Medigap polices help you cover medical expenses that are not covered by Medicare. These can be co-pays for treatment or deductibles that must be met before benefits can begin. Each plan is designated by a letter such as F, K, or M. A Medigap plan must also contain a basic core of benefits.
Medigap Plan M is a new policy created this year under the health law changes. Medigap Plan M includes a core benefit. This core coverage provides for Part A inpatient hospital copays, all hospital costs when Part A coverage is exhausted, Part B coinsurance charges, the first three pints of blood, and the new Part A hospice with palliative treatment coverage. All Medigap plans also now cover all costs of Part B preventative care and a benefit for a foreign travel medical emergency as part of its core coverage. A new part of the core also includes copays for Skilled Nursing Facilities in 2011.
On admission to the hospital under Medicare Part A, a fee of $1100 needs to be paid. Medigap Plan M covers 50% of this fee. Some plans cover all of this fee, but they cost more. Medigap Plan M provides no coverage for excess fees as some plans do. If you physician does not accept the medicare payment as payment in full, you will have to make up the extra cost. Some plans provide this extra benefit.
Medicare Part B has a deductible of $115 that must be met. Medigap Plan M does not cover this fee. Overall, Medigap Plan M provides most gap coverage but pays less for hospital coverage. The most common plan, Medigap F, covers 100% of costs, but its premiums are about 25% higher. If you don’t go to the hospital much, this may be a more economical plan for this coming year.