Medicare Supplement Plan M

By: Agnus Smith
Published: Thursday, July 26 2018
Last Updated: 4 years ago

If you're on the verge of qualifying for Medicare, it's important for you to review your options for Medicare Supplement Plan M coverage. As a form of inexpensive, subsidized health insurance for seniors 65 and over, Medicare allows you to access the health care you need to live out your golden years with dignity. However, Medicare doesn't cover all of your costs. That's where Supplemental plans like Medicare Plan M come in.

Altogether, there are 10 Medicare Supplemental plans, and each covers out-of-pocket expenses to some degree. Before you speak to a Medicare insurance specialist about which Medigap insurance plan is right for you, here's some information about Medicare Supplement Plan M.

What Is Medicare Plan M?

Medicare Supplement Plan M was created to help offset the cost of medical care for seniors who are eligible for Original Medicare Parts A and Part B. It's one of 10 Medigap insurance plans offered by private insurance companies.

Since Medicare Plan M coverage is standardized by the US government, it's easier for you to compare plans from insurer to insurer. The only difference is the cost of Medicare Plan M premiums and the underwriting criteria to qualify. Medigap Plan M is accepted by any doctor who takes Medicare, and it pays for any costs not covered by your Original Medicare.

What Medicare Supplemental Plan M Covers?

Your Medicare Supplemental Plan M will remove some of the financial concerns about copays and coinsurance from your shoulders. It takes care of many out-of-pocket expenses if you're hospitalized beyond the allowable limit for Medicare Part A. As long as you've met the required portion of your deductible, your Medicare Supplement Plan M will cover:

  • Medicare Part A hospital costs for up to one year after you've exhausted your original Medicare limit.
  • Medicare Part B coinsurance and copays.
  • Up to three pints of blood if you need a transfusion during a medical procedure.
  • Coinsurance and copays for Part A hospice care coverage.
  • Coinsurance and copays for Part A approved skilled nursing care (SNC).
  • 50% of your Medicare Part A deductible.
  • Foreign emergency care up to the plan limit.
  • Doctor's office visit copays above $20.
  • Emergency room copays, if you are admitted to the hospital after.

What Doesn’t Medicare Plan M Cover?

Medicare Supplement Plan M pays for many out-of-pocket expenses not covered by your Original Medicare Part A and Part B insurance. However, Medigap Plan M will only cover the insured. If you're married, your spouse will have to purchase their own Medicare Supplemental Plan M Coverage. Be aware that seniors living in Massachusetts, Minnesota, and Wisconsin will be offered Medigap Plan N coverage with different standards. Expenses not covered under Medicare Plan M include:

Excess charges are fees that doctors are allowed to charge above the approved limit. They're capped at 15%. Doctors in Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont are not allowed to charge excess fees.

Medicare Supplement Plan M Cost

You'll get the same Medicare Plan M benefits no matter who you purchase your plan from. The only difference is the amount of your Medicare Supplemental Plan M premiums. We go out of our way to make sure you'll get the most accurate, updated quotes from companies offering Medicare Plan M coverage.

Any premiums you pay toward your Medicare Plan M policy go to a private insurance company; your Medicare premiums are separate. We invite you to browse our website and compare prices from different Medicare Plan M providers.

Who Should Consider Medicare Plan M?

Medicare Plan M is for seniors who don't mind paying a little extra each month to avoid higher out-of-pocket expenses later. If you don't want Medicare Advantage and you don't have another health insurance plan through an employer, consider Medicare Plan M coverage. The following health insurance does not provide the same benefits as Medigap Plan M:

  • Medicare prescription drug plans
  • Medicaid
  • Employer-provided plans, including Federal Employees Health Benefits Program (FEHBP)
  • Veteran's benefits
  • Indian Health Service, Tribal, and Urban Indian Health plans
  • Long-term care insurance

You must already have Medicare Part A and Part B in order to apply for a Medigap Plan M policy. If you have a Medicare Medical Savings Account (MSA) Plan, it's illegal for an insurance company to sell you any Medigap plan.