Medigap Plan M is one of the lesser-known Medicare Supplement options. It fills many of the same gaps as other Medigap plans. However, it takes a unique approach to the Part A hospital deductible. Instead of covering the full $1,736 Part A deductible in 2026, Medigap Plan M covers only 50%. That means you pay $868 out of pocket per benefit period.
In exchange, monthly premiums are typically lower than more comprehensive plans. This trade-off makes it an appealing middle-ground option for some Medicare beneficiaries. Plan M is standardized by federal law. Every insurance company must offer the same benefits. Only the premium and customer service differ between carriers. As a result, shopping for this plan comes down to price and company reputation.
What Does Medigap Plan M Cover?
Medigap Plan M covers most of the same benefits as the popular Plan G. It pays 100% of Part A coinsurance and hospital costs. It also covers up to 365 additional hospital days after Medicare benefits run out. Part B coinsurance and copayments are covered at 100%. The first three pints of blood are fully covered as well.
Skilled nursing facility coinsurance is another area where Plan M provides full coverage. Medicare only covers the first 20 days of a skilled nursing stay. For days 21 through 100, the daily coinsurance is $217 in 2026. Plan M picks up that entire cost. Part A hospice care coinsurance is also covered at 100%.
However, there are notable gaps. Plan M does not cover the Part B annual deductible of $283 in 2026. It also does not cover Part B excess charges. These are amounts some doctors charge above the Medicare-approved amount. For example, a doctor who does not accept Medicare assignment could charge up to 15% more. Foreign travel emergency care is covered at 80% after a $250 deductible.
Medigap Plan M Benefits Table
| Coverage Area | Medigap Plan M | Plan G | Plan N |
|---|---|---|---|
| Part A coinsurance and hospital costs (up to 365 extra days) | 100% | 100% | 100% |
| Part B coinsurance or copayment | 100% | 100% | 100% (with copays*) |
| Blood (first 3 pints) | 100% | 100% | 100% |
| Part A hospice care coinsurance | 100% | 100% | 100% |
| Skilled nursing facility coinsurance | 100% | 100% | 100% |
| Part A deductible ($1,736 in 2026) | 50% | 100% | 100% |
| Part B deductible ($283 in 2026) | Not covered | Not covered | Not covered |
| Part B excess charges | Not covered | 100% | Not covered |
| Foreign travel emergency | 80% | 80% | 80% |
*Plan N charges copays of up to $20 for some office visits. Emergency room visits carry a copay of up to $50 unless you are admitted to the hospital.
How Much Does Medigap Plan M Cost?
Medigap Plan M typically costs less per month than Plan G. The premium savings reflect the partial Part A deductible coverage. In most cases, you can expect premiums to fall between Plan N and the high-deductible plans. However, exact pricing depends on your age, location, and insurance carrier.
Insurance companies use three pricing methods for Medigap policies. Community-rated plans charge everyone the same premium regardless of age. Issue-age-rated plans base your premium on the age when you first buy the policy. Attained-age-rated plans start lower but increase as you get older. Typically, attained-age plans seem cheapest at first. Over time, they often become the most expensive option.
The real cost comparison goes beyond monthly premiums. With Medigap Plan M, your worst-case annual out-of-pocket cost includes $868 for the Part A deductible share. You also pay the $283 Part B deductible. That totals $1,151 before counting any Part B excess charges. Plan G limits your exposure to just $283 per year. As a result, the premium savings from Plan M must outweigh the higher potential out-of-pocket costs.
Who Should Choose Medigap Plan M?
Medigap Plan M works best for Medicare beneficiaries who rarely need hospital stays. The Part A deductible only applies when you are admitted to a hospital. If you go years without an inpatient stay, you save on premiums without paying the deductible. This makes Plan M attractive for relatively healthy enrollees.
However, Plan M is not ideal for everyone. If you have chronic conditions requiring frequent hospitalizations, Plan G offers better protection. The full Part A deductible coverage under Plan G eliminates that financial risk. Similarly, if your doctors charge Part B excess charges, Plan G is the only standard plan that covers them.
Plan M is also worth considering if you want broader coverage than Plans K or L. Those high-deductible plans cover even less of the Part A deductible. Plan K covers only 50% of several benefits that Plan M covers at 100%. For example, Plan K covers only 50% of Part B coinsurance. In most cases, Plan M offers a stronger safety net than K or L at a moderate premium.
Medigap Plan M vs Plan G vs Plan N
Plan G is the most popular Medigap plan in 2026. It covers everything except the Part B deductible. Plan G also covers Part B excess charges at 100%. This gives enrollees maximum predictability. The only annual cost beyond premiums is $283.
Plan N is the second most popular option. It offers lower premiums than Plan G. However, Plan N introduces small copays for doctor visits and emergency room trips. It does not cover Part B excess charges. Medigap Plan M shares that gap with Plan N. Neither plan protects you from doctors who charge above the Medicare-approved amount.
| Feature | Plan M | Plan G | Plan N |
|---|---|---|---|
| Monthly premium | Lower | Highest | Moderate |
| Part A deductible coverage | 50% | 100% | 100% |
| Part B excess charges | No | Yes | No |
| Copays for office/ER visits | No | No | Yes |
| Worst-case annual out-of-pocket (beyond premium) | $1,151+ | $283 | $283 + copays |
| Best for | Healthy, budget-conscious | Maximum coverage | Moderate savings |
The choice depends on your health, budget, and risk tolerance. Medigap Plan M saves on premiums but carries more financial exposure. Plan G costs more monthly but eliminates nearly all out-of-pocket surprises. Plan N falls in between with predictable copays.
How to Buy Medigap Plan M
The best time to buy Medigap Plan M is during your Medigap Open Enrollment Period. This six-month window starts the first day of the month you turn 65 and are enrolled in Part B. During this period, insurers cannot deny you coverage. They also cannot charge higher premiums based on your health history.
After your Open Enrollment Period ends, buying any Medigap plan becomes harder. Insurance companies can use medical underwriting in most states. They may deny coverage or charge more based on pre-existing conditions. However, some states offer additional protections. For example, several states have birthday-rule provisions. These allow you to switch Medigap plans annually without underwriting.
Medigap Plan M is available in 47 states and the District of Columbia. Massachusetts, Minnesota, and Wisconsin use their own standardized Medigap systems. Typically, not every carrier offers Plan M in every state. It is less widely sold than Plan G or Plan N. You should compare quotes from multiple insurers. The benefits are identical by law, so the lowest premium wins. Contact your State Health Insurance Assistance Program (SHIP) for free, unbiased guidance on comparing plans in your area.
Frequently Asked Questions About Medigap Plan M
Does Medigap Plan M cover prescription drugs?
No. No Medigap plan sold after 2006 includes prescription drug coverage. You need a separate Medicare Part D plan for medications. You can enroll in Part D alongside any Medigap policy.
How often do I pay the Part A deductible with Plan M?
The Part A deductible applies per benefit period, not per calendar year. A new benefit period starts after you have been out of the hospital for 60 consecutive days. In most cases, beneficiaries have only one or two benefit periods per year.
Can I switch from Plan G to Medigap Plan M later?
You can apply to switch at any time. However, outside of your Open Enrollment Period, the insurer may require medical underwriting. They could deny your application based on health conditions. Some states offer guaranteed-issue switching rights that bypass underwriting.
Is Medigap Plan M being discontinued?
There are no plans to discontinue Medigap Plan M in 2026. It remains one of the 10 standardized plan letters available nationwide. However, fewer carriers sell it compared to Plan G or Plan N. Availability varies by state and region.
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Official Sources & Resources
For verified Medicare information and enrollment help:
- Medicare.gov: medicare.gov
- CMS.gov: cms.gov
- NAIC Medigap Guide: naic.org
- KFF Medicare Research: kff.org/medicare
- Find Your SHIP: medicare.gov/contacts
Content last reviewed April 2026. If you notice any outdated information, please contact us.