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Medicare Supplement (Medigap) Insurance Plan M

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Medicare Supplement Plan M is more or less in the middle in terms of the portions of Original Medicare (Part A and Part B) out-of-pocket costs that Medigap plans cover.

With a Medigap Plan M policy, the following costs and benefits are covered:

  • Medicare Part A hospital coinsurance and hospital costs up to a year after Original Medicare benefits are used up
  • Part A hospice care coinsurance and copayments
  • Medicare Part B copayments and coinsurance
  • First three pints of blood for a medical procedure
  • Skilled Nursing Facility care coinsurance
  • Medicare Part A deductible (50%)
  • Foreign travel emergency coverage (80% of approved costs up to plan limits)

One Original Medicare expense that Medigap Plan M doesn’t cover is the Medicare Part B deductible. Medigap Plan M also doesn’t cover Part B excess charges. Excess charges are an amount that a doctor or physician can charge (up to 15%) more than the Medicare-approved amount for a visit or service.

Medicare Supplement Plan M costs

Medicare Supplement insurance is sold by private insurance companies that set monthly premiums for their policies based on any of three rating systems: community-rated, issue-age-rated, and attained-age-rated. Insurance companies may consider factors such as gender, age, and health status to set premium amounts. So, Medigap Plan M premiums may vary depending on where you buy it, but all Medigap Plan M policies include the same basic benefits.

Your Medigap insurance company generally can’t cancel your policy unless you don’t pay the plan premium, your application included information you knew to be incorrect, or the Medigap insurance company becomes bankrupt or insolvent.

When to enroll in Medicare Supplement Plan M

If you want to enroll in Medigap Plan M (or any Medigap policy), you might want to consider enrolling during your six-month Medigap Open Enrollment Period (OEP). This six-month period begins on the first day of the month that you’re both aged 65 or over, and enrolled in Medicare Part B. During your OEP, you’ll generally enjoy a guaranteed issue right to enroll in a Medigap Plan M policy even if you have a pre-existing health condition* without having to pay a higher premium than a healthy person. You must be enrolled in Medicare Part A and Part B, and live within the plan’s service area.

Outside your OEP, you may still apply for a Medigap plan, but you may need to undergo medical underwriting, and acceptance isn’t generally guaranteed. However, in some cases you may have a guaranteed issue right to enroll in a Medigap plan after your OEP ends.

Not every insurance company that sells Medicare Supplement insurance plans offers Medigap Plan M. To help you build a quick and convenient search for Medigap plans such as Medigap Plan M, feel free to take advantage of our obligation-free Medigap plan finder. To get started, enter your zip code where indicated on this page.

*Pre-existing conditions are generally health conditions that existed before the start of a policy. They may limit coverage, be excluded from coverage, or even prevent you from being approved for a policy; however, the exact definition and relevant limitations or exclusions of coverage will vary with each plan, so check a specific plan’s official plan documents to understand how that plan handles pre-existing conditions.

This website and its contents are for informational purposes only. Nothing on the website should ever be used as a substitute for professional medical advice. You should always consult with your medical provider regarding diagnosis or treatment for a health condition, including decisions about the correct medication for your condition, as well as prior to undertaking any specific exercise or dietary routine.

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