Priority Health Medigap Plan D
Medigap Plan D is Medicare supplement insurance. It helps pay almost all the health care costs of your basic Original Medicare benefits, except for the Medicare Part B deductible and excess charges. Emergency care is covered anywhere you travel worldwide.
Now available on all Priority Health Medigap plans:
- Assist America for global emergency travel assistance
- Opportunity to receive a 12% household discount on your monthly premium
- Hearing discounts from TruHearing
- Vision discounts from EyeMed
The chart below shows what Original Medicare pays, what this plan pays and what you'll pay in 2021. The amount Original Medicare pays changes every year on Jan. 1. Benefits paid by Medigap plans will automatically change when Original Medicare coverage changes.
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Medicare Part A
Hospitalization
Coverage per benefit period for semi-private room and board, general nursing and miscellaneous services and supplies.
First 60 days
Original Medicare pays
Plan D pays
You pay
Part A deductible is $1,484.
Days 61-90
Original Medicare pays
Plan D pays
You pay
Day 91 and after (while using 60 lifetime reserve days)
Original Medicare pays
Plan D pays
You pay
Once lifetime reserve days are used, additional 365 days
Original Medicare pays
Plan D pays
You pay
Plan D pays 100% of Medicare-eligible expenses.
Beyond the additional 365 days
Original Medicare pays
Plan D pays
You pay
Skilled nursing facility care
Coverage per benefit period. You must meet Medicare's requirements, including having been in a hospital for at least 3 days and entered a Medicare-approved facility within 30 days after leaving the hospital.
First 20 days
Original Medicare pays
Plan D pays
You pay
Days 21-100
Original Medicare pays
Plan D pays
You pay
Day 101 and after
Original Medicare pays
Plan D pays
You pay
Blood
First 3 pints
Original Medicare pays
Plan D pays
You pay
Additional blood after first 3 pints
Original Medicare pays
Plan D pays
You pay
Hospice
Available as long as your doctor certifies you are terminally ill and you elect to receive these services
Hospice care
Original Medicare pays
Plan D pays
You pay
Outpatient prescription drugs
Original Medicare pays
Plan D pays
You pay
Inpatient respite care
Original Medicare pays
Plan D pays
You pay
Plan D pays 5% of Medicare-eligible expenses.
Medicare Part B
Physician and outpatient services
You must meet your Part B deductible once each calendar year (Jan. 1 - Dec. 31). Once you have been billed $203 in Medicare-approved amounts for covered services, you have met your Part B deductible for the calendar year.
Medical expenses: In or out of the hospital and outpatient hospital treatment, such as physician's services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment.
First $203 of Medicare-approved amounts
Original Medicare pays
Plan D pays
You pay
Part B deductible is $203.
Remainder of Medicare-approved amounts after first $203
Original Medicare pays
Plan D pays
You pay
Part B excess charges: Charges above Medicare-approved amounts
Original Medicare pays
Plan D pays
You pay
Medicare preventive care
First $203 of Medicare-approved amounts when applicable
Original Medicare pays
Plan D pays
You pay
Part B deductible is $203.
Medicare approved amounts (after deductible is met) when applicable
Original Medicare pays
Plan D pays
You pay
Blood
First 3 pints
Original Medicare pays
Plan D pays
You pay
Next $203 of Medicare-approved amounts (Part B deductible)
Original Medicare pays
Plan D pays
You pay
Part B deductible is $203.
Remainder of Medicare-approved amounts
Original Medicare pays
Plan D pays
You pay
Clinical laboratory services
Tests for diagnostic services
Original Medicare pays
Plan D pays
You pay
Medicare Parts A & B
Home health care
Medicare-approved services
Medically necessary skilled care services and medical supplies
Original Medicare pays
Plan D pays
You pay
First $203 of Medicare-approved amounts for durable medical equipment
Original Medicare pays
Plan D pays
You pay
Part B deductible is $203.
Remainder of Medicare-approved amounts for durable medical equipment
Original Medicare pays
Plan D pays
You pay
Other benefits: Services not covered by Medicare
Foreign travel
Emergency care services beginning during the first 60 days of each trip outside the U.S.
$250 Foreign travel deductible that must be met once each calendar year
Original Medicare pays
Plan D pays
You pay
Assist America®
All Priority Health Medigap plans include Assist America, a free service for global emergency travel assistance when more than 100 miles from home or in a foreign country. Learn more.
If you are in your Medigap Open Enrollment Period or have a Guaranteed Issue Right, your application can't be turned down and you will pay the lowest premium. If you are not, your application can be turned down for health reasons, or it may be accepted but at a higher monthly premium. See the Outline of Coverage for details.
Before you apply
The application form will ask you if you have received a copy of two documents. You can view or print them here:
- The federal government's brochure about choosing a Medigap plan:
Choosing a Medigap Policy
- Information about Priority Health Medigap plans:
2021 Medigap Outline of Coverage (Rates effective January 2021)
2020 Medigap Outline of Coverage (Rates effective January 2020)
Priority Health Medigap plans come with a 12-month rate guarantee. Your rate stays the same for 12 months after your effective date (the date your plan starts).