Deep Dive into Medigap Plan N

Diver photo representing Deep Dive into Medigap Plan N

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Medigap Plan N – Plan N is quickly becoming the fastest-growing Medicare supplement on the market today. If you enroll in Plan N, you’ll have excellent benefits and minimal out-of-pocket costs. It packs quite a punch for a lower premium than some of the other supplements.

Let’s take a deeper look into Medigap Plan N so that you can decide if it’s the right plan for you.

What is covered by Medigap Plan N?

Medicare Plan N will provide coverage for many of the costs that are leftover from Original Medicare. As long as whatever treatment you receive is covered by Part A or Part B and your doctor accepts Medicare, you’ll be able to use Plan N as your supplemental insurance plan. Unlike Medicare Advantage plans, supplements do not utilize provider networks. Nearly 96% of all healthcare providers accept Medicare, so you can use a Medigap plan all over the country.

Below is a list of expenses that remain after Original Medicare pays but are covered under Plan N:

  • Part A deductible ($1556 in 2022)
  • Part A coinsurance with an extra 365 days of coverage
  • Hospice care coinsurance
  • Skilled nursing facility coinsurance
  • First 3 pints of blood
  • Part B copayments and coinsurance
  • Foreign travel emergency, up to plan limits

What is not covered by Plan N?

Plans F and G offer more coverage than Plan N. So, what is Plan N missing? First, it does not include coverage for the Part B deductible, which is $233 in 2022. Second, it does not pay for any Part B excess charges.

An excess charge is an amount over and above the Medicare-approved amount. If your provider does not accept Medicare assignment, they are allowed to charge an additional 15% of the Medicare-allowed amount. That extra 15% is called the excess charge.

Many people don’t see the excess charges as a reason not to enroll in Plan N. For one, there are eight states that don’t allow excess charges at all. The “MOM” (Medicare Overcharge Measures) states include Vermont, Rhode Island, Pennsylvania, Ohio, New York, Minnesota, Massachusetts, and Connecticut. If you live in one of those states, you won’t need to worry about Part B excess charges, regardless of which Medicare supplement plan you choose.

Senior couple discussing Medigap Plan N over invoices in the living room
The most notable difference between Plan N and the other two popular plans (F & G) is that you will have copayments in Plan N.

The second reason many people don’t consider excess charges is because they are so rare. Most providers accept Medicare assignment and do not charge additional amounts for services.

The most notable difference between Plan N and the other two popular plans (F and G) is that you will have copayments in Plan N. Each time you visit your doctor, you will pay up to $20 for a visit. And each time you visit an emergency room, you’ll pay up to $50. Note that we say “up to” because your provider might charge less. In addition, if you get admitted to the hospital after visiting an emergency room, your copay is waived.

Lastly, Plan N does not cover any services that aren’t included in Original Medicare. We touched on this briefly earlier, but now we want to explain what this means. Original Medicare does not include common healthcare needs like prescription drugs, routine dental care, and vision and hearing services. Plan N is not alone in this aspect – all Medicare supplements follow the same rule.

How much does Plan N cost?

The average cost of Plan N ranges from $80 – $180. There are a number of things that go into determining your premium, including your age, gender, tobacco use, and location. (Areas with higher costs of living should expect higher premiums.)

The insurance company you choose to enroll through also has a big impact on the premium. Since all Medigap plans are standardized, their benefits are the same from one carrier to the next. However, the insurance companies get to set their own rates. Some carriers are known for having higher rates than others. You should ask your licensed insurance agent about the history or rate increases when considering one insurance company over another. We can’t guarantee one who has a history of minimal increases isn’t going to change that pattern, but we can make predictions based on past numbers.

The majority of plans increase their premiums with age. We assume that the older we get, the more healthcare we’ll need, hence the higher rates. However, one of the great things about Medigap Plan N is that it has seen extremely low rate increases over the last few years. Some states have even seen a 0% increase! That is great news, especially when you compare it to other plans that are increasing by 6% or more each year.

Who is eligible for Medicare Supplement Plan N?

Anyone who is enrolled in Original Medicare (Parts A and B) can enroll in Plan N. You can choose to enroll in a supplement at any time of the year, but you will get the best options and rates if you enroll during your Initial Enrollment Period (IEP), which is around the time you turn 65.

In most cases, enrolling at any other time will require you to pass medical underwriting. (Some states have their own rules around medical underwriting, which might be more lax than in most of the country.)

What are the best alternatives to Plan N?

The best alternative to Plan N is Medigap Plan G. It has more benefits than Plan N since it pays for the Part B deductible and excess charges. There are also no copays associated with Plan G. However, you will pay a higher monthly premium, somewhere between $110 – $280 per month.

We hope this deeper dive into Plan N has been helpful. If you have any questions or need help with your Medicare enrollment, we are here for you! Our Medicare advisors specialize in this area of insurance and can help you make sure you get enrolled in the right plan. Give us a call today!

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Justin Brock

President & CEO of Bobby Brock Insurance