Medigap Plans N and G - which plan should YOU choose? We look at the primary similarities and significant differences, plus 2 real-life examples that demonstrate why some Medicare beneficiaries should choose Plan N and others will find Plan G to be the most cost-effective option. Below we break down Medicare Part B Excess Charges, co-payments, premiums and state-specific exceptions - the most important considerations when evaluating Medicare Supplement Insurance Plans G vs N!
Medicare Supplement Insurance Plan G vs Medicare Supplement Insurance Plan N. You might’ve heard about them -they’re the most popular Medigap plans right now!
I’ll start by explaining 3 primary similarities between Plan G and Plan N. Next, I’ll highlight 3 significant differences between the two. Then, I’ll touch on premiums and state-specific exceptions. Finally, I’ll describe 2 real-life examples to help you understand why some people are better off with Medigap Plan G and others are better off with Medigap Plan N. Hopefully, this will shed a little light on the two most popular Medigap plans!
Let’s start with 3 primary similarities between Medicare Supplement Insurance Plans G and N. First, the Medicare Part A deductible IS covered under both plans. Second, the Medicare Part B deductible of $185 per year is NOT covered under either plan. Third, both plans cover hospitalization, skilled nursing facility care, blood, hospice care and foreign travel.
For complete coverage information, click the link in the description to access our Medigap Plan Comparison Chart.
Now let’s talk about 3 significant differences between Medigap Plan G vs Medigap Plan N.
First, doctor visit and outpatient co-payments. Plan G has no co-pays. Plan N has co-pays of up to $20 per office visit. Second, emergency room co-payments. Plan G has no emergency room co-pays. Plan N has a co-pay of up to $50 per emergency room visit. However, this co-pay is waived if you’re admitted to the hospital. Third, Medicare Part B Excess Charges.
Ok, you might be asking yourself, “What are Medicare Part B Excess Charges?” Allow me to explain! Medicare has a Fee Schedule. Some doctors, based on their education and/or training, don’t agree to the fee Medicare is willing to reimburse. These doctors are permitted to charge up to 15% more than the Medicare Fee Schedule permits. These are called Excess Charges. If no Excess Charges appear on a policy, the insured person must pay that additional 15%. While it’s fairly uncommon, some individuals will run into this as out-of-pocket expenses.
So, moving back to the third significant difference between Medigap Plans G and N: Excess Charges. Plan G covers Excess Charges of up to 15%. Plan N does not cover Excess Charges. For a comprehensive breakdown of the differences between Plans G and N, click the link in the description to access our Medigap Plan Comparison Chart.
In most states, Medigap Plan G generally runs about $20-25 more per month than Medigap Plan N. The condition of your health may determine which plan is best for you!
If you live in Wisconsin, Minnesota or Massachusetts, you won’t find “Medigap Plan G” or “Medigap Plan N” on the menu! Each of these 3 states has its own policy identification system. But fear not! We’re developing new videos that focus on each of those states. Be sure to subscribe to the SMS YouTube Channel so you don’t miss a thing!
So far, we’ve highlighted the 3 primary similarities and 3 significant differences between Medigap Plan G vs Medigap Plan N. We’ve also talked about premiums and state-specific exceptions. Now let’s see what this looks like in practice, using real-life examples.
In Example 1, Medigap Plan N is the better choice. Tom is a 74-year-old man. He lives a healthy lifestyle and doesn’t take any medications. The only time Tom sees a doctor is when he goes for his annual physical.
In this case, Plan N is the more cost-effective option for Tom. Here’s why: Tom will pay a lower premium for Plan N. Tom will have to pay a co-pay for his annual physical and any visits the emergency room. However, his annual out-of-pocket costs under Plan N will STILL be lower than the higher annual premium he’d pay for Plan G. If Tom selected Plan G, he would pay more money for coverage he doesn’t need! So Tom’s best option is likely Plan N.
In Example 2, Medigap Plan G turns out to be the better option. Linda is 68-year-old woman who lives a sedentary life. She’s a tobacco user who’s slightly overweight and has high blood pressure. Linda’s on several medications. She visits her doctor at least 4 times a year, if not more frequently. In this situation, Linda would benefit more from Plan G. Here’s why: Linda will pay a higher premium for Plan G. However, Linda will not have to pay co-pays for her doctor visits or any visits to the emergency room. Although Linda’s annual premium is higher under Plan G, her total annual out-of-pocket costs will exceed the amount she’d save on the Plan N premium because of her frequent doctor and/or emergency room visits. If Linda selected Plan N, she would likely end up paying more than the annual Plan G premium when the deductible and co-pays are taken into account! So Linda’s best option is likely Plan G.
While these 2 examples are great for demonstration, I encourage you to look beyond generic charts and bottom-line pricing. Finding the best plan to fit your needs AND your budget is what we do here at Senior Market Solutions! Our licensed Medigap Insurance Advisors do ALL the legwork so YOU can focus on living your life!