Medigap Plan M Supplement Insurance

Medigap Plan M is one of several plans sold by private insurers that help people cover the “gaps” in their coverage with Original Medicare – Medicare Part A and Part B.

Also called Medicare Supplement Plan M, it covers most typical out-of-pocket costs associated with Original Medicare. But it pays only half of your Medicare Part A deductible if you are hospitalized.

Medigap Plan M – like all other Medigap Plans – does not provide dental, vision, hearing or prescription drug coverage. You can purchase a Medicare Advantage plan that will cover these costs.

Alternatively, you can add a Medicare Part D prescription drug plan to your Original Medicare to cover prescription medicine costs. But it still won’t cover hearing, dental and vision care.

You cannot add any Medigap plan to a Medicare Advantage plan.

Medigap Plan M has a lower monthly premium than comparable Medicare supplement plans. But the trade-off is that you have to pay half of your Medicare Part A hospital insurance deductible.

Where you live, when you purchase your plan and other factors may affect how much your monthly premium will be.

Medigap plans are standardized – meaning that no matter where you buy a Medicare Plan M policy, the benefits will be the same. But Medigap plans are sold by private insurers, and each insurance company uses different measures to set its monthly premium.

The biggest difference between Medigap Plan M and Medigap Plan D is how much each pays toward your Medicare Part A deductible – $1,600 in 2023. Medigap Plan M pays 50% of this deductible, while Medigap Plan D covers the full deductible. 

The trade-off is that monthly premiums for Plan M will likely be less than those for Plan D.

Monthly premiums for Medigap Plan M and Plan D vary depending on where you live and other factors. If you’re considering both Medigap plans, compare costs among different insurance companies selling one or both.

Medigap Plan M is best suited for people who don’t mind paying the Medicare Part A deductible and who live in states that don’t allow Medicare Part B excess charges.

Doctors are allowed to charge up to 15% above the Medicare-approved cost for services. Under Plan M, you have to pay this excess charge out of your pocket.

But if you live in one of the eight states that prohibit excess charges, Plan M may again be worth considering.

Medicare Part A hospital insurance only comes into play if you are admitted as an inpatient to a hospital. If you don’t expect you’ll need to be hospitalized – or can afford half the cost of the deductible – Medigap Plan M may be worth considering.