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Medigap - Plan M
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Important Points
Plan M is one of the ten uniform Medigap plans available.
In exchange for a lower premium, you pay half of the Part A deductible.
Fewer companies offer Plan M compared to other Medigap plans.
Mohring Insurance Services LLC | Talk to a Medicare Expert at (866) 440-1885
Plan M - The Deductible Sharing Plan
Medigap Plan M is one of the new Medigap plans created by the Medicare Modernization Act. It first came on the market in the summer of 2010.
Medigap Plan M has the same basic benefits as other Supplement plans, however, it has a slightly reduced monthly premium in exchange for your willingness to pay for half of your hospital deductible and all of your annual outpatient deductible. By sharing in these deductibles as well as excess charges, you get a reduced premium.
Plan M can typically be a good fit for the person who doesn't expect to visit the hospital often and feels they can afford the occasional cost-sharing. It is important to have a licensed agent who specializes in Medicare to help you. They can evaluate the differences in premiums and make sure that the savings are worth the risk of sharing in some of the expenses.
Medigap Benefits - Plan M
Medicare Part A Coinsurance & Hospital Costs
(Up to an additional 365 days after Medicare benefits are used)
Medicare Part B Coinsurance or Copayment
Blood (First 3 Pints)
Part A Hospice Care Coinsurance or Copayment
Skilled Nursing Facility Coinsurance
50%
Medicare Part A Deductible
Medicare Part B Deductible
Medicare Part B Excess Charges
Foreign Travel Emergency (up to plan limits)
Medigap Plan M - Example
Mr. Johnson buys a Medigap Plan M policy for his coverage. He really likes the idea of saving on his monthly premiums. He also has a decent amount of money set aside to pay for the occasional 50% co-insurance on the Part A deductible that he may incur. A few years into the policy, Mr. Johnson needs ankle surgery which will require him to stay overnight in the hospital. Mr. Johnson will pay for his share of the Part A deductible.
Medigap Plan M will pay most of his outpatient follow ups. Though he must first pay the annual Part B deductible, Medicare pays 80% of his outpatient care after that. His Medigap Plan M picks up the other 20%. If his surgeon does not accept Medicare's assigned rates, he will also pay the Part B excess charge. This excess charge is limited to 15% above what Medicare allows the doctor to charge. Therefore, the potential cost sharing on excess charges is small enough that Mr. Johnson feels comfortable.
Quotes for Medigap Plan M
Each Medigap insurance company chooses which plans it will offer for sale unless state law requires the company to offer certain plans. Since most people don't understand cost-sharing, they tend to fear it. Therefore, we see only a few companies offering Plan M for sale. It can be quite the chore to track them down, but if you get assistance from a Mohring Insurance Services LLC licensed agent, we can get quotes for you right over the phone.
Since only a few companies offer Medigap Plan M, we can help you get quotes from the companies that do. Contact Mohring Insurance Services LLC online to request a quote!
Key Points
Plan M offers lower monthly premiums in exchange for reduced benefits compared to some other Medigap plans.
With Plan M, you pay 50% of your Part A hospital deductible, the Part B deductible, and excess charges.
Plan M is offered less frequently compared to other plan options.
Plan M might be a fit for someone looking to save on premiums that have a decent nest egg set aside.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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Rates are reviewed periodically and are subject to change in your state.
Cost Estimates are based on the information entered, using data about past experiences by beneficiaries with similar attributes and the premiums and benefits provided by the plan. Actual costs may vary. Monthly medical costs are represented by annual figures divided evenly per month.
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