Medicare Plans by Turning 65 Solutions


Medicare Supplement (Medigap) Plan M

Medigap Plan M has similar benefits to other Medicare supplements. However, it grants a lower premium in return for you paying a portion of your Original Medicare deductibles. It is mainly because this is a cost-sharing plan, like K and L but the only thing in Plan M that you need to pay 50% is your Part A hospital deductible, which is 1600$ in 2023.


Medigap Plan M Coverage

Coverage that is provided under this plan goes as follows:

  • Medicare Part B coinsurance/copayments
  • Part A hospice care coinsurance
  • 50% of Medicare Part A’s deductible which is 1600$ in 2023
  • Skilled nursing facility care coinsurance
  • The first three pints of blood for a medical procedure
  • 80% of approved costs for foreign travel emergency (up to plan limits)
  • Medicare Part A hospital and coinsurance expenses for up to one year after Original Medicare benefits are expired

Medigap Plan M does not cover Medicare Plan B’s excess charges or deductibles, which helps keep your plan’s monthly premium low. If you are worried about Part B excess charges there are ways how to avoid them. Those can happen only if you go to a doctor or hospital that doesn’t accept Medicare’s payment as payment in full, so you may be charged up to 15% above the Medicare-approved amount. Always check doctors in your area who accept Medicare coverage to avoid unplanned out-of-pocket expenses. It may give you peace of mind that those charges are extremely rare because most doctors accept Medicare coverage nationwide.

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Medicare Supplement Plan M Cost-Sharing

Unlike other cost-sharing Medigap policies, (plan K and plan L) this plan doesn’t have a maximum out-of-pocket limit amount of how much you can spend before your policy starts to pay for everything. But, you don’t have to be worried because the only thing with this plan that isn’t covered 100% is Part A’s deductible, which is only covered for 50% (except for Part B deductible which you have to pay anyways before your policy kick in. All other coinsurance costs are covered.

When you share the cost for your Part A deductible and pay your annual Part B deductible which is 226$ for 2023, you will see that the monthly premium for this plan can be very much lower in comparison to the other comprehensive plans on the market. However, of all 3 Medigap cost-sharing policies, plan M provides the most coverage, and keeps the premium low. The monthly premium for this plan may be from 120$ to 200% (but this may depend on several factors like ZIP code, age, gender, etc.) 

When Do I Enroll?

When you are searching for a Medigap policy be aware to do so in the Medigap Open Enrollment period which is a 6-month open enrollment window. It starts during your Initial Enrollment period when your Part B becomes effective. Initially, this period goes 3 months before you are 65 and ends three months after you turn 65. To get a Medigap policy you must have Original Medicare, that is the way you need to wait for your Part B effective date. If you get it in this period, you have guaranteed issue rights, which means you cannot be turned down based on any pre-existing health conditions.

Nevertheless, you can apply for a Medicare Supplement plan anytime in a year, but be aware that you may be turned down based on your health because you will need to answer a health questionnaire.

Are you interested in having your Medicare cost-sharing partially covered, or even fully covered? If so, contact the Medicare agents at Turning 65 Solutions. We can help you find a Medigap plan that suits your budget, as well as your healthcare needs. Call 830-308-8953.