Plan M
Mid-tier comprehensive — covers half the Part A deductible
Plan M covers 50% of the Part A deductible (vs Plan G's 100%), skilled nursing facility coinsurance, foreign travel emergency, and the core federal benefits. It does not cover the Part B deductible or Part B excess charges. Plan M is offered relatively rarely and may not be available from every insurer in every state.
Coverage of the 10 federal benefits
- 6 · Fully covered
- 1 · 50% covered
- 3 · Not covered
What Plan M covers (federal CMS standardization)
The covered-benefits matrix below is verbatim from medicare.gov. Every cell is federally frozen by the 1990 NAIC Medicare Supplement Standardization Act.
- Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up)Covered ✓
- Part B coinsurance or copaymentCovered ✓
- Blood (first 3 pints)Covered ✓
- Part A hospice care coinsurance or copaymentCovered ✓
- Skilled nursing facility care coinsuranceCovered ✓
- Part A deductible50%
- Part B deductibleNot covered
- Part B excess chargesNot covered
- Foreign travel emergency (up to plan limits)Covered ✓
- Out-of-pocket limit (applies to Plans K and L only)Not covered
State availability
Plan M is part of the federal 10-letter Medigap system. Massachusetts, Minnesota, and Wisconsindo not use the federal letter system — if you live in those states, your Medigap plan structure is different. See your state page:
When can you buy Plan M?
During your federal 6-month Medigap Open Enrollment Period (per 42 U.S.C. § 1395ss), every insurer that offers Plan M in your state must issue you a policy regardless of your health status. Outside that window, in most states, insurers may medically underwrite, deny, or surcharge .
Compare Plan M side-by-side
The full federal benefits matrix with Plan M highlighted:
| Benefit | A | B | CMACRA grandfathered | D | FMACRA grandfathered | G | K | L | M | N |
|---|---|---|---|---|---|---|---|---|---|---|
| Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up) | ||||||||||
| Part B coinsurance or copayment | 50% | 75% | See note | |||||||
| Blood (first 3 pints) | 50% | 75% | ||||||||
| Part A hospice care coinsurance or copayment | 50% | 75% | ||||||||
| Skilled nursing facility care coinsurance | 50% | 75% | ||||||||
| Part A deductible | 50% | 75% | 50% | |||||||
| Part B deductible | ||||||||||
| Part B excess charges | ||||||||||
| Foreign travel emergency (up to plan limits) | ||||||||||
| Out-of-pocket limit (applies to Plans K and L only) |
Reading the matrix: ✓ = the plan covers 100% of the federally-defined benefit; 50%/75% = the plan pays that share of the benefit; ✗ = the plan does not cover the benefit. Plans C and F are closed to people newly eligible for Medicare on or after 2020-01-01 per MACRA 2015 grandfathering. Massachusetts, Minnesota, and Wisconsin do not use the federal 10-letter system; see your state page for the state-specific Medigap structure.