Medicare Plan M is a Medigap supplement commonly referred to as the Deductible Sharing Plan. Medigap Plan M is a relatively new plan introduced by the Medicare Modernization Act. Plan M hit the market in 2010 but remains relatively unknown. Sometimes Medigap Plan M can be referred to as Medigap Part M or Medicare Part M – both are incorrect, but we can understand why there is confusion.
Benefits included in Medigap Plan M
Many Medigap Plan M benefits are similar to other Medigap Supplement Plans. Plan M covers the Medicare Part A Coinsurance and Hospital Costs – including 365 days after your Medicare Benefits are used up. Plan M covers your Medicare Part B coinsurance and copayment. Also protected are the first three pints of Blood. Medicare Part A Hospice Care copay and coinsurance are covered as well. The coinsurance for a skilled nursing facility and some Foreign Travel Emergency is covered through Plan M. Medigap Plan M also covers 50% of the Medicare Part A Deductible. This area differs from most of the Supplement Plans on the market and is Part of the reason Plan M is referred to as the Deductible Sharing Plan.
What is Not Included in Medigap Plan M?
In addition to paying 50% of your Part A Deductible, you will also be responsible for your Part B deductible. The Part B deductible is $226.00 for the 2018 plan year. You are also responsible for any excess charges incurred during your medical care. Excess charges are charges that providers may pass on to you if they do not accept Medicare assignment. This can be an additional 15% over the Medicare-approved charges for services. Please see our article on Medicare Excess Charges for more information.
Who is a good candidate for Plan M?
By sharing half of the Part A deductible($1,600 deductible per benefit period for 2023) and assuming responsibility for the Part B deductible ($226 for 2023), you will be pleased to know that your premiums could be significantly lower than other Medicare Supplement Plans. The tricky part is determining whether this plan suits your individual healthcare needs. If you are not experiencing any medical issues or procedures, this plan could save you significant premiums. However, there are no guarantees on health, so discussing this plan and other options with a knowledgeable agent is very important.
We are happy to help you navigate the sometimes confusing world of Medicare. Please get in touch with us with questions or concerns about your Medicare options.