Medigap Plan M
Medicare Supplement Plan M is a “fairly new” Medicare Supplement created by Medicare in 2010, as part of the Medicare Modernization Act.
Medicare Supplement Plan M will pay 50% of the Medicare Part A hospital deductible. It also provides 365 days of hospital coverage.
Medicare Supplement Plan M does not pay the annual Medicare Part B deductible or excess charges. It does however cover the remaining 20% of expenses that Medicare Part B does not cover.
Although Medicare Plan M offers comprehensive coverage, it unfortunately is not offered in all markets, and therefore may not be an option in your zip code.
Medigap Plan M - Consider this Scenario
Mr. Morris is relatively healthy, an avid runner, and recently retired with a considerable nest egg. He buys a Medigap Plan M for his coverage and feels he will enjoy the savings on the yearly Medigap premiums. Mr. Morris also doesn’t mind paying for the occasional 50% co-insurance on the Part A deductible that he may incur. A few years into his retirement, he needs knee surgery which requires an overnight stay in the hospital. Mr. Morris will pay $670 in 2018 for his share of the Medicare Part A deductible not covered by his plan.
Mr. Morris’s Plan M will also cover most of his physical therapy treatments and outpatient follow-ups. Medicare pays 80% of his outpatient car, after he meets the $183 Medicare Part B deductible. His Medicare Supplement Plan M picks up the other 20%. If his knee surgeon does not accept Medicare’s assigned rates, he may also be responsible for the Medicare Part B Excess Charges. These charges are limited to 15% above what Medicare allows the doctor to charge. Mr. Morris feels confident that his potential cost sharing is minimal, so it’s not a big deal for him.
So, if you’re like most people when it comes to understanding cost-sharing and trying to figure out which insurance companies offer a Plan M, you may feel like your “spinning-your-wheels” just trying to figure it all out. If so, you’re not alone . . .
Fortunately, the trusted insurance agents at New Jersey Medicare Plan can help - just give us a call at 1 (844) 280 -0785 and we’ll do the heavy lifting for you!
|Medicare Supplement Insurance Plans (Medigap)|
|Part A coinsurance and
hospital costs (up to an
additiona 365 days after
Medicare benefits are used)
|Part B coinsurance or
|Blood (first 3 pints)||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A hospice care
coinsurance or copayment
|Skilled nursing facility care
|Part A deductible||100%||100%||100%||100%||100%||50%||75%||50%||100%|
|Part B deductible||100%||100%|
|Part B excess charges||100%||100%|
|Foreign travel emergency
(up to plan limits)
* Plan F is also offered as a high-
dedutible plan by some issuers in
some states. If you choose this
option, this means you must pay for
Medicare-covered costs (coinsurance,
copayments, deductibles) up to the
deductible amount of $2340 in 2020
before your policy pays anything. Plan C and plan F are only available to those who are not new to Medicare.
** Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission.
*** For Plans K and L, after you meet your out-of-pocket yearly limits and your yearly Part B deductible ($198 for 2020), the Medigap plan pays 100% of covered services for the rest of the calendar year.