Medigap Plan M

Information Provided by a Medicare Supplement Insurance Representative

Medicare with Plan M

The chart below describes the common Medicare benefits along with gaps left by Medicare for you to pay.

Part A (Hosptial Insurance)
I. In patient Gap (you pay) Plan M
days 1-60 deductible* %50
days 61-90 life time reserve coinsurance ✔ Paid
days 91-150 coinsurance ✔ Paid
after 150 days Medicare quits paying next 365 paid in full ✔ Paid
II. Skilled Nursing Gap (you pay) Plan M
Medicare pays 20 days in full
days 21-100 ✔ Paid
Part B (Medical Insurance)
Gap (you pay) Plan M
Annual Deductible ✖ Not Paid
Medicare Covers 80% 20% ✔ Paid
Part B Excess 100% ✖ Not Paid
$50,000 emergency medical outside USA $250.00 deductible 80/20 ✔ Paid

*The hospital benefit period is reset by Medicare 60 days from your previous hospital release date.

The Medicare Supplement Insurance Plan M is a new addition to the Medicare Supplement line up as of June 1, 2010. This additon is an attempt to lower out-of-pocket costs for consumers and to provide them with additional benefits not found in their current plans.

Medicare Supplement Plan M includes basic benefits which include:

  • Hospitalization: Medicare Part A coinsurance plus coverage for 365 additional days after Medicare benefits end.
  • Medical Expenses: Medicare Part B coinsurance (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services. Plans K, L, and N require insured to pay a portion of Medicare Part B coinsurance or copayments.
  • Blood: First 3 pints of blood each year. Hospice: Medicare Part A coinsurance.

Hospice Care will be included in all Medicare Supplement Insurance Plans as of June 2010.

Medicare Supplement Insurance Plan M offers increased cost-sharing and includes many similar benefits to other plans like Medicare Supplement Insurance Plan D , but will only cover 50% of the Medicare Part A (Hospital) deducible and none of the Medicare Part B (Medical) deductible. The cost of Medicare Supplement Insurance Plan M is expected to be priced at approximately 92% of the current Plan D costs, or 85% of Medicare Supplement Insurance Plan F, which is currently the most popular plan.

Medicare Supplement Insurance Plan M includes the basic benefits, which include inclusive coverage for Medicare Part A (Hospital) inpatient coinsurance, coverage for expenses after your Medicare benefits run out, coinsurance for Medicare Part B (Medical) blood services, hospice charges for drugs, and foreign travel emergency expenses.

Medicare Supplement Insurance Plan M could be beneficial if you have not been to the hospital for a while or do not anticipate going to the hospital soon because Medicare Part A (Hospital) covers inpatient related costs. This plan could be beneficial to you if you do have frequent doctor visits. A good rule-of-thumb would be to make sure that the premiums on the Medicare Supplement Insurance Plan M cut your premiums by at the minimum one half of the annual Medicare Part A (Hospital) deductible. If you are not saving at least this much or more on your premiums, you could at best break even or lose money if you undergo inpatient hospital care.

All plans were standardized by the federal government in 1992 for your protection. This means that you are to go by the letter I.D. of the plan to determine what benefits each plan will cover.

The only 2 things that an insurance company who offers a Medicare Supplement Insurance Plan M can have any control of are:

  1. Underwriting
  2. Premium price


We have only briefly touched on one Medicare Supplement Insurance Plan, and as you can see it can be very confusing and somewhat overwhelming. We deal with Medicare daily and your Medicare Specialist here at can “Take the Mystery Out of Medicare” by walking you through the maze every step of the way. We are committed to you by shopping the best plans from the top companies available. We will do what it takes to make sure you become a very happy, satisfied client. To find out more if a Medicare Supplement Insurance Plan F is right for you, contact a Medigap Plan Representative now or talk to one of our licensed Medicare Specialists by entering your zip code and clicking the ‘Go’ button.


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