Medicare Plan N Costs and Coverage
Key Takeaways
- Plan N is one of 10 Medicare Supplement Insurance (Medigap )Medicare Supplement Insurance (Medigap) is designed to provide coverage that Original Medicare (Parts A and B) does not. Medigap policies are purchased in addition to Original Medicare and have their own monthly premiums you’ll need to pay. policies available in most states.
- Medigap plans help with out-of-pocket costs from Original Medicare’sOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). Part A and Part B, including copaysA copayment is the fixed amount you pay directly to your provider for medical services or prescription drugs covered in your plan. For example: If your plan includes a copayment of $20 for office visits, you’ll pay $20 to your doctor whenever you have an appointment. , coinsurance and deductiblesA deductible is an amount you pay out of pocket before your insurance company covers its portion of your medical bills. For example: If your deductible is $1,000, your insurance company will not cover any costs until you pay the first $1,000 yourself. .
- Medicare Plan N offers a lower premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. than other comprehensive Medigap plans because it doesn’t cover the Part B deductible and Part B excess charges.
- All Plan N policies must offer the same benefits, but not all companies must sell Plan N.
- Plan N is sometimes compared to Plan G, which has higher monthly payments but covers more than Plan N.
Original Medicare beneficiaries have several ways to save on the high out-of-pocket costs that can come with Parts A and B. Many turn to Medicare Supplement Insurance, or Medigap. Of the 10 Medigap policies available in most states, Medicare Supplement Plan N is one of the more popular choices.
But what is Medicare Plan N, and how does it stand out from some of the other options?
If you’re nearing Medicare eligibility or newly enrolled, here’s what you’ll want to know about Medicare Plan N.
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What Is Medicare Supplement Plan N?
Medicare Supplement Plan N is a Medigap policy that covers a lot of the fees you’d otherwise have to pay yourself if you have Original Medicare. Medigap plans are sold by private insurers and must be purchased and maintained separately from your Medicare policy. These plans are standardized by the federal government, so Medicare Plan N will cover the same things, pretty much wherever you live. The exceptions include Massachusetts, Minnesota and Wisconsin: Plan N can’t be purchased in these three states because they offer their own specific Medicare Supplement Insurance options.
If your insurer does not offer Plan N, don’t assume that it’s not available in your area. Private insurers do not have to offer all 10 Medigap plans, which means you may be able to find it offered by another company.
It’s a Plan, Not a Part
While some may refer to it as Medicare Part N, there is no such thing. It is a separate plan offered by private insurers. Parts generally refer to A, B, C and D only. Parts A and B are offered by the government. Part C is Medicare Advantage, an alternative to Parts A and B that offers at least the same coverages and benefits (more on Medicare Advantage below). Like Medigap, Part C and Part D (Medicare Prescription Drug Plan) are sold by private insurance companies.
What Does Medicare Supplement Plan Cover?
Like other Medigap plans, Plan N helps cover out-of-pocket costs from Medicare Part A and Medicare Part B. This includes:
Note: Medigap plans do not include outpatient prescription drug coverage. If you need prescription drugs, you will need to enroll in Part D separately from any Medigap plans you have.The Plan N Medicare supplement helps cover most or all of several common Medicare costs and can be very useful if you ever experience a substantial medical event. Here’s what’s covered by Medicare Plan N:
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Medicare Supplement Plan N Benefits
Benefits
Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits run out
- 100%
Medicare Part B coinsurance or copayment
- 100%*
Blood for medical procedure
- First 3 pints
Hospice care (Part A) coinsurance or copayment
- 100%
Skilled Nursing Facility coinsurance
- 100%
Part A deductible
- 100%
Part B deductible
- Not covered
Part B excess charges (amount charged by your doctor or provider above what Medicare approves)
- Not covered
Emergency coverage during foreign travel (up to plan limits)
- 80%
*Plan N generally pays 100% of your Part B coinsurance, but you may pay:
- Copayments up to $20 for some office visits
- Copayments up to $50 for emergency room visits that don’t require inpatient admission
How Much Does Medigap Plan N Cost?
Plan N, like all Medigap plans, has its own premium that’s separate from Medicare’s monthly costs. These plans are sold by private insurers and prices can vary. But in general, Plan N policies have lower premiums than some of the other more-comprehensive Medigap plans such as Medicare Plan G or Medicare Plan F. Why?
- Plan N doesn’t cover the Plan B deductible. This is the amount you pay before Medicare covers 80% of your medical costs. Then, Plan N will pick up the remaining 20%.
- You may have to pay some excess charges. Excess charges are the fees from your doctor or provider that are more than the Medicare-approved amount. With Plan N, you’ll pay the difference.
- Most of your copays and coinsurance are covered, but not all. According to the Medicare website, Medicare Plan N coverage includes 100% of Part B coinsurance or copayments “except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in inpatient admission.”
When Can I Enroll in Plan N?
The best time to enroll in any Medigap plan is after you first sign up for Medicare Part B. This opens a six-month open enrollment period that begins the first month your Medicare is active. If you enroll during this time, you have guaranteed issue rights — your coverage does not have to go through medical underwriting and you can’t be denied because of pre-existing conditions.
You can still sign up for a Medigap plan after your open enrollment period. However, you’ll need to go through a medical exam to qualify. Insurers are allowed to charge more and even limit or deny coverage if you sign up outside your six-month Medigap open enrollment.
If you or a loved one are looking to sign up for Medigap after this time, you may be able to qualify for guaranteed issue rights if at least one of the following is true:
- You’re a Medicare beneficiary who lost supplemental coverage through no fault of your own.
- You’re retired and your former employer cancelled your coverage.
- You moved to a new state and can’t keep your old Medigap coverage.
- You switched from Medigap to Medicare Advantage but want to change back within the first 12 months.
Looking for a plan with prescription drug coverage?
What’s the Difference Between Medigap Plan N and Plan G?
Both Medicare Plan N and Plan G are highly comprehensive options. For example, they both cover the Part A deductible and coinsurance for care received at a skilled nursing facility. But if you or a loved one is weighing Medicare Plan N vs. Plan G, there are some key differences to know about when making your choice.
- Plan G covers more, but has a higher monthly cost. Unlike Medicare Plan N, Plan G will cover your excess charges in return for a higher premium. Plan G also covers all of your Part B coinsurance; with Plan N, you may have copayments for some office and emergency room visits.
- Plan G may have a high deductible option to lower your costs. In some areas, you can choose to pay all your coinsurance, copayments and deductibles until you reach your deductible. After you reach this amount, your Plan G policy will pick up the standard amounts. In exchange, these plans typically offer a lower monthly premium.
Medicare Plan N vs. Plan G
How Does Medigap Plan N Compare to Medicare Advantage?
Medicare Supplement Plan N and Medicare Advantage both accomplish a major goal: saving beneficiaries money on their Medicare. They’re also both offered by private insurers. But their similarities end there.
As we’ve explained, Medicare Plan N is a Medigap plan that is designed to be used alongside Original Medicare. It helps pay the bills not covered by Parts A and B, including most coinsurance and copayments, your Part A deductible, and much more. For the extra cost, it can help keep your Medicare costs from skyrocketing if you need more than routine or preventive care. But in many cases it does not add any extra benefits to your coverage.
If you have Medicare Advantage (Part C), you can not purchase Medicare Plan N or any other Medigap plans. Medicare Advantage replaces Original Medicare (Parts A and B), but offers the same Part A and B benefits or coverage as Original Medicare. Along with receiving Part A and B benefits, Medicare Part C often bundles additional services like dental, hearing, vision and prescription drug coverage.
A few more differences between Medicare Supplement Plan N and Medicare Advantage to know:
- Cost: Many Part C plans offer no-cost monthly premiums while still offering the same coverage as Parts A and B, as well as extra services. With Plan N, you’ll need to pay the Part B premium as well as your Plan N premium each month.
- Coverage: With Original Medicare and Plan N, you can receive approved treatment anywhere in the U.S. — as long as the doctor accepts Medicare assignment. This can be a big advantage for beneficiaries who travel often as Medicare Advantage often uses provider networks. This is a group of local providers contracted by your insurer to provide care. Seeing a doctor outside of this group is often more costly or limited to emergencies.
Sources
- How to compare Medigap policies. Medicare.gov.
- F, G & J Deductible Announcements. CMS.gov.
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