Medicare Supplement (Medigap) Plan M: Deductible-Sharing Plan

Medigap Plan M provides the same basic benefits as other supplements. However, it has a slightly reduced monthly premium in exchange for your willingness to pay half of your hospital deductible and all of your annual outpatient deductible. By sharing in these deductibles as well as excess charges, you get the benefit of reduced premiums.

 

Medigap Plan M could work for someone who doesn’t expect a hospital stay often and feels he or she can afford the occasional cost-sharing. However, it’s important to have a licensed agent who specializes in Medicare supplements to help you. We will evaluate the differences in premiums and make sure that the savings are worth the risk of some expenses.

Medigap Plan M Example – Knee Surgery

Bob buys a Medigap Plan M for his coverage. He feels he will be comfortable on the premium savings. He also has a decent nest egg to pay for the occasional 50% co-insurance on the Part A deductible that he may incur. A few years into his policy, he needs a knee surgery which requires an overnight stay in the hospital. Bob will pay $682 in 2020 for his share of the Part A deductible.

Plan M will also cover most of his outpatient followups. Though he must first pay the annual Part B outpatient deductible, Medicare pays 80% of her outpatient care after that. His Medicare Supplement Plan M picks up the other 20%. If his knee surgeon does not accept Medicare’s assigned rates, he will also pay the Part B excess charge. That excess charge is limited to 15% above what Medicare allows the doctor to charge. So the potential cost sharing on excess charges is minimal enough that Bob feels comfortable.

 

Medigap Plan M Insurance Carriers

Every Medicare supplement carrier chooses which plans it will offer for sale unless state law requires the carrier to offer certain plans. Because most people don’t understand cost-sharing, they tend to fear it, and therefore we see few carriers offering Plan M for sale. Trying to track them down can be a chore, but if you get assistance from a Nevada Medicare Benefits licensed advocate, we can provide quotes for you right over the phone, via email or in person.

We are contracted with many Medicare Supplement insurance companies. Contact Us using this online request form for a quick no-hassle quote.