Medigap Plan M

Medigap Plan M is a newer Medicare supplemental insurance policy that became effective June 1, 2010.  Plan M was created to offer a low cost Medigap plan to consumers that increased their Medicare benefits.  Medigap Plan M carries very low monthly premiums with slightly higher out of pocket expenses for treatment and services provided.

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Medigap Plan M allows subscribers the flexibility to choose which hospital or doctor they will receive their medical services from.  Unlike a Medicare Advantage plan, Medicare subscribers who have Medigap Plan M are not required to choose a doctor from a network and do not have restrictions on service providers, as long as the providers accept Medicare insurance.

Medigap Plan M Coverage

Medicare supplemental insurance plan M covers the following:

  • All basic Medicare benefits provided by Plan A
  • 50% of the hospital deductible of Medicare Part A (up to $550)
  • 100% of copayments for office visits or emergency room visits
  • 100% of coinsurance for Medicare approved skilled nursing facilities
  • Foreign travel emergency expenses

Items Not Covered

Medigap Plan M does not cover the following:

  • Medicare Part B deductible ($155)
  • Medicare Part B excess charges

Excess charges are the fees doctors charge that run over the amount that Medicare will approve and pay for.  This may be a concern for many Medicare patients, however, most states have laws prohibiting doctors from charging more for services than Part B will cover.

Benefits of Part M

Medigap Part M is exactly the same as Medigap Part D except that it does not cover 100% of the Medicare Part A deductible.  Because of this difference, Part M monthly premiums are cheaper than Part D, but the policy holder ends up paying more out of pocket when services are provided.

Part M is ideal if you rarely stay in the hospital or do not anticipate any hospital visits in the future.  This plan is best for those who expect to make regular visits to the doctor’s office, but do not require hospitalization.  If you need excessive hospital care or services, you will be better served with a Medigap Plan F policy.  If you are having trouble determining which plan is best for you, fill out the zip code form to compare policies and find the best available policies in your area.