What is a Medicare Supplement Plan?
Medicare Supplement Plans are designed to fill in the gaps in original Medicare coverage. They cover some of the expenses not covered by original Medicare plans, and can often completely replace these plans. Original Medicare only covers a portion of your hospital bills and other services, and leaves big gaps in your coverage. Medicare Supplement plans can eliminate these gaps.
There are currently 14 Medicare Supplement plans available. They are labeled alphabetically from A to N. Plans A through E also have a letter modifier (A1,A2, etc.), which indicates added benefits. Plan M is an additional option in select markets, and is sometimes available as simple Plan M or Plan M with the letter modifier.
Together, these plans are sometimes called Medigap plans. The Plan M coverage of Medicare Supplement Plans (as well as other Medigap coverage) can vary between states.
If you’re looking for detailed, in-depth information about Medicare Supplement Plans, you can check out our post on the basics of Medicare Supplement Insurance.
Medicare Supplemental Plan M
Medicare Supplement Plan M is your last hope to strengthen coverage in an affordable Medicare Supplement Plan to support you in the various costs that Medicare doesn’t cover.
You can get this plan at a premium below Original Medicare cost. However, you can only enroll in Medicare Supplement Plan M during your initial Medicare Part B enrollment period, and you’ll need to pay your premium in full up front.
How Does Medicare Supplement Plan M Work?
Medicare Supplement Plan M, like other Medicare supplements, can help pay for the things that Original Medicare doesn’t cover. Medigap Plan M helps cover Medicare deductibles, coinsurance expenses, and copayments. It can also help pay for outpatient prescription drug coverage.
It includes medical benefits similar to those that Original Medicare Part A and Part B provides, except it covers things that Medicare doesn’t cover.
If you enroll in this plan, you’ll be able to get:
- Inpatient hospital insurance coverage
- Supplement insurance for skilled nursing facility care
- Coverage for home health, hospice care, and private duty nursing
- Hospital intensive care coverage
- What Does Medicare Supplement Plan M Cover?
Picking the Best Plan for You
Responsibility for the health needs of individual Americans is shared by many parties. Employees are responsible for working with their employers to cover themselves and their families. Insurers are responsible for covering the employee and the employee’s family. And the federal government is responsible for covering most of the health care of the elderly and disabled. To carry out its responsibility, the government established a health care program for seniors, Medicare. Medicare is also referred to as Part A of the Social Security Act or more simply as Part A.
Part A Medicare is major medical insurance that covers inpatient care, such as hospital stays, as well as diagnostic and preventive care. To cover outpatient care, such as doctor’s visits and lab tests, Part A Medicare has two programs, shown in table A below.
Enrolling in a Medigap Plan M
When you enroll in a Medicare Supplement plan, you must select a Medicare Advantage plan that includes Part A and Part B coverage. Along with your Medicare Advantage plan, you will also need to choose a Medigap plan.
Medicare Advantage plans have deductibles and coinsurance, which are costs you will have to pay after you’ve met the plan’s deductible. A Medigap plan is key in reducing your out-of-pocket costs. When you select a Medigap plan, you choose a supplement that will take care of some or all of your costs.
Selecting a Medigap plan is not the same as picking a health coverage plan; it is more complicated than that. Medigap plans A through N all take care of the costs that Medicare Advantage plans don’t. To cover all your costs, you would need to select all the plans that begin with the letter “A” and go all the way to “N.” It is recommended that you compare between plans A through N to ensure that you are getting the best coverage for your medical needs.
Questions or Concerns?
Medicare Supplement Plans are HMO’s and PPO’s that are offered by private insurance companies, that complement your Medicare coverage. They offer some of the same types of coverage as Original Medicare like: inpatient hospital stays and a range of Part A and B services.
Plans sold through the insurance marketplace are standardized to offer certain basic benefits, but the main difference between Medicare Supplement Plans is the the price of the monthly premiums. Even among the plans that are standardized, some may offer better coverage for things like hospital stays and outpatient services.
The four main categories of Medicare Supplement Plans are:
M1-Original plans that guarantee an extensive level of benefits. These are endorsed by the Centers for Medicare and Medicaid Services.
M2-These plans give you a lower premium, but have less coverage.
M3-These are the highest risk, highest benefit plans.
M4-As with M2, these plans give you a terrific savings. These plans are typically cheaper than M3 plans.
M4 plans may be a good option if you are not chronically sick. A good example may be coverage for skilled nursing care, where M4 plans would be good for less severe forms of rehabilitation and recovery.