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Medigap Plan N

Cheerful senior woman understanding Medigap Plan N

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Medigap Plan N – Plan N enrollment numbers are growing faster than any other Medicare supplement plan. It doesn’t offer the most comprehensive coverage, but it does have some of the most affordable, stable premiums. Many Medicare beneficiaries are looking at Plan N as one of the best-valued Medigap policies on the market today. Let’s talk about what Plan N is, what it covers, and the features that make it popular.

How do Medigap plans work?

Medigap plans, also called Medicare supplement plans, are one way that individuals can choose to get secondary coverage to their Original Medicare benefits. (Original Medicare consists of Part A and Part B.) What many people don’t realize is that while Original Medicare offers excellent benefits, it still leaves beneficiaries with many out-of-pocket expenses. A Medigap policy is designed to pick up some or all of those remaining expenses.

The amount of coverage your Medigap plan has depends on which of the ten plans you choose. Plan N takes care of many leftover expenses, but not as many as Plans F or G. (We’ll talk a little more about those later.) One of the nice things about Medigap plans is that their coverage is standardized. That means that no matter where you purchase a plan, the coverage will be the same. Plan N is Plan N, no matter where you live or which private insurance company you buy it from.

To give you an idea of the benefits Medigap plans provide, let’s review a few of the costs you’ll be responsible for with Original Medicare alone.

The deductible for Part A is $1556 in 2022. That applies to each time you get admitted to the hospital, as long as it’s been at least 60 days since your last inpatient stay. The first 60 days of admission are paid for by Part A. Then, you’ll pay a coinsurance of $389 per day until day 90. Following that, your portion will be $778 per day if you have any of the 60 lifetime reserve days left. If you don’t have those reserve days, you’re responsible for the entire cost.

As you can see, Part A expenses add up quickly.

Part B applies to outpatient services. You must pay a $233 (for 2022) deductible, and then Part B operates on an 80/20 split, with you paying for 20% of the cost for services.

What does Medigap Plan N cover?

Plan N will pick up many of the expenses that remain after Parts A and B pay their share.

Plan N covers:

  • Part A deductible
  • Part A coinsurance plus an additional 365 days of hospital costs after Part A benefits are exhausted
  • Part A hospice care coinsurance
  • Skilled nursing facility care coinsurance
  • Blood (first 3 pints)
  • Part B coinsurance
  • 80% of foreign travel emergencies (up to plan limits)

What doesn’t Plan N cover?

There are two main costs not covered by Plan N: Part B excess charges and the Medicare Part B deductible. There are also some copayments that are required if you enroll in Plan N.

The only two Medigap policies that pay for the Part B deductible are Plan F and Plan C. However, those plans are only available to Medicare beneficiaries who turned 65 before January 1, 2020. No newly-eligible beneficiaries can enroll in either plan. If you enroll in any other Medigap policy, including Plan N, you’ll be responsible for the Part B deductible, which is $233 in 2022.

Plan N does not include coverage for Part B excess charges. A Part B “excess charge” is an amount over and above a Medicare-approved amount. If your doctor doesn’t accept Medicare assignment, they are allowed to add a charge that is up to 15% of the Medicare allowable rate. That extra 15% is called the excess charge. However, many people don’t consider this a limitation of Plan N. The reason is that most healthcare providers (about 96% of them) accept Medicare assignment and therefore do not charge more than the Medicare-approved fees. In addition, there are eight states that prohibit this practice. Those states are called Medicare Overcharge Measures or MOM states. They include Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, Vermont. If you live in one of those states, Part B excess charges are a non-issue.

Portrait of senior businessman sitting at office not understanding Medigap Plan N
With Plan N, you will be responsible for up to $20 for every doctor’s office visit and up to $50 for emergency room visits.

The last notable difference between Plan N and the two other most popular Medicare supplements (Plans G and F) are office copayments. With Plan N, you will be responsible for up to $20 for every doctor’s office visit and up to $50 for emergency room visits that don’t result in inpatient admission. Note the use of the words “up to.” Your provider may charge less, but never more than those amounts. There are no copays for a visit to an urgent care clinic, so it’s wise to use one of these facilities if you can’t see your primary care physician and aren’t experiencing a major medical emergency.

Lastly, there are some basic services that are not covered by Plan N or any other Medicare supplement plan. Prescription drugs, routine dental care, vision, and hearing services are not included as covered services. Since they aren’t part of Original Medicare benefits, Medigap policies also do not include them. You’ll need to be sure to enroll in a separate Part D prescription drug coverage to avoid Part D penalties.

Who is eligible for Plan N?

You must be enrolled in Medicare Parts A and B to enroll in Plan N or any other Medicare supplement. Unlike Plans F and C, there are no birthday cutoffs. Any Medicare beneficiary can choose Plan N.

The best time to enroll is during your Initial Enrollment Period or IEP. This is a 7-month window around your 65th birthday. During that time, you’ll have guaranteed issue rights to any Medicare supplement plan you want. What that means is that no insurance company can deny coverage based on your health status or history. There is no medical underwriting required.

Outside of your IEP, you may not have these same guaranteed issue rights, and you will likely have to undergo the medical underwriting process to get any Medigap plan. However, some states have more flexible rules when it comes to this. If you are older than 65, check with one of our licensed insurance agents to find out if you are still eligible for Plan N.

Which doctors accept Plan N?

Another advantage to Medicare supplement insurance plans is that they are so widely accepted. As long as your provider accepts Original Medicare, they’ll also accept your Medigap plan. This is true regardless of which insurance carrier you have your plan with. There are no provider networks when it comes to Medicare supplements. This is an even bigger benefit for individuals who travel a lot or live in different parts of the country during the year. They’ll have access to care wherever they are.

How much does Plan N cost?

Premiums for Plan N are not as standardized as the plans themselves. Your premium will be determined by the pricing method of the insurance company. Individual factors like age, gender, tobacco use, and location will all be used to calculate your premium. In addition, most premiums increase as you age.

That being said, the average premium for Plan N is between $80-$180 per month.

The lower premiums (when compared to Plan G and Plan F) are what attract many people to this plan. In addition, rate increases have been extremely low in recent years. Some states have even seen a 0% increase for two straight years. In contrast, Plans F and G can see 3% – 6% increases each year.

If you don’t mind the copayments, Plan N offers exception value lower monthly premiums.

What are the alternatives to Medicare supplement Plan N?

The best alternative to Plan N is Plan G. Plan G will cover the Part B deductible and the excess charges that Plan N doesn’t cover. Plus, there are no doctor’s visit or emergency room copays under Plan G. Of course, as we mentioned, you’ll have a higher premium for this increase in benefits.

Another alternative is Plan F. There are virtually no out-of-pocket expenses with Plan F, but you must have turned 65 prior to 2020 to be eligible.

Plan N Versus Medicare Advantage

“Which is better: Medicare supplements or Medicare Advantage plans?” We get asked this question a lot, and with all the TV commercials surrounding Advantage plans, it’s easy to see why. The answer to that question is not so simple.

Medicare Advantage plans, also called Medicare Part C, work very differently than Medicare supplements. In a way, they replace your benefits under Original Medicare. If you enroll in Part C, you’ll get your Part A and B benefits from a private insurance company instead of the federal government. Part C plans take those benefits, toss in a few extras, and wrap them all into one policy. We won’t deny that’s a pretty convenient option.

However, there are a few drawbacks to Part C plans. First, you’ll be required to utilize certain provider networks. This is in start contrast to Medigap plans, which can be used nearly anywhere. Second, you’ll have more out-of-pocket expenses for deductibles, copays, and coinsurance amounts with an Advantage plan.

There’s a lot to learn about Advantage plans, and you should certainly consider them if they’re available in your area. Choosing between a Medicare supplement plan and a Medicare Advantage plan should not be taken lightly as the choice has a great ability to impact your medical expenses. A Medicare advisor at Bobby Brock insurance can help you navigate this decision.

How do I enroll in Plan N?

The best way to enroll is through an independent, licensed health insurance agency like us! At Bobby Brock Insurance, we take the time to get to know you and your unique situation. This helps us offer you the best Medicare options.

Once you’ve made a decision, we can shop from multiple insurance companies to make sure you get a competitive rate. Long after your enrollment is complete, we’ll be here to help you continue your Medicare journey.

Call our office to learn more about Plan N!

Frequently Asked Questions

Does Plan N cover prescription drugs?

No, Plan N does not include prescription drug coverage. You’ll need to enroll in a Part D prescription drug plan in addition to Plan N.

Does Plan N cover dental?

Medicare supplement insurance does not include routine dental benefits, including cleanings and dentures. However, it will cover emergency dental services in a hospital setting.

How much does Plan N cost?

On average, Plan N costs between $80 – $180. However, individual factors like your gender, age, and zip code greatly impact your premium.

Which insurance company sells Plan N?

Most private insurance companies offer Plan N, but not all of them do. In addition, some have higher premiums than others. You should always shop at different carriers to find the best rates.

What is Medicare Plan N?

Medicare Plan N is the same as Medigap Plan N or Medicare supplement Plan N.

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