Medigap Plan D
Plan D covers everything Plan G covers except Part B excess charges: the Part B 20% coinsurance, the Part A deductible, hospital and skilled nursing coinsurance, blood, hospice cost-sharing, and 80% of foreign travel emergencies. You pay the annual Part B deductible yourself — and if a doctor doesn't accept Medicare assignment, the excess is yours too.
Who Plan D tends to fit
- People whose doctors all accept Medicare assignment — then excess charges never come up, and Plan D's coverage works exactly like Plan G's in practice.
- People in states that ban Part B excess charges, where the one benefit D lacks can't be billed at all — ask your advisor whether yours is one.
- People who want Plan G's shape without the excess-charge benefit and are curious how the letter prices in their state.
The trade-offs
- Part B excess charges aren't covered — a doctor who doesn't accept assignment can bill up to 15% above Medicare's approved amount in most states, and that bill is yours.
- You still pay the annual Part B deductible ($283 in 2026) — no plan sold to people newly eligible for Medicare on or after January 1, 2020 is allowed to cover it.
- Not every carrier offers every letter — Plan D quotes can be thin on the ground in some states, so ask what's actually quotable before anchoring on it.