What are Medigap Supplement insurance plans or Medigap plans? Since you are on this page, you’re probably informed that Medigap can help you pay for out-of-pocket costs from Original Medicare (Part A and Part B). These out-of-pocket costs include deductibles and coinsurance. You can get a Medicare Supplement Insurance plan from a private insurance company and it is optional.
It is easy to compare Medicare Supplement (Medigap) Plan D with Medicare Supplement (Medigap) Plan M because they are essentially the same. The only difference is that with Medigap Plan D, the insurance covers the entire Part A deductible. While with Medigap Plan M, you will cover half of the Medicare Part A Deductible.
Medicare Supplement insurance plans are consistent no matter where you buy them. So, a Medigap Plan M you purchase in Alabama will have the same benefits as the Plan M you purchase in California. (Plan availability and premiums can vary.) If the plan has the same letter title, it will include the same coverage, location does not matter.
How does the Medicare Supplement Insurance Plan M coverage work?
Here is the benefits and amount that Medigap Plan M covers:
- It will cover up to 80% of foreign travel emergencies (or up to the plan maximum).
- The coinsurance for Skilled nursing facility (SNF) care.
- 50% of Part A deductible costs.
- Coinsurance payment or copayment for Part B.
- The first three pints of blood for a medical procedure.
- Copayment or coinsurance payment for Part A hospice care.
- If you used up all your Original Medicare benefits, then Plan M will cover an extra 365 days of Part A hospital coinsurance and hospital costs.
Medicare Part B excess charges or deductible is not under the Medigap Plan M coverage. Any extra cost that is outside of the Medicare-approved charge are Part B “excess charges.” For instance, let’s say that the Medicare-approved charge for a specialist appointment is $100. However, the physician rejects that charge and instead bills you an extra 10% for the appointment. This means that Medicare will send the physician $80 because they are responsible for 80% of the approved charge. And you will handle the left over $20 and also the remaining $10 for the remaining 10% cost. The out-of-pocket costs that you owe will total at $30.
If you are under Medigap Plan M, you will have no out-of-pocket spending limit. This means that any out-of-pocket costs that Medigap Plan M or Original Medicare does not cover, you must pay. In contrast, if you don’t want to pay out-of-pocket costs, then get a plan with an out-of-pocket spending limit. This means that your plan will cover 100% of the approved services for the rest of the calendar year once you’ve reached the limit of out-of-pocket costs.
Please note that if you want a Medicare Supplement Insurance plan, it may be easier for you to get it at certain times than others.
How to Compare Medigap Plan M with other Medicare Supplement insurance plans
Please be aware that a Medigap Plan M may not be available in your state, or every city in each state.
Do you want to compare and contrast the benefits of a Medigap Plan M versus other Medicare Supplement insurance plans? Then use our Medigap plan finder which is a tool to help you find the Medigap plan that fits your needs.