Plan M

There are 10 standardized Medigap plans available in most states and they are lettered from Plan A to Plan N. All the plans differ in terms of coverage for services, out-of-pocket limits, and premium costs.

Plan M offers supplemental coverage or Original Medicare and as a relatively low monthly premium. It’s great for Medicare beneficiaries who are financially prepared to pay out-of-pocket for some of their healthcare expenses.

Coverage Benefits

Medigap Plan M

Medigap Plan M is one of the cost-sharing Medigap policies. Out of all the three available cost-sharing plans, plan M offers the most comprehensive benefits. The only cost-sharing that is required is for the Part A deductible. Plan M members will need to pay 50% of the Part A inpatient deductible.

Plan M will pay for all of your coinsurance and copays associated with Medicare Part B. Also it will cover the Part A inpatient coverage up to 365 days after the Part A benefits have been exhausted.

Plan M does not cover the Part B deductible or Part B excess charges. Not every state allows Part B excess charges, so if you reside in one of those states, this is not an issue. Excess charges are not common, even in states that allow them.

Medigap Plan M covers:

What Medicare Supplement Plan M Doesn't Cover

  • Part B deductible

  • Prescription drugs.

  • Long-term care (like non-skilled care you get in a nursing home).

  • Dental care.

  • Vision care.

  • Private-duty nursing.

Individuals Who Benefit from Plan M

Medigap Plan M is a good option for individuals who would like coverage outside of Original Medicare and don’t mind paying 50% of hospital costs. Plan D is also great for individuals who like to occasionally travel outside of the United States and are looking for a plan with a lower monthly premium.

Medigap Plan M Premiums

Individual premiums will vary based on which state the individual is seeking coverage in, which carrier they’re purchasing from, and also individual factors like gender, age, tobacco use, and a few other details. The average cost for Plan M ranges from $120-$2000 each month. In general, Plan M premiums are higher in states who have a higher cost of living.

Plan M and Prescription Drug Coverage

Medigap Plan M does cover prescription drugs administered while under inpatient care. However, it does not cover medications that have been prescribed by a doctor and are administered at home. Medigap plan members will need to enroll in a stand-alone Part D plan to get prescription drug coverage.

The Best Alternative to Plan M

There are several good alternatives to Plan M, depending on how much an individual wants to pay for the monthly premium. More comprehensive coverage is offered by Plans F and G, but they come with the highest premiums. The other two cost-sharing plans are Plans K and L. They have less coverage than Plan M, but also have lower monthly premiums.

How to Compare

Medigap Plan M Rates

There is a lot of information about each plan online, but to get an accurate quote, you’ll need to enlist the help of a licensed Medicare agent. Instead of calling each insurance carrier to get a quote, we can compare premiums across many different carriers, ensuring that you enroll with one that gives you the best rate.

We’ll need to collect some information from you in order to provide quotes since your premium is based on your information and health history, but our services come at no additional cost to you! If you choose to enroll in a Medigap plan through our agency, we also offer unlimited support. If you have problems with your coverage or have questions about how your plan works, we will be here to help.

Questions to be advised on:

The Missouri Medicare Advisor website character Matt Temmen discussing Questions to be advised on.
“Part N” is incorrect terminology. “Parts” only refer to Original Medicare (Parts A and B), Medicare Advantage plans (Part C) and prescription drug plans (Part D).
Yes, Plan M is available for all Medicare beneficiaries to enroll in.
As with every other aspect of Medicare, the answer to that question depends on your healthcare needs and budget. The difference between the two plans involves the cost-sharing portion. Plan M requires 50% cost-sharing for the Part A deductible and Plan N requires copays for Part B.
If you turned 65 prior to January 1, 2020, you may be able to move to Plan F. However, if you do not have guaranteed issue rights, you will have to first pass medical underwriting.
Individuals can enroll in Plan M as long as they have already enrolled in Original Medicare – Parts A and B. The best time to enroll is during your open enrollment period, which begins on your Part B effective date. Beneficiaries will have six months from that day to enroll in a plan with guaranteed issue rights. After that time frame, enrollment may be declined based on an individual’s health history.
Neither Plan M nor any other Medicare supplement plan offer benefits for routine vision exams or eyeglasses. Medicare beneficiaries who enroll in a Medicare supplement should consider enrolling in a separate Dental, Vision, Hearing (DVH) plan.
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