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Medicare Supplement Insurance: Plan M

If you’re viewing this page, you’re probably already aware that Medicare Supplement insurance plans, also known as Medigap plans, help pay for your Original Medicare (Part A and Part B) out-of-pocket costs, such as coinsurance and deductibles. Medicare Supplement insurance plan is optional insurance available from private insurance companies.

 

Medicare Supplement (Medigap) Plan M benefits are the same as those of Medigap Plan D, except that with Plan M, you pay half of the Medicare Part A deductible (while Medigap Plan D covers the entire Part A deductible).

 

Note that because Medicare Supplement insurance plans are standardized, plans named with the same letter designation include the same coverage no matter where you buy the policy. That is, a Medigap Plan M policy you buy in Nevada has the same benefits as a Plan M policy you buy in Texas. (Plan premiums and availability may differ.)

 

Medicare Supplement Insurance: Plan M coverage

Medigap Plan M covers the following costs and benefits:

  • Part A hospital coinsurance and hospital costs up to an additional 365 days after Original Medicare benefits are exhausted
  • Part A hospice care coinsurance payment or copayment
  • Part B copayment or coinsurance payment
  • First three pints of blood for a medical procedure
  • Skilled nursing facility (SNF) care coinsurance
  • 50% of Part A deductible costs
  • 80% of foreign travel emergency coverage (up to plan limits)

 

Medigap Plan M does not cover the Medicare Part B deductible or excess charges. Part B “excess charges” are additional costs outside of the Medicare-approved charge. For example, suppose Medicare’s allowed charge for a specialist appointment was $100, and the physician chose not to accept that amount and instead charged an additional 15% for the visit. In this example, Medicare would pay 80% of the allowed charge, sending the physician $80. The beneficiary is responsible for paying not only the remaining $20, but also the excess 15% charge — another $15, making the total out-of-pocket cost $35.

 

Medigap Plan M has no out-of-pocket limit, meaning you must pay any out-of-pocket costs that aren’t covered by Original Medicare or Medigap Plan M. When a Medigap plan has an out-of-pocket spending limit, it means that once you’ve spent that amount on out-of-pocket costs and your yearly Part B deductible, your plan will pay 100% of covered services for the rest of the calendar year.

 

It’s important to know that there are certain time periods when it may be easier for you to get a Medicare Supplement insurance plan than other times.

 

Compare Medigap Plan M with other Medicare Supplement insurance plans

Medigap Plan M may not be available in every state, or every part of every state.

 

Our Medigap plan finder invites you to compare the benefits of Medigap Plan M against other Medicare Supplement insurance plans to find the one that may suit your needs.

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