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Medicare Supplement Plan M

Last Updated: May 16, 2019 By Paul Moyer

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Keeping your health in tip-top condition should be a key priority, but life has a way of making us put it at the bottom of our to-do list.

As well as eating well and working out, ensuring that you have the right health insurance and supplements in place is an integral part of taking good care of yourself.

With so many policies and options available, it can be hard working out where to start and what you need.

While Medicare does a good job at patching up the necessities, there are gaps which need to be filled, and this is where Medicare supplements come into play.

Medicare Supplements, also known as Medigap plans, help to pay for any out-of-pocket costs, deductibles, and coinsurance not covered by Medicare and save you from having to face huge bills and debts.

They are available from private insurance companies, and this means you have the opportunity to shop around and source the very best deal for your needs.

One example of a Medigap plan is Plan M, which can be a good choice if you are unsure where to start.

Plan M is often seen as an excellent middle ground, offering a central option between Plan A, which is the most basic option available, with limited coverage at very cheap premiums, and Plan F—the top plan, offering 100-percent coverage, but at significantly increased premiums.

Benefits of Medigap Plan M

Medigap Plan M can help you with a variety of benefits offering coverage to ensure you are not out of pocket in areas such as:

  • Part A hospital coinsurance and hospital costs for up to 365 days after your original Medicare plan has expired
  • Part A hospice care coinsurance payment or copayment
  • Part B copayment or coinsurance payment
  • The first three pints of blood required in any medical procedure
  • Skilled nursing facility (also known as (SNF) care coinsurance
  • 50 percent of all Part A deductible costs
  • 80 percent of all foreign travel emergency coverage (up to the limits set by your plan)

Another advantage of a Plan M is the maximum out-of-pocket aspect. This means that any costs which are not covered by your Medicare plan, or by the Medigap plug, will need to be paid for by the policyholder.

The difference is that there is a limit to the amount you can spend. Once you have hit this limit, you will be covered for 100-percent of all medications, treatments, and healthcare requirements for the remainder of the time predetermined by your plan—usually a year.

Costs

It is important to remember that purchasing a Plan M will not entitle you to cover the Plan B deductible or excess charges.

These excess charges occur when as doctor charges a price above that set by Medicare—this is capped at a limit of 15 percent. Medicare will pay the basic rate, but you will need to top up any extra.

The out-of-pocket element also means that your costs are somewhat controlled. While you will have to find the budget for the initial costs, and certain percentages of the categories covered.

This will be between 50 and 80 percent and then you will reach a point where the payments are taken care of, and this can provide essential peace of mind if you know or suspect you will require long-term care.

The premiums for Plan M are on the lower end of the scale, meaning that this is a more affordable option for those on all sorts of budgets.

There is, of course, a price to pay for this reduced cost; you will have to find more of the coverage, including deductibles and coinsurance.

With this plan, you will be trading lower, more affordable premiums for the sacrifice of being responsible for covering a more significant percentage of your medical costs.

Plan M is often closely compared to the very similar Plan N, and it can be challenging to choose between the two.

One key difference is that Plan N can have lower premiums for comparable coverage, and this often helps it inch ahead in the competition.

Plan N is the cheaper option, but it does not cover Part B deductibles or copayments which come with visits to the emergency rooms or seeing a doctor.

While Plan M also excludes this bonus—indeed, this exemption has become commonplace across all healthcare plans and supplements—it can actually work out as the cheaper option, as it does not require co-payments.

In addition, it only covers 50 percent of your Plan A deductible, and this can significantly reduce your monthly premiums.

When deciding on a plan, it is crucial to see the bigger picture. It may be tempting to go for the cheapest possible monthly premiums with the honest intention of making up the shortfall in the event of an emergency.

In real life, however, things are unlikely to work out this way. You run the risk of facing huge bills thanks to deductibles and exemptions, and this can work out far more expensive than opting for a more comprehensive plan from the outset.

medicare supplement plan m

Medicare Supplement Plan M Alternatives

Plan N – One of the most popular plans, Medigap Plan N covers most of your expenses, but is not as comprehensive as F, G, or C.

Plan K – With a $5,500 out of pocket limit, Medigap Plan K keeps your premiums much lower.

Plan C – Leaving excess charges from Part B filing open, Medigap Plan C’s coverage is one of the most comprehensive.

Availability

The affordable cost of Plan M means that it is more accessible to a wider market. It is seen as a halfway option, offering more than the basics, but fewer bells and whistles than Plan F.

It can be an ideal option for those who have more complex health issues or ongoing conditions. If you think you may need care in a hospital or a skilled nursing facility, Plan F can offer the coverage you need while still being affordable.

Taking care of your health is a priority, and it is crucial that you choose a healthcare solution which works for you.

Plan M allows a good amount of coverage for an affordable price, and can provide you with the security and financial protection you need should the worst case scenario occur.

Make sure you research all options before committing, and be sensible and forward thinking with your finances to get the best deal for yourself and your family.

First Published May 16, 2019

About Paul Moyer

Paul Moyer is the owner and Founder of SavingFreak.com. He is a licensed insurance agent, personal finance blogger, and financial coach. With the help of with his wife Amy, Paul has been debt free since 2006.

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Table of Contents

  • Benefits of Medigap Plan M
  • Costs
  • Medicare Supplement Plan M Alternatives
  • Availability

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