Medigap Plan M – Medicare Supplement

Medigap Plans
Part A Hospital Coinsurance Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
365 Hospital Reserve Days Yes Yes Yes Yes Yes Yes Yes Yes Yes Yes
Part B coinsurance Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Benefit for Blood Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Hospice coinsurance Yes Yes Yes Yes Yes Yes 50% 75% Yes Yes
Skilled Nursing Facility No No Yes Yes Yes Yes 50% 75% Yes Yes
Part A deductible No Yes Yes Yes Yes Yes 50% 75% 50% Yes
Part B deductible No No Yes No Yes No No No No No
Part B excess No No No No Yes Yes No No No No
Foreign Travel Benefit No No 80% 80% 80% 80% No No 80% 80%
Out-of-pocket limit N/A N/A N/A N/A N/A N/A $4,940 $2,470 N/A N/A

The new Medicare Supplement Plan M begins with an effective date of June 1, 2010. The changes are designed to lower out-of-pocket costs for consumers and to provide them with additional benefits not found in their current plans.

Medicare Supplement Plan M offers increased cost-sharing and includes many similar benefits to Plan D, but will only cover 50% of the Part A deducible and none of the Part B deductible. The cost of Plan M is expected to be priced at approximately 92% of the current plan D costs, or 85% of Plan F. Plan F is currently the most common plan.

Medigap Plan M is very similar to current Plan D. It will offer the core benefits of covering the 20% that Medicare doesn’t cover at the doctor, hospital and with skilled nursing and hospice coverage. However, Plan M will not cover the Medicare Part B deductible (currently $135/year) and it will only cover half of the Part A deductible (currently $1100/year). This means a deductible of $550 for Part A, and overall would result in a slightly lowered premium cost. Also, once the part B deductible is met, you will not be liable for co-payments for physician appointments.

Plan M includes the principle Core Benefits, which include inclusive coverage for Part A hospital inpatient coinsurance, coverage for expenses after your Medicare benefits run out, coinsurance for Part B, blood services, hospice charges for drugs, and foreign travel emergency expenses. General hospice care is included in Plan B and all other Medicare Supplement Plans in 2010.

Plan M could be beneficial if you have not been to the hospital for a while or do not anticipate going to the hospital soon because Part A covers inpatient related costs. This plan could be beneficial to you if you do have frequent doctor visits. You will want to make sure that the premiums on this plan can cut your costs by at the minimum $550 annually, which is what you will have to pay for half of the 2010 Medicare Part A deductible. If you are not saving $550 or more on your premiums, you could break even and be paying the same amount. You could also lose money if you do undergo inpatient hospital care.

Not all providers offer all of the Medicare Supplement Plans. This could be especially true for the new Plan M. It can also be difficult to determine which plan is right for you. Our trained specialists can help you find the plan that best fits your needs and budget. Most insurance carriers offer a variety of plans, so our specialists can help you shop around for the best price.

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