What Is Medigap Plan M? What You Need to Know

Medigap Plan M is a Medicare Supplement Insurance plan that covers certain out-of-pocket expenses for Medicare members, including copays, coinsurance and deductibles. It’s nearly identical to Medigap Plan D, but while Plan D covers the full Medicare Part A deductible, Plan M covers only half.

How it works

When Medicare pays for services, you’re responsible for certain out-of-pocket costs unless you have Medicare Supplement Insurance, or Medigap, to help cover them. Medigap plans are only for Original Medicare members — Medicare Advantage members can't buy a Medigap plan.

There are 10 standardized Medigap plans available in most states (except Massachusetts, Minnesota and Wisconsin, which use different standards). The plans differ in terms of coverage for services, out-of-pocket limits and premium costs.

Medigap Plan M pays for the full cost of most of the services it covers, but it covers only half of the Medicare Part A deductible. That deductible is , so under Plan M, you would be responsible for $816.

What Medigap Plan M covers

Here’s what Medigap Plan M covers, according to Medicare.gov:

• Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.

• Part A deductible (50%).

• Part A hospice care coinsurance or copayment.

• Part B coinsurance or copayment.

• Skilled nursing facility care coinsurance.

• Blood transfusion (first three pints).

• Medically necessary emergency health care services for the first 60 days when traveling outside the U.S. Deductible and limitations apply.

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What Medigap Plan M doesn’t cover

Medigap Plan M doesn’t cover one benefit that’s included in some other plans available to new Medicare members: Medicare Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).

Additionally, all Medigap plans, including Plan M, sold to new Medicare members don’t cover the following:

How much does Medigap Plan M cost?

Medigap plans are standardized and regulated by the government but sold by private companies. Those companies set premiums according to factors including age, location and tobacco use.

In Atlanta, a metro area with average costs for Medigap policies, monthly Medigap Plan M premiums for a 65-year-old female nonsmoker range from $89 to $162.

An $89 Medigap Plan M policy has the same standardized Medicare coverage as one that costs $162. Companies may add on extra perks like discounted gym memberships, but the core Medicare benefits are the same, so go ahead and compare based on price.

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Your Medigap open enrollment period is the easiest and least expensive time to enroll in a Medigap plan.

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