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Medigap Plan M

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 Deductible50% coverage
Medicare Part B DeductibleNo coverage
Medicare Part B “Excess Charges”*No coverage
Copayment or Co-Insurance Fee for Medicare Part B services100% coverage
Part A Co-Insurance Fees & Hospital Costs for up to 365 days after Original Medicare Benefits are Exhausted100% coverage
Cost of first 3 Pints of Blood100% coverage
Copayment or Co-Insurance Fee for Medicare Part A Hospice Care100% coverage
Co-Insurance Fees for Skilled Nursing Facility Care100% 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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