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Is Medigap Plan M for you?

Maryalene LaPonsie | June 6, 2011

Medigap Plan M is one of two newcomers to the slate of 10 Medigap offerings, having debuted in June 2010 along with Plan N.

Generally considered an alternative to the popular Medigap Plan F policy, Plan M pays 50 percent of the Medicare Part A deductible ($1,132 in 2011) and none of the Medicare Part B deductible ($162 in 2011), according to Medicare.gov.

Medigap Plan M offers protection against such costs as lengthy hospitalizations, skilled-nursing facility stays and medical emergencies during foreign travel.

When a need that falls within the plan arises, Medigap Plan M is a supplemental health insurance policy that can reduce your out-of-pocket expenses. To determine whether Medigap Plan M is right for you, first make sure you have basic knowledge of Medicare and Medigap plans, and then evaluate whether Plan M's features are tailored to your specific needs.

Medicare and supplemental health insurance

Medicare is medical insurance offered by the federal government to senior citizens, as well as individuals with certain disabilities. Broken into two parts, Part A and Part B, Medicare includes both hospital and outpatient medical coverage. However, original Medicare requires beneficiaries to pay for deductibles, coinsurance and co-payments.

Medigap is the name given to policies sold by private health insurance companies to fill the 'gaps' in original Medicare. Not comprehensive medical insurance, Medigap instead covers your original Medicare co-payments, coinsurance and deductibles. If you are married, your spouse will need to purchase a separate Medigap plan if they also qualify for Medicare because Medigap plans only cover one person.

Medigap is not right for everyone. If you have a Medicare Advantage plan, you cannot buy Medigap supplemental health insurance, for instance.

When you compare insurance quotes for Medigap plans, you will see there are 10 plans in total, labeled with a letter from A through N (new policy sales of Medigap Plans E, H, I and J have been discontinued). Each letter represents a standardized package of benefits. Compare quotes from different companies to find the best health insurance rate for the plan that's right for you.

Medigap Plan M benefits

As one of the new Medicare supplemental health insurance options, Medigap Plan M provides coverage for the following:

  1. Part A coinsurance for hospital costs up to 365 days after your original Medicare benefits are exhausted
  2. 50 percent of the Part A deductible
  3. Part A Hospice coinsurance and co-payments
  4. Part B coinsurance and co-payments
  5. Part B preventive care coinsurance
  6. First three pints of blood
  7. Skilled nursing facility coinsurance
  8. Emergency care during foreign travel

Medigap Plan M does not pay Medicare Part B excess charges, which means those expenses will still need to be paid by you out-of-pocket if you go with Plan M. Still, Medigap offers supplemental health insurance policy that can greatly reduce Medicare out-of-pocket expenses.



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