Medigap Plan N Has Major Benefits
When selecting insurance, it’s smart to balance potential coverage needs with the cost of premiums. You may find the best value by purchasing a less expensive Medicare Supplement Plan N that does not cover all of the gaps in Medicare coverage, especially for benefits you will not use or that have low out-of-pocket risk.
How Medicare Supplement Plan N Compares to Other MediGap Plans
Part B excess charge. Plan G does make up that difference if there is any. If your doctor agrees to accept Medicare’s standard payment, you would not need that benefit.Note that the vast majority of providers will accept the standard Medicare payment. Doctors in the following states are not even allowed to charge excess charges: CT, MA, MN, NY, OH, PA, RI, and VT.You can see if your doctor accepts Medicare-approved payment amounts by checking www.medicare.gov/physiciancompare/.
- Another difference between the benefits of Plan G and Plan N lies in copayments for outpatient services. Medigap Plan N charges you a copayment of up to $20 for a doctor’s appointment that is not 100 percent covered as recommended preventive care, whereas Plan G covers outpatient services with $0 copay.
- Finally, Medigap Plan N also has a $50 copay charge if you go to the emergency room and are not admitted as an inpatient by a doctor, whereas G will not charge a copay.
What are “Medicare excess charges?”
In Medicare, the term excess charges refers to any charges your doctor bills you over and above the standard Medicare reimbursement rate under Medicare Part B. So if Medicaid Part B reimburses your doctor $509.19 to put in a pacemaker, but your doctor charges $750 for the procedure, then the difference of $241.81 would be considered excess charges.
Excess charges are unusual: Most doctors who accept Medicare patients will accept the standard reimbursement rates for the services they perform. But a few doctors will charge more than the standard rate. They will send you a bill for the difference.
Medicare supplement Plan G will cover these excess charges. Medicare Plan N will not. Both are very comprehensive plans. The treatment of excess charges is one of just a few small differences between Plan G and Plan N.
Medicare Plan N is also generally available at a slightly lower monthly premium than Plan G.
Plan G is more popular. But in states that don’t allow doctors to charge excess charges (CT, MA, MN, NY, OH, PA, RI, and VT), Plan N may represent the better value.
How to Apply for a Medicare Supplement Plan N
If you’d like a professional opinion on how different Medigap plan benefits might fit your needs, please call 1-800-913-3416 to request your confidential and comprehensive free consultation.
Medicare Supplement Plan N Frequently Asked Questions
What does Medicare Supplement Plan N cover?
Medicare Plan N covers the following services for enrollees:
- Your Part A deductible
- Your Part A coinsurance as well as hospital costs for up to 365 days after you use up all your benefits under traditional Medicare.
- Plan N covers your 20% coinsurance payments otherwise due under Medicare Part B, which covers physicians fees, lab fees, and durable medical equipment. You’ll still have a copay of $20 for some office visits, and up to a $50 copay for emergency department visits that don’t result in a hospital admission.
- Your first three pints of blood.
- Hospice care coinsurance or copayments under Part A
- Skilled nursing facility care coinsurance
- 80% of foreign travel care (up to plan limits).
Medicare Supplement Plan N does not cover your deductible for Part B ($233 in 2022), or Part B excess charges. However, since most doctors who accept Medicare patients will accept Medicare assignment and bill Medicare directly, it’s rare for Medicare enrollees to encounter this.
Also, there is no maximum out of pocket limit under Plan N. As of 2022, the only plans that set a cap on out-of-pocket costs are Plan K and Plan L.
Am I Eligible for Medigap Plan N?
To be eligible for Medigap Plan N, you must first be enrolled in Medicare Parts A and B (original Medicare).
Additionally, you must live within your carrier’s plan service area.
If you enroll during your Medigap Open Enrollment Period, there are no medical underwriting requirements. You can enroll regardless of your medical condition and history. However, medical underwriting requirements may apply if you enroll outside of the enrollment period.
How much does Medigap Plan N cost?
There’s no one specific premium for Medigap Plan N. All Medigap plans are standardized, but offered by different health insurance companies. Your premium will vary based on the insurance carrier, age, sex, your Zip code, and whether you use tobacco. As of 2022, plans range from around $120 to $180 per month.
It’s a good idea to work with a Medicare supplement insurance broker who can compare available costs and plans in your area.
Does Plan N require me to stay within a network?
Medicare supplement plans do not rely on care provider networks. If you’re enrolled in Plan N, or any other Medigap plan, you can use your benefits with any doctor who accepts Medicare patients.
Can I use Plan N out of state?
You can use your benefits under Plan N in any state, and even out of the country. However, Medicare Plan N will only cover 80% of your costs for Medicare-covered services out of the country.
Does Plan N cover prescription drugs?
No, Plan N does not cover prescription drugs. However, you can purchase a standalone Medicare Part D plan that does cover prescription drugs, and is designed to work very well in combination with Medicare Supplement plans.
Is there a high-deductible version of Plan N?
Not at this time. There’s a high-deductible version of Plan F (not available to new Medicare enrollees) and Plan G, but not for Plan N.
Do I have to be in Medicare Part B to get Plan N?
Yes. To be eligible for Plan N, you need to enroll in both Medicare Part A and Medicare Part B.
Does Plan N cover care outside the country?
Yes, Medicare Plan N will cover up to 80% of care received outside of the United States, up to plan limits.
Get more of your Medicare Supplement Plan N questions answered at Medicare.gov.