Medigap is a common name for Medicare Supplement plans. Medicare Supplement is additional health insurance that helps pay leftovers in costs left by the Original Medicare because Medicare pays a lot, but not everything. Medigap is sold through private insurance companies approved by Medicare. There are 10 Medicare Supplement plans, marked alphabetically from the letter A to the letter N, each offering a different range of coverage.
Every Medicare supplement plan is a secondary payer to Original Medicare. Since Parts A and B of Medicare do not cover 100% of healthcare expenses, Medigap plans help you pay the remaining costs. As long as the provider accepts Medicare assignment, they will also accept one of the Medicare supplement plans.
Plan M
Medigap Plan M is a Medicare Supplement insurance plan with a low monthly premium and bigger out-of-pocket expenses. It is designed for people who do not expect they will need hospital treatment and do not mind the cost-sharing policy.
Medigap Plan M offers coverage for the following: 100% of Medicare Part A coinsurance and hospital costs, 50% of Part A deductible, 100% of Part A hospice care, first 3 pints of blood each year, 100% skilled nursing facility care coinsurance, 100% Part B coinsurance and copayment, and 80% of foreign travel medical costs.
Medicare Supplement plan M does not provide coverage for the following: Part B deductible, Part B excess charges, DVH services (dental, vision, and hearing), long-term care, and prescription drug coverage.
As for enrollment for Medigap plans, it is best to enroll in it during the Open Enrollment Period (OEP). Otherwise, during other enrollment periods, you may be required to take medical underwriting, and enrollment is not guaranteed. So the best time to enroll in Medigap Plan M is during six months of OEP, which begins on the first day that you turn 65 and are enrolled in Medicare Part B. To be eligible for any Medigap plan, Plan M included, you need to be enrolled in Original Medicare – Part A (hospital insurance) and Part B (hospital insurance), and live within the plan`s service area.
As for the costs, Medicare Supplement plans are standardized and regulated by the government but sold by private companies, so the costs vary from carrier to carrier. Factors that make the final premium equation include age, location, and tobacco use. In 2022 average Plan M premium was from $72 to $260 per month.
Is there a difference between Medicare Parts and Medicare Plans?
Do not confuse parts for plans, because it is a huge difference. There is no Medicare Part M, there are only four parts of Medicare: Part A, Part B, Part C, and Part D. Part A and B are Original Medicare, Part C is Medicare Advantage, and Part D is prescription drug coverage. Plans are only Medicare Supplements, and there are 10 of them, from Plan A to Plan N. Plans are secondary to Parts, as stated at the beginning of this blog. So there is only Medicare Supplement Plan M or Medigap Plan M, there is no Part M.
Craig W. Hansen is an insurance professional and co-founder of William & Michael Advisor Group LLC and Jersey Insurance Solutions. Craig has served his clients in many facets of the insurance industry, always with the same goal: excellence in service while building solid, long-term, lasting relationships. With over a decade of experience in the insurance benefits industry, Craig’s clients know they can call on him anytime and receive platinum service with a smile.
