Plan M Cuts Premiums by Splitting Costs
Scenario: Meet Ron
Ron is a 72-year-old retired teacher from Pennsylvania. He’s on a tight budget but wants decent protection from big hospital bills. He chose Medicare Plan M because it offers lower premiums than Plan G while still covering most Medicare costs. But Plan M only covers 50% of the Part A deductible and doesn’t cover excess charges, which caught him off guard after a recent surgery.
His goals:
- Lower his monthly Medicare costs
- Avoid surprise hospital bills
- Fill gaps in coverage
- Make sure he can afford healthcare even in emergencies
Let’s break down how Ron—and you—can make the most of Medicare Plan M while protecting against financial risk.
Know What Plan M Does and Doesn’t Cover
How it works:
Plan M pays 100% of most Medicare cost-sharing except:
- Only 50% of the Part A hospital deductible
- $0 toward Part B excess charges
- $0 drug coverage, dental, vision, or hearing
Why it’s smart:
You get comprehensive coverage for less than Plan G
Pros:
Lower premiums, still solid protection
Cons:
Partial hospital deductible coverage and no excess charge protection
Who should consider it:
Retirees in good health with occasional hospital visits
Who shouldn’t:
Frequent healthcare users or those seeing non-participating Medicare doctors
Tip: Ron paid $816 when hospitalized—Plan M covered the rest.
Compare Plan M Premiums Across Carriers
How it works:
Plan M benefits are standardized—price is not.
Why it’s smart:
Find a better deal with the same coverage
Pros:
Easy to save without losing any benefits
Cons:
May require health questions to switch
Who should consider it:
Anyone who hasn’t compared quotes in the last year
Who shouldn’t:
Those with major health issues who may not qualify for a new policy
Tip: Ron switched insurers and dropped his premium from $135/month to $112/month—saving $276/year.
Add a Hospital Indemnity Plan to Cover the Deductible
How it works:
Plan M only covers 50% of the Part A deductible. A hospital indemnity plan pays you cash for inpatient stays.
Why it’s smart:
Fills the gap for hospital costs
Pros:
Pays a lump sum per hospital day
Cons:
Small monthly cost ($20–$40)
Who should consider it:
Anyone on Plan M or K
Who shouldn’t:
People with large emergency savings
Tip: Ron added a plan that pays $250/day up to 5 days—more than enough to cover his half of the deductible.
Add Dental, Vision, and Hearing Insurance
How it works:
Like all Medigap plans, Plan M excludes dental, vision, and hearing care.
Why it’s smart:
Routine care gets expensive fast
Pros:
Covers cleanings, glasses, and hearing aids
Cons:
Annual benefit limits and waiting periods
Who should consider it:
Anyone with frequent dentist or eye visits
Who shouldn’t:
People who rarely use these services
Tip: Ron pays $30/month for coverage that includes two cleanings and $150 off glasses yearly.
Get a Standalone Part D Plan for Medications
How it works:
Plan M doesn’t include drug coverage—you need to enroll in a Medicare Part D plan.
Why it’s smart:
Avoids high prescription costs and late enrollment penalties
Pros:
Plans start under $20/month
Cons:
Must be reviewed yearly for best pricing
Who should consider it:
Everyone using Medicare
Who shouldn’t:
No one—this coverage is essential
Tip: Ron’s $16/month plan covers his cholesterol and blood pressure meds, saving him $480/year.
Avoid Part B Excess Charges by Choosing the Right Doctors
How it works:
Plan M doesn’t cover excess charges—fees up to 15% above Medicare’s approved rate.
Why it’s smart:
Avoid this charge entirely by using Medicare-assigned doctors
Pros:
$0 in excess charge risk
Cons:
May limit your doctor choices
Who should consider it:
Anyone with Plan M, N, or K
Who shouldn’t:
People unwilling to check doctor status
Tip: Ron uses Medicare’s physician search tool to ensure all his doctors accept assignment.
Use a Fixed Index Annuity to Cover Ongoing and Emergency Costs
How it works:
A Fixed Index Annuity with a Guaranteed Lifetime Withdrawal Benefit (GLWB) creates a steady stream of income to cover Plan M premiums, deductibles, and extra medical costs for life.
Why it’s smart:
Offsets the risks of rising healthcare costs
Pros:
Guaranteed income, market protection, potential growth
Cons:
Limited liquidity
Who should consider it:
Retirees who want predictable income for healthcare
Who shouldn’t:
Those who need full access to their funds short term
Tip: Ron used $60,000 from a CD to fund a GLWB annuity that now pays him $350/month—enough for Plan M, Part D, and a hospital plan.
Want the Best Coverage Without Overpaying?
Our agents at The Annuity Expert offer free quotes, comparisons, and custom strategies to help you pair Plan M with the right mix of supplemental coverage and guaranteed income.
Contact The Annuity Expert’s financial advisors and insurance agents today for a free quote and make your Medicare coverage work harder for you.
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