If you’re on Medicare, you probably know that without additional insurance, you could be responsible for large out-of-pocket bills. Medicare Supplement (Medigap) Plan M is an insurance policy that works secondary to Original Medicare and helps you control those costs. Medigap Plan M is one of the ten standardized Medicare Supplement plans available.
What Does Medicare Supplement Plan M Cover?
Medicare Supplement Plan M covers the following Medicare expenses:
- Medicare Part A coinsurance
- Medicare Part B coinsurance or copayment
- Blood (first three pints) (75%)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Medicare Part A deductible, which is $1,408 in 2020 (50%)
- Foreign travel emergency
Medigap Plan M only covers half of the Medicare Part A deductible. Part A covers your inpatient services, so you’d only receive a bill if you’re admitted to the hospital for treatment. If you have Plan M in 2020, you’d have to pay $704 for the deductible instead of the full $1408.
What Doesn’t Medicare Supplement Plan M Cover?
There are a few costs from Original Medicare that Plan M doesn’t cover. Plan M doesn’t provide protection from:
- Medicare Part B deductible, which is $198 in 2020
- Medicare Part B excess charges
The costs of Medicare Part B excess charges can be difficult to predict, but fortunately, most doctors don’t require them, and they have to notify you ahead of time if they do. Most doctors accept Medicare assignment, which is the amount that Medicare agrees to pay for a given service. If the provider wishes to receive more compensation, they can apply excess charges, which can be up to an additional 15% of the amount that Medicare pays. If you have Medicare Supplement Plan M, you’d be responsible for the excess charges.
Is Medicare Supplement Plan M Right for Me?
Medigap Plan M may offer the right level of coverage for you if your healthcare providers don’t charge excess charges. Otherwise, you may want to find a plan that covers these fees, such as Medigap Plan G. Availability for Plan M is limited as many carriers don’t offer it, so you may not be able to apply for it, or find a plan at a competitive rate.
We ultimately recommend that our clients choose the plan that gives you the coverage that you need, at a price that you can afford. Your Medicare Supplement plan should make you feel comfortable that you can receive top-notch healthcare when you need it and without having to worry about the cost. Medigap Plan M may be the right choice for you, but it’s wise to compare your options for Medicare Supplement plans before making your selection.
Nothing on this website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.