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Is a Medicare Supplement Insurance Plan M the Right Option for Me?
Medicare Supplement Plan M is one of eight standardized Medicare Supplement Insurance plans available for purchase in most states (Massachusetts, Minnesota, and Wisconsin have their own standardized Medicare Supplement plans). These plans are also known as Medigap since they fill in the coverage gaps left by Original Medicare Parts A and B. Medicare Supplement Plan M is sometimes referred to as the “shared deductible plan” and is one of the more popular supplement plans because it often has low monthly premiums with a decent amount of coverage.
Supplement Plan M covers 50% of your Original Medicare Part A deductible — the hospitalization deductible. In 2021, the deductible is $1,484 so you would be responsible for paying $704 toward annual out-of-pocket expenses for services including: inpatient hospital care, care in a skilled nursing facility, hospice care and some home health services. With Plan M, you are also responsible for paying the entire annual outpatient deductible.
In exchange for taking on what the industry calls “shared deductibles” and excess charges, Plan M offers beneficial reduced monthly premiums. This plan is often attractive to people who are in good health, those who don’t usually require hospital or skilled nursing care, and who are able to budget for potential unexpected medical emergencies. Keep in mind though, unlike Plan K for example, Plan M has NO out-of-pocket limit, so you are responsible for paying any out-of-pocket costs not covered by Original Medicare or Plan M.
What Does Medicare Supplement Plan M Cover?
Hospital Expenses: Once Original Medicare Part A benefits are used up, covers 100% of Original Medicare Part A coinsurance and hospital costs up to 365 days.
Medical Expenses: Original Medicare Part B coinsurance or copayments.
Transfusions: First three pints of blood you receive in a medical procedure.
Hospice Care: Pays 100% Original Medicare Part A hospice care coinsurance or copayments.
Skilled Nursing: Pays 100% of facility care coinsurance
Additional Hospitalization Expenses: Pays 50% of the Original Medicare Part A deductible.
Foreign Travel Medical Emergencies: Pays 80% of foreign travel emergency medical coverage (up to plan limits).
Part B Deductible
Part B Excess Charges
Medigap Plan M does not cover prescription drugs. However, you can buy an additional Medicare Prescription Drug plan to cover prescription drug costs. Another option is a Medicare Advantage plan, which typically covers prescription drugs and may also include other benefits, such as dental, gym memberships, vision and hearing coverage.
What Does Medicare Supplement Insurance Plan M Cost?
Monthly premiums are set by the private insurance companies who offer Medicare Supplement Insurance and are based on age, health status, gender and various other factors. Depending on these factors including location, insurance companies may charge different premiums for the same Medicare Supplement Plan M. That’s why it is in your best interest to shop around to ensure you are paying the lowest amount possible for your Medigap coverage. Companies may not cancel your coverage unless you don’t pay the plan premium, you weren’t truthful on the application, or the Medigap insurance company becomes bankrupt or insolvent.
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Meet a Medicare Supplement Plan M User
Ross is a recently retired accountant and, no surprise, a numbers guy. So, when it came time to shop for a Medicare Supplement Plan, he had a strategy—identify a plan that offered good hospitalization benefits.
This was important to Ross because he has a history of hospitalizations related to his asthma. Now that he was going on Medicare, it was important to him to find a supplement plan that kicked in for 100% of hospital expenses once Original Medicare coverage was used up and also helped share the burden of paying his hospitalization deductible.
A world traveler, he also wanted peace of mind that he’d be covered if his asthma acted up when he was out of the country. If he could get a plan that also offered lower premiums, even better.
For these reasons, Ross chose Medicare Supplement Plan M.
Need help navigating the Medicare Supplement Insurance Plan alphabet? To ensure you’re getting all the benefits you deserve, complete the online form to request a callback or call now and speak to a SelectQuote Medicare Plan Expert.