.

This distinction matters for your budget: a Medigap Plan D policy will not pay for your medications. If you want drug coverage, you generally need to add a standalone Part D prescription drug plan. For reference, the 2026 Part D national base beneficiary premium is $38.99 per month, though what you actually pay depends on the specific plan you choose.

Throughout this guide, "Plan D" refers exclusively to the Medigap (Medicare Supplement) plan.

What Medigap Plan D covers in 2026

Medigap benefits are standardized by federal law, so a Plan D policy from one insurer covers exactly the same services as a Plan D policy from any other insurer in most states (Massachusetts, Minnesota, and Wisconsin standardize differently). Only the premium changes from company to company.

• Part A hospital coinsurance, plus coverage for an additional 365 days after your Medicare hospital benefits are used up (100%).
• The Part A deductible, which is $1,736 per benefit period in 2026 (100%).
• Part A coinsurance for long hospital stays—$434 per day for days 61–90 and $868 per day for lifetime reserve days in 2026.
• The Part B coinsurance or copayment—typically the 20% of approved charges you would otherwise owe after meeting the Part B deductible (100%).
• Skilled nursing facility care coinsurance, which is $217 per day for days 21–100 in 2026 (100%).
• Part A hospice care coinsurance and copayments (100%).
• The first 3 pints of blood (100%).
• Foreign travel emergency care: 80% of approved costs after a $250 deductible, up to a $50,000 lifetime maximum, generally for emergencies during the first 60 days of a trip.

What Plan D does NOT cover

Plan D is comprehensive, but it leaves a few specific gaps you should plan around.

• The annual Part B deductible. You pay this yourself; it is $283 in 2026. (Federal law has barred newly eligible enrollees from buying any Medigap plan that pays the Part B deductible since January 1, 2020.)
• Part B excess charges. If a provider does not accept Medicare assignment, they may bill up to 15% above the Medicare-approved amount, and Plan D does not pay this. Only Plans F and G cover excess charges.
• Prescription drugs. You need a separate Part D plan for medication coverage.
• Routine dental, vision, hearing aids, and long-term custodial care—none of which Original Medicare or any standardized Medigap plan covers.
• Your monthly Part B premium ($202.90 in 2026), which you continue to pay separately to Medicare.

Plan D vs. Plan G: a near-twin comparison

Plan D is almost identical to the popular Plan G. The single difference: Plan G also covers Part B excess charges, while Plan D does not. Everything else—Part A deductible, hospital and Part B coinsurance, skilled nursing coinsurance, blood, hospice, and 80% foreign travel emergency—is the same on both. Neither plan pays the Part B deductible for new enrollees.

Because the plans are so similar, the choice often comes down to two questions: how likely are you to see a provider who charges excess fees, and which plan is priced lower in your area? In many regions providers accept Medicare assignment (so excess charges rarely apply), which can make Plan D a reasonable, sometimes lower-cost alternative to Plan G. But premiums vary widely by insurer, age, location, and how the policy is rated, so compare actual quotes before deciding.

What Plan D costs

There is no single national price for Medigap Plan D. Because the benefits are standardized but premiums are not, each insurer sets its own rate, and your premium depends on factors like your age, ZIP code, tobacco use, gender, and whether the policy is community-rated, issue-age-rated, or attained-age-rated. Two people with identical Plan D coverage can pay very different premiums.

When budgeting, remember that your total monthly Medicare cost includes more than the Medigap premium. You also pay the standard Part B premium of $202.90 per month in 2026 (higher if income-related monthly adjustment amounts, or IRMAA, apply), plus any separate Part D drug plan premium. Higher earners pay an IRMAA surcharge on Part B and Part D once modified adjusted gross income exceeds $109,000 (single) or $218,000 (joint), based on 2024 income.

The upside of Plan D is predictability: once you pay the Part B deductible ($283 in 2026) and your premiums, the plan absorbs most remaining cost-sharing, so a hospital stay or a string of doctor visits generally won't produce large surprise bills.

Who should consider Plan D—and when to enroll

Plan D can suit someone who wants robust, predictable coverage close to Plan G but expects their providers to accept Medicare assignment (making excess-charge protection less valuable). It is also worth a look if a Plan D quote in your area undercuts Plan G.

Timing matters more than almost anything else. Your best window is the 6-month Medigap Open Enrollment Period that starts the month you are 65 or older AND enrolled in Part B. During this window you have a guaranteed issue right: insurers must sell you any Medigap policy they offer at their best available rate regardless of your health. Outside this window, in most states insurers can use medical underwriting and may charge more or decline you, so missing it can permanently affect your options.

This article is educational and independent—medicareloginguide.com is not affiliated with or endorsed by the federal government or the Medicare program. Confirm specifics and compare plans available to you on the official Medicare website before enrolling.