Plan M covers many, but not all, of the out-of-pocket costs that can arise from Medicare coverage. 50% of the deductible for hospital services (Medicare Part A) is covered but the deductible for medical services (Medicare Part B) is not covered and must be paid by the enrollee. Additionally, excess charges above the Medicare-approved amount for a medical service is also not covered by Plan M.
The table below outlines which out-of-pocket costs are covered by Plan M and what out-of-pocket costs are not covered or partially covered.
|Plan M Coverage|
|Medicare Part A Deductible||50% coverage|
|Medicare Part B Deductible||No coverage|
|Medicare Part B “Excess Charges”*||No coverage|
|Copayment or Co-Insurance Fee for Medicare Part B services||100% coverage|
|Part A Co-Insurance Fees & Hospital Costs for up to 365 days after Original Medicare Benefits are Exhausted||100% coverage|
|Cost of first 3 Pints of Blood||100% coverage|
|Copayment or Co-Insurance Fee for Medicare Part A Hospice Care||100% coverage|
|Co-Insurance Fees for Skilled Nursing Facility Care||100% coverage|
|Foreign Travel Medical Emergency Coverage (up to plan limits)||Yes|
|Annual Limit on Enrollee Out-of-Pocket Expenses?||Not Applicable|
Plan M includes coverage (up to plan limits) for emergency healthcare received during foreign travel. Four out of ten Medigap plans do not include this benefit.
If you are interested in coverage for all the out-of-pocket costs listed in the above table, consider Plan F.
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