Medigap Plan N

Medicare Supplement Insurance Plan N-Is It Right For You?

Medicare Plan N is designed to help pay for the out-of-pocket expenses not covered by Medicare Parts A and B. It helps fill in the gap for hospital, medical, and skilled services. It has similar benefits to other Medigap plans such as Plan F and Plan G but generally costs less. This makes it an attractive option for many people

Medigap Plan N Coverage

  • Hospitalization: pays Part A coinsurance and provides coverage for 365 additional days after Medicare benefits end.
  • Medical Expenses: pays Part B coinsurance (excluding copays for office visits and ER) and 20% of Medicare-approved expenses or copayments for hospital outpatient services.
  • Blood: pays the first 3 pints of blood annually. Original Medicare pays for any pints beyond 3.
  • Hospice Care: pays Part A coinsurance.

Additionally, Medigap Plan N pays for skilled nursing facility care and the Medicare Part A deductible for hospitalization.

There are some things Medigap Plan N will not cover. It does not cover the Medicare Part B deductible or excess charges. Excess charges are the difference in cost between what a health provider charges for a medical service and the Medicare-approved amount. It also will not cover the copay or coinsurance for doctor’s office and emergency room visits.

Medigap plans have been standardized by the federal government. This means that the only difference in plans offered by one insurance company is the monthly premium. You are eligible to purchase a Medicare supplement insurance plan if you are currently covered under Medicare Parts A and B, are about to turn 65 or are about to receive Part B coverage.

There are 11 Medigap plan options in total. They are labeled A, B, C, D, F, high-deductible F, G, K, L, M, and N. Plans E, H, I, and J are no longer available.

How does Plan N compare to other Medigap Plans? It provides more coverage than Plans K and L. For example, it covers 100% of the Medicare Part B coinsurance and copayments, whereas K and L only pay 50% and 75%, respectively. The same is true with the Medicare Part A deductible.

Plan N has a lower premium than Plans A through G. Additionally, the only out-of-pocket expenses beyond the monthly premium are a $20 copay for office visits and a $50 copay for a trip to the ER.

Generally, Medicare Supplement Plan N costs about 25% less than the more comprehensive Plan F.4 But a lower cost also means that Plan N will fill in fewer gaps in Original Medicare. There is generally always a trade-off for savings. So when comparing Medicare Plan N to other Medigap plans, always weigh the costs against the level of benefits. The chart below will help you make these comparisons.

Choosing the right supplemental insurance means considering the cost of the Medigap insurance plan along with what is covered and what is not. With Plan N, considerations should include the cost of the Medicare Part B deductible and the small deductibles required for each doctor’s office and emergency room visit. Compare these costs to the cost of the Medigap Plan N premium.

It is equally important to consider any drawbacks, such as the plan not covering a stay beyond 365 days in the hospital or beyond 100 days in a skilled nursing facility.  Additionally, Plan N does not cover any Medicare Part B excess charge that a doctor may charge a patient beyond that which is covered by Medicare.

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