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Medicare Supplement plans are popular as they help cover your out of pocket costs that you otherwise might owe under Original Medicare and give you the flexibility to see any doctor in the country that accepts Medicare, giving you maximum doctor coverage relative to say a Medicare Advantage plan.
However, the comprehensive nature of some Medicare Supplement plans can get expensive. In today’s post, we’ll explore Medicare Supplement Plan N – a more affordable Medigap option – and whether it might be right for you.
While default government program Original Medicare provides coverage for a wide range of healthcare services, it does not cover all of the costs associated with medical and health care. In particular, the most common cost not covered is a 20% coinsurance that you have to pay for all outpatient medical services (for example: if a health service costs $1,000 you have to pay 20% or $200).
That is why many Medicare participants choose to buy a Medicare Supplement Plan, also known as a Medigap Plan. These are Medicare insurance policies that are sold by private insurance companies to cover expenses, or “gaps,” that are not part of customers’ Medicare coverage.
In total, there are 10 Medigap plans available: Plans A, B, C, D, F, G, K, L, M, and N. Medicare supplement plans are standardized, which means that each plan type offers coverage for a standardized list of basics. However, each plan type adds coverage beyond the basic Original Medicare services, and that is where the differences lie. As you might guess, you pay more if you are receiving more benefits and coverage.
If you search Medicare.gov, you will see that there is no official “Part N” of government-issued Medicare. However, with some additional research you will find that private insurance companies offer “Plan N” coverage as part of their Medicare Supplement plans available. “Part” and “Plan” are mistakenly interchanged a lot but you should be aware that when you talk about “Plan A, B, C, D etc,.” that is different to Medicare “Part A & B” which refers to the default government program.
Plan N is typically considered the more affordable option relative it’s more comprehensive cousins Medicare Supplement Plan F (which is no longer available to newly eligible Medicare beneficiaries) and Plan G.
Medigap Plan N provides a good balance of comprehensive nationwide coverage at a lower premium while delivering the same catastrophic coverage benefits of Plan F & G.
What Are the Pros and Cons of Medicare Supplement Plan N Coverage?
The Pros of Medigap Plan N:
Can you enjoy lower premiums relative to Plan F & G (the two most comprehensive plans)
Your key Medicare cost are covered including the most important catastrophic costs (being hospital and medical costs)
Can you enjoy access to any doctor nationwide that accept Medicare
The Cons of Medigap Plan N:
In return for a lower premium, you will have some small copays for doctor visits (up to $20) and emergency room visits (up to $50)
You will still need to pay the Part B Deductible each year before insurance kicks in
If you don’t use health services you still need to pay the premium each month
You may be charged a medical or ‘Part B Excess Charge’ by your doctor. This is an amount a doctor can charge above the Medicare-determined standard rate (also known as ‘assignment’) for a service. Doctors who don’t accept assignment can charge up to 15% above the assignment rate that you be responsible for for under Plan N. However, this is uncommon as 98% of Medicare doctors, physicians and other providersaccepted Medicare assignment.
In Conclusion
Depending on your health concerns and the kind of care you are currently receiving (or would like to receive), a Medicare Supplement/Medigap Plan that offers a Plan N option could be either a great option for you or not.
How can you tell? We recommend you speak with a CoverRight Licensed Insurance Agent who can answer your questions in about 30 minutes. Why not schedule a call now?
Plan N doesn't offer a high-deductible version. Plan N also doesn't cover your vision, dental, and hearing expenses, even preventive ones—for those, you'll likely need a Medicare Advantage plan.
Some of the most notable disadvantages include high monthly premiums, limited guaranteed enrollment periods, and a lack of additional benefits like vision, dental, or prescription drug coverage.
Plan N covers your $1,632 Medicare Part A deductible, coinsurance for Medicare Parts A and B, three pints of blood and 80% of any medical costs you have during foreign travel. Plan N does not cover your Medicare Part B deductible. And Plan N copays for doctor visits don't count toward the Part B deductible.
As is true for all supplemental policies, these plans are not adequate as stand-alone health coverage, as they can leave you with unlimited out-of-pocket costs in the event of a serious medical condition.
Medigap Plan N: Cost Savings with Moderate Coverage
While Plan G is considered more comprehensive, Medigap Plan N offers a more budget-friendly option for those who like the idea of exchanging a few additional out-of-pocket costs for a lower premium.
The biggest difference between Medigap Plan G and Medigap Plan N is that Plan N has copays for certain medical office and emergency department visits, whereas Plan G doesn't. If you wouldn't need to pay the copays often, Medigap Plan N could cost less overall.
Plan F, Plan G and Plan N are the most popular types of Medicare Supplement plans. Medicare Supplement Plan F is the most comprehensive Medigap option available, providing beneficiaries with 100% coverage of Medicare-covered medical expenses after Original Medicare pays its portion.
Most individuals that dislike a Medicare Advantage plan usually have had a bad experience with in-network providers, plan authorizations for medical care, or having to wait a long time to have an appointment scheduled. Some of these concerns can be attributed to the healthcare provider.
In some cases, you'll have a higher share of costs when you see an out-of-network doctor. In other cases, you're not covered at all if you go out of network. This is particularly important if you travel a lot because Medicare Advantage plans generally don't provide out-of-state coverage.
First, you agree to pay the small annual Part B deductible ($240 in 2024). You will also pay co-payments up to $20 for doctor appointments. Emergency room visits have a $50 copay. Finally, people with Medigap N also pay excess charges to some medical providers.
The out-of-pocket maximum for Plan N is the Part B deductible plus office/ emergency room copays. The out-of-pocket maximum for high deductible Medigap plans is equal to their deductible ($2,700 in 2023). That is true in all years.
Medicare supplemental insurance may be worth it if you value doctor choice. As John Hill, president of Gateway Retirement in Rock Hill, South Carolina, points out, "You may also want to consider a supplement when you want your doctor and not the insurance company in charge of your care.
With Medicare Supplement Plan F, you get the most complete coverage available. First, it includes all the benefits of Medicare Supplement Plans A, B and C. In addition, Plan F provides coverage for skilled nursing facility care, Medicare Part A and B deductibles, and international travel medical emergency help.
A Medigap plan (also called a Medicare Supplement), sold by private companies, can help pay some of the health care costs Original Medicare doesn't cover, like copayments, coinsurance and deductibles.
While Medigap Plan N covers 100 percent of your Plan B coinsurance, you're responsible for doctor's visit copays up to $20 and emergency room visit copays of $50. Plan N is similar to plans F and G, but it can be significantly less expensive.
The average Medicare Supplemental health insurance cost for Plan N premiums in 2023 are lowest for beneficiaries at age 66 ($100.57 per month) and highest at age 85 ($173.83 per month). 10% of Medigap beneficiaries have Plan N.
There are two areas that Plan G covers, that Plan N doesn't. Plan N doesn't cover: Excess Charges: This an additional cost that some providers charge. Most healthcare providers that accept Medicare also accept Medicare assignment, which is the cost that Medicare states they'll pay for a given service.
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