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Medigap Plan M

Medicare Plan M is a Medigap supplement that is 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 of these are not correct, but we can understand why there is confusion.

Medigap Plan M
Medigap Plan M

Benefits included in Medigap Plan M

Many of the Medigap Plan M benefits are similar to other Medigap Supplement Plans. Plan M covers the Medicare Part A Coinsurance and Hospital Costs – including and additional 365 days after your Medicare Benefits are used up. Plan M covers your Medicare Part B coinsurance and copayment. Also covered is the first three pints of Blood. Medicare Part A Hospice Care copay and coinsurance is 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 is one area that is different from most of the Supplement Plans on the market and part of the reasoning 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 D deductible is $183 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($1,340 deductible per benefit period for 2018) and assuming responsibility for the Part B deductible ($183 for 2018) 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 is right for your individual healthcare needs. If you are not going to be experiencing any medical issues or procedures this plan could save you significant premiums. However, there are no guarantees on heath, so discussing this plan along with other options with a knowledgeable agent is very important.

We are happy to help you navigate the sometimes confusing world of Medicare! Please contact us with questions or concerns with your Medicare options.