Medicare Supplement Plan M – Medigap Plan M

Medicare Supplement Plan M is used with your Original Medicare and is commonly called Medigap.

Medigap health insurance coverage is used to help fill gaps in coverage left for the insured to pay once Medicare has paid their portion of the bill.

Plan M will only pay a portion of the cost remaining once Medicare pays its portion of the bill.

Plan M doesn’t cover all medical costs leaving a portion of out-of-pocket expenses for the insured to pay.

Educate yourself about the different plan options before choosing a Plan.

Plan F and Plan G are the most comprehensive options with the best overall coverage; however, these plans cost more.

*For people who are new to Medicare, Plan F is no longer available unless you turned 65 before January 1, 2020. If you already have Plan F, you can still hold on to it.

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Plan M will fill in the gaps for:

  • Hospital stays
  • Skilled nursing facility care
  • Medicare Part A Hospice care

You must pay a portion of your Part A deductible; Plan M only pays some of the rest.

Plan M pays the remaining percentage of your Medicare-approved medical expenses which are not covered directly by Medicare. Typically, this is 20% of your approved healthcare expenses.

The medical cost might occur through:

  • Your physician
  • Treatments, Inpatient or outpatient surgeries
  • Your approved supplies
  • Therapies
  • Equipment
  • Additional expenses for medically necessary and approved by Medicare.

Plan M doesn’t cover your Medicare Part B deductible or any of your Part B excess charges.

Plan M Benefits

Also included in Plan M benefits are when blood is needed during any of your medical procedures or surgery. Medicare coverage will begin after your first 3 pints of blood. Plan M will then cover these first 3 pints, and no additional expense is made to the insured. There is some emergency care for your foreign travel which is provided. After the insured has paid the deductible, then Plan M covers 80% of the necessary medical expenses.

You, the patient, are still responsible for paying 20% for these expenses. Plus, there is a lifetime limit for foreign travel medical benefits. Use the chart below to compare Medigap Plan M to the other options available.

Medigap Benefits Medigap Plans
A B C D F* G* K L M N
Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes***
Blood (first 3 pints) Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Part A hospice care coinsurance or copayment Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled nursing facility care coinsurance No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess charge No No No No Yes Yes No No No No
Foreign travel exchange (up to plan limits) No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit** N/A N/A N/A N/A N/A N/A $6,620 in 2022 $3,310 in 2022 N/A N/A

(source)

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Licensed Agent
1 (855) 710-0541
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