Medigap Plan M Details

Find out how Medigap Plan M works and what it covers

by Senior 65+ on Oct 23, 2015

Medigap Plan M Overview

Medicare Supplement Plan M, commonly known as Medigap Plan M, helps to fill in some of the gaps in coverage that Original Medicare leaves open. Medigap Plan M offers supplemental coverage that has a lower monthly premium than some other Medigap plans, because you still have to pay for some Medicare costs.

Remember Medicare Plan M plans are designed to complement Original Medicare Part A and Part B. Below is a list of what you would pay under Original Medicare alone, and then what you would pay if you enroll in Medigap Plan M

Medigap Plan M Benefit Details

Benefits Original Medicare Alone Original Medicare With Medigap Plan M
Doctor Network All Doctors that accept Medicare All Doctors that accept Medicare
Part A Hospital Benefit Period Deductible You pay $1,364* You pay 50%
Hospital days 61-90 You pay $335 per day per day You pay $0
Hospital Days 91-150 You pay $670 per day per day (lifetime reserve days) You pay $0
Beyond Lifetime Reserve Days You pay 100% You pay $0 up to an additional 365 hospitalization days.
Skilled Nursing Facility Care Days 1-20 You pay $0 (Part A deductible applies)** You pay $0, after Part A deductible
Skilled Nursing Facility Care Days 21-100 You pay $167.50 per day You pay $0, after Part A deductible
Hospice Respite Care You pay 5% You pay $0
First 3 Pints of Blood You pay 100% You pay $0
Additional Blood You pay $0 You pay $0
Part B Annual Deductible You pay $185 You pay $185
Ambulance You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Doctor’s Office Copays/Coinsurance You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Durable Medical Equipment You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Part B Excess Charges You pay 100% (Part B deductible applies) You pay 100% (Part B deductible applies)
Foreign Travel Emergency You pay 100% You pay 20%***
Out-Patient Surgery You pay 20% (Part B deductible applies) You pay $0, after Part B deductible
Urgent Care You pay 20% (Part B deductible applies) You pay $0, after Part B deductible


Next Steps for Medigap Plan M

Get quote: Click here to see prices for Plan M

The fine print of the Medigap Plan M Chart Above

*Medicare Part A deductible is broken down into 60 day benefit periods. You have to pay the deductible if you reenter the hospital after 60 days from discharge. Example: If you enter the hospital March 1st you’ll pay the Part A deductible. If you leave the hospital 5 days later and return to the hospital on July 6th, you will be charged the Part A hospitalization benefit again.
**For Skilled Nursing you must have a 3-day qualifying stay in the hospital to qualify for Skilled Nursing Facility care AND you’ll still pay the benefit period Part A deductible ($1,364).
***Foreign Travel Emergency requires a deductible of $250. You will have to have your emergency within the first 60 days of travel, and the plan has a lifetime coverage amount of $50,000.
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