Medigap Plan M
| Medigap Plan M Policy Coverage | |
|---|---|
| Basic Benefits |  |
| Part A Deductible | |
| Part B Deductible |  |
| Part B Excess | |
| Skilled Nursing Coinsurance | |
| Foreign Travel Emergency | |
| At Home Recovery | |
| Additional Preventative Care | |
Quick Introduction to Medigap Plans
Medigap is a private health insurance policy that is designed to cover medical costs not covered by Medicare programs. It covers many costs— such as copayments, coinsurance, and deductibles— that people would otherwise have to pay individually. There are fourteen different Medigap plans, ranging from A to N. Although any insurance company offering Medigap is required to offer Plan A, the availability of other plans will vary by insurance company and by state. These plans do not cover costs for long-term nursing, vision, dental care, hearing devices, or private nursing. This article will deal exclusively with Medigap Plan M, covering some of the benefits and other considerations.
Medigap's new Plan M Policies
Medigap Plan M was introduced, along with Plan N, on June 1, 2010 as part of MIPPA (also known as the Medicare Improvements for Patients and Providers Act). Like its predecessors, Medigap Plan M includes a handful of basic coverage features in addition to its unique advantages. Among other things, this basic coverage includes:
- Coinsurance for Medicare Part A as well as any costs that arise after hospital benefits run out
- Coinsurance for Medicare Part B (preventative services)
- Copayment/Coinsurance for Medicare Part B (non-preventative services)
- The first three pints of blood, if any is required for treatment
Coverage Details and Limitations for Medigap Plan M
In addition to the above, Medigap Plan M offers the following benefits:
- Covers 50% of the hospital deductible of Medicare Part A (up to $275 per benefit period)
- Covers co-insurance for Medicare Skilled Nursing
- Foreign Travel Emergency Coverage
Along with its advantages, however, Medigap Plan M also has some drawbacks:
- Provides no Medicare Part B Deductible Coverage; Part B Deductible is $155
- Provides no coverage for allowable Medicare Excess Charges, up to 15% over Medicare-approved expenses
Further Considerations Regarding Medigap Plan M
Overall, this plan minimizes out-of-pocket costs for hospitalization, overseas care and skilled nursing. Its premiums tend to run up to 30% lower than that of a typical full-coverage Medigap plan, but this is balanced by the fact that a greater proportion of any potential health care costs are borne directly by the policy-holder.