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Medicare Supplement Part M | Medigap

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Medicare Supplement Insurance Plan M

Medicare Supplement Insurance, also known as Medigap, helps pay some of the costs that Original Medicare doesn’t cover, like:

  • Deductibles
  • Copays
  • Coinsurance

Original Medicare and Medicare Supplement Insurance work together:

  • First, Original Medicare (Part A and Part B) pays its share of the Medicare-approved amount for your covered health care costs
  • Then, your Medicare Supplement Insurance pays its share

You can buy Medigap policies through private insurance companies. There are several different Medicare Supplement plans, so you can choose the one that fits you best.

Partial Benefits, No Yearly Out-of-Pocket Limit

Plan M has similar coverage as Part A but does not cover the Part B deductible. It also doesn’t cover Part B excess charges. You will receive Part B excess charges when your doctor charges more than the Medicare-approved amount for a service. You may not always receive excess charges. But in the case you do, it’s up to you to cover those.

Important note: Plan M has no out-of-pocket limit. This means that you will have to pay all out-of-pocket costs that Original Medicare and Medigap Plan M don’t pay. You will also have to meet your Part B deductible before Original Medicare starts paying for Part B services.

Medigap Plan M offers coverage for:

  • 50% of Part A deductible, which is $1,340 in 2018
  • Part A hospital coinsurance and costs (up to an additional 365 days after your Original Medicare benefits have been exhausted)
  • Part B copays or coinsurance
  • First three pints of blood for an approved medical procedure (yearly)
  • Part A hospice care copays or coinsurance
  • Skilled Nursing Facility (SNF) coinsurance
  • 80% of foreign travel emergency benefits

Because Medicare Supplement insurance plans are standardized, no matter what state you buy a Plan M policy, it will be the same. Premiums and availability could be different though.

Medicare Supplement vs. Medicare Advantage

It’s important to know that a Medicare Supplement Plan is different from a Medicare Advantage Plan. A Medicare Advantage Plan is another way to receive Medicare benefits. A Medicare Supplement Plan (Medigap policy) works together with your Original Medicare benefits and supplements them. Before you decide which option fits your needs, it’s a good idea to read about these choices and talk with a Medicare specialist.

Things to remember:

  • You must have Original Medicare (Part A and Part B)
  • You must continue to pay your Part B premium
  • You will also pay a monthly premium for your Medigap policy
  • You can buy a Medigap policy from any insurance company that’s licensed in your state to sell one
  • Your Medigap policy cannot be canceled by the insurance company as long as you pay your monthly premium
  • Medigap policies are not allowed to offer prescription drug coverage

For more information:

  • Visit Medicare.gov
  • Contact the private insurance companies that sell Medigap policies
  • Call 1-800-MEDICARE (1-800-633-4227) (TTY: 711) 24 hours a day, seven days a week
  • Call your State Health Insurance Assistance Program (SHIP)