by Russell Noga | Updated August 20th, 2023
Medicare supplement plans (Medigap) for 2024 provide supplemental insurance for seniors enrolled in Original Medicare Parts A & B.
Medigap policies cover the shortfall in coverage provided by Original Medicare. They reduce your financial liability for inpatient and outpatient services at the hospital and doctor’s office.
Without a Medigap plan, you’ll have to pay the remaining 20% of costs not covered by Medicare out-of-pocket.
As a senior, these unexpected medical and hospital expenses could ruin your finical planning for your retirement. A Medigap plan helps you mitigate this risk, bringing predictability to your annual healthcare costs.
Medigap plans are available in ten options, each offering a different scale of benefits. Some are comprehensive or near-comprehensive, while others have limited coverage.
Choosing the right plan to match your healthcare needs and budget is critical to avoid being over or under-insured.
What Is Medicare Supplement Plan M?
Medigap Plan M is one of ten Medicare supplement plans designed to help seniors cope with covering specific out-of-pocket costs relating to Original Medicare Parts A & B.
Medigap policies provide financial assistance for coinsurance, copays, and deductibles.
Plan M benefits are similar to those offered in Plan D, which is one of the more comprehensive Medigap plans.
The difference between Plan D & M is that Plan M only covers 50% of the Medicare Part A deductible. However, you get lower premiums than Plan D.
What Does Medicare Supplement Plan M Cover?
The CMS, a federal agency, regulates the Medigap market. This organization ensures all insurers offer plans with consistent benefits.
So, if you purchase a Plan M policy from Aetna, it has the same benefits as a Plan M policy from UnitedHealthcare or any other industry provider.
Plan M’s benefits are very similar to Plan D, but you have 50% coverage of the Part A deductible. Here’s what you can expect from Plan M.
- Part A coinsurance and hospital costs for up to 365 days after using up Medicare benefits.
- Part A hospice care coinsurance or copayment.
- Part B coinsurance or copayment.
- Blood transfusion costs for the first three pints of blood.
- 50% of the Part A deductible.
- Skilled nursing facility care coinsurance.
- 80% of emergency healthcare costs when traveling outside the US for 60 days. ($250 deductible and $50,000 maximum apply).
- No out-of-pocket limit.
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What Isn’t Covered by Medicare Supplement Plan M?
Plan M only covers 50% of the Medicare Part A deductible, and it doesn’t cover the Part B deductible. All Medigap plans only cover the cost of Original Medicare Part A & B expenses.
So, you don’t have any coverage for preventative treatment like foot care, chiropractic, physiotherapy, and acupuncture.
Medigap plans don’t cover dental, vision, or hearing services, and there’s no coverage for stays at unskilled nursing homes or private duty nursing. You also have no coverage for prescription drugs.
What are the Average Monthly Premiums for Medicare Supplement Plan M?
Original Medicare is a Federally-funded healthcare initiative. You receive Medicare Part A automatically when you turn 65, provided you’re registered for Social Security.
Medicare Part B is optional, and many seniors with employee or union healthcare plans delay enrolling in this policy until their healthcare insurance ends.
You’ll need to have Original Medicare Parts A & B to be eligible for enrollment into a Medigap Plan. Unlike Original Medicare, Medigap plans are available from private healthcare insurers.
As a result, the cost of a Medigap plan can vary widely between insurers.
The CMS doesn’t regulate plan pricing models between insurers as they do with the standardized benefits offered in Medigap plans.
As a result, the price you pay for Plan M with UnitedHealthcare, for example, might be higher or lower than with another provider like Cigna or Blue Cross Blue Shield.
The cost of a Plan M policy can range between $72 to $274 monthly, depending on your provider. When Medigap insurers issue your policy, they look at factors like your age, gender, smoking status, and location to determine your risk profile.
If you live in Texas, your premiums might be less expensive than in California or New York.
If you’re a man, you’ll usually pay more than a woman; if you’re a smoker, you’ll pay more in premiums than a nonsmoker.
How Do You Enroll in Medicare Supplement Plan M?
You can register for a Medigap policy during the six-month Open Enrollment period starting on your 65th birthday.
You can choose an insurer and a plan during this time, and the provider must accept you into their Medigap scheme. You get automatic approval for a plan, even if you have pre-existing medical conditions.
However, you might have to undergo medical underwriting if you register outside the open enrollment period.
If you have pre-existing conditions and the insurer deems you a high risk to its Medigap scheme, they can charge you higher-than-average premiums or deny your application.
In some instances of applying outside Open Enrollment, you might qualify for “guaranteed issue rights.” In this case, you might be able to avoid medical underwriting and receive a plan, even if you have pre-existing conditions.
A Medigap agent can assist you with understanding guaranteed issue rights and if they apply to your situation.
What are the Best Alternatives to Medicare Supplement Plan M?
Medigap Plan G is the best alternative to Plan M. You get all the same benefits and more, including full coverage for the Medicare Part A deductible.
Plan G is the most comprehensive Medigap plan after Plan F, which covers the Medicare Part B deductible. However, Plan F is unavailable for seniors who qualify for Medicare after January 1, 2020.
Plan G is also available in a high-deductible version. The HD Plan G has the same benefits as the standard version but increases the Medicare Part A deductible from $1,600 to $2,700.
In exchange for a higher deductible, you get a 75% to 80% reduction in monthly premiums.
Call Us to Learn More About Medicare Supplement Plan M
Contact our office at 1-888-891-0229 to speak to a fully licensed Medigap agent.
Our consultations and quotes are free, and we’ll match you with the right plan for your healthcare requirements and budget.
Our team works with all the insurers, and we’ll secure the best rate on monthly premiums for your plan.
If you can’t talk to us right now, leave your details on our contact form. We’ll get a qualified, experienced Medigap agent to call you back.
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Frequently Asked Questions
What is Medicare Supplement Plan M?
Medicare Supplement Plan M is one of the standardized Medigap plans available to individuals with Original Medicare. It provides additional coverage to help fill the gaps left by Medicare Part A and Part B.
What does Medicare Supplement Plan M cover?
Plan M covers a portion of certain Medicare Part A and Part B costs. This includes hospitalization, hospice care, and skilled nursing facility coinsurance or copayments. It also covers 50% of the Medicare Part A deductible.
Does Plan M cover the Medicare Part B deductible?
No, Medicare Supplement Plan M does not cover the Medicare Part B deductible. Beneficiaries are responsible for paying this deductible out of pocket before their coverage begins.
Are there any annual out-of-pocket limits with Plan M?
No, Medicare Supplement Plan M does not have an annual out-of-pocket limit. However, it provides coverage for a percentage of the costs, which can help limit your expenses.
Can I use any healthcare provider with Plan M?
Yes, you can use any healthcare provider that accepts Medicare assignment with Plan M. There are no restrictions or networks, giving you the freedom to choose your preferred doctors and hospitals.
Is Plan M available in all states?
Yes, Medicare Supplement Plan M is available in all states, but not all insurance companies offer it. The availability of Medigap plans can vary by state and insurance provider.
Can I switch from my current Medigap plan to Plan M?
Yes, you can switch from your current Medigap plan to Medicare Supplement Plan M. However, depending on your state and the insurance company, you may be subject to medical underwriting, which can affect your eligibility and premium rates.
How does the cost-sharing work with Plan M?
With Plan M, you share costs with the insurance company. The plan covers a portion of the costs, such as coinsurance or copayments, for covered services. However, it does not provide full coverage for all expenses.
Does Plan M cover foreign travel emergency care?
Yes, Medicare Supplement Plan M provides coverage for foreign travel emergency care. It covers 80% of the billed charges for medically necessary emergency care received outside the United States, up to plan limits.
Where can I find more information about Medicare Supplement Plan M?
For more information about Medicare Supplement Plan M, you can visit the official Medicare website (medicare.gov) or consult with a licensed insurance agent who specializes in Medicare. They can provide detailed information, compare different plans, and assist you in making an informed decision.