Medicare coverage can be confusing because it consists of many different pieces and parts. Medicare is divided into several parts, including Medicare Part A, Medicare Part B, Medicare Part C, and Medicare Part D. Each part has different coverage details, and some parts are managed by private insurance companies instead of the Federal Medicare program.
If that weren’t confusing enough, Medicare supplement insurance is also available. There are approximately ten different supplement plans today, and Plan N is just one of those plans. So, what is Medicare Plan N, and how does it work? Keep reading, and we will give you all the details you need to know, including coverage information and cost.
What Is Medicare Plan N?
Medicare Plan N is a Medicare supplement insurance plan that helps cover many out-of-pocket costs not covered by Original Medicare. You might also hear the plan called Medigap Plan N, Medicare Supplement Plan N, or even Medicare Part N. All these terms refer to Plan N supplement insurance.
Out-of-Pocket Expense Coverage
These plans help pay for out-of-pocket expenses, like copays, coinsurance, and deductibles. Plan N will help cover your Medicare Part A deductible and coinsurance for Part A hospital stays, inpatient services, hospice care, or care in a skilled nursing facility.
Medigap plans can no longer legally cover your Part B deductible, although Plan N will cover Part B preventive care coinsurance amounts.
Medicare Supplement Plan N requires a $20 copay for doctor’s office visits and a $50 copay for emergency room visits. Plan N also covers foreign travel emergencies.
Additional Details
Medigap Part N will also pay for up to 365 days in the hospital after your Part A benefits are used up.
It does not cover Part B excess charges. Some Medigap plans cover these excess charges, but they are rare as most healthcare providers accept the Medicare-approved amount for their services.
KEY TAKEAWAYS
- Medigap Part N is one of ten plans offered through private insurers to help cover some of the costs associated with Original Medicare.
- Medicare Supplement Plan N will pay Part A deductibles and a portion of Part A and B coinsurance, copays, blood for transfusions, and medical services in foreign countries.
- Medicare Plan N requires a monthly premium, which varies based on certain conditions. There is a zero deductible associated with these plans.
How Medicare Supplement Insurance Plans Work
So, how do these Medigap plans work? Remember that Medigap is simply another term for a Medicare supplement plan. Medicare beneficiaries often spend money out of their pocket when they receive services from their physician or healthcare provider.
Even though they have health insurance through Medicare, they are still responsible for copays, deductibles, and other out-of-pocket costs. These Medicare supplement plans exist to help those on Medicare benefits pay for these costs.
Private Insurers
Medicare supplemental insurance plans are not officially part of the Federal Medicare program. This means the Centers for Medicare & Medicaid Services (CMS) do not manage them. Instead, they are managed and administered by private insurance companies.
Standardized Across States
Unlike Medicare Advantage plans, Medigap plans are standardized across 47 states today. This means a Medigap plan will have the exact coverage details across those states, even if a different company sells it. For example, a Medigap Plan N sold by Blue Cross Blue Shield will have the same benefits and coverage details as a Plan N sold by Cigna or Aetna.
Similarly, all Medigap Plan G and Plan F plans are the same across different companies. This is in contrast to how Medicare Advantage plans work. Advantage plans vary from provider to provider. Each insurance company is allowed to set its own rules, including coverage details and costs, as long as it provides at least the same minimum level of coverage as Original Medicare.
Enrolled in Original Medicare
Another essential thing to remember is the eligibility criteria for Medigap plans. You must be enrolled in Medicare to be eligible for a Medigap policy and in Original Medicare to purchase a Medigap policy.
You cannot have both a Medicare Advantage plan and a Medigap plan. If you decide to purchase a Part C Advantage plan, you are not eligible to buy a Medigap policy. You can, however, have Original Medicare with a prescription drug plan and still sign up for Medigap.
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What Does Medigap Plan N Cover?
We have briefly touched on Plan N’s coverage details, but let’s dive deeper into what Plan N pays for. First, let’s examine the coverage details of Plan N that are specific to Medicare Part A.
Coverage for Medicare Part A
Plan N covers your Part A hospital coinsurance costs and Part A deductible, plus an additional 365 days in the hospital once your Part A benefits are used. It also pays for hospice care coinsurance and other amounts related to inpatient admission, like skilled nursing facility care. Finally, Medicare Part N will pay for the first three pints of blood associated with a blood transfusion since Medicare only covers the amount past the first three pints.
Coverage for Medicare Part B
Now, we will examine the coverage associated with Plan N, and Medicare Part B. Medigap Plan N does not cover your Medicare Part B deductible. Current laws prevent any new Medigap plans from covering your Part B deductible. However, Plan N does cover many costs associated with your Part B coverage. Plan N covers Medicare Part B coinsurance amounts, except a $20 copay for doctor visits and a $50 copay for emergency room visits. No copay is generally associated with visits to an urgent care facility, and Plan N covers these coinsurance amounts.
Plan N generally covers coinsurance amounts associated with nearly all outpatient services covered under Medicare Part B, and these plans even provide benefits for emergency care in foreign countries. Remember that Medicare does not usually cover medical services outside the United States.
Plan N does not cover Part B excess charges, although these charges are relatively rare when using Medicare providers.
Medicare Supplement Plan N vs Plan G
So, what are the differences when comparing Medicare Plan N vs Plan G? Medigap Plan G is generally considered one of the most comprehensive plans available. Many coverage details between the two plans are identical. Both plans provide coverage for your Part A deductible and coinsurance amounts.
Similarities in Coverage
Both plans provide additional hospital benefits after your Medicare benefits are used, and both provide coverage for the first three pints of blood in a transfusion. Similarly, Plan N and Plan G cover your Part B coinsurance amounts and provide coverage for foreign travel emergencies. Neither plan covers your Part B deductible.
Differences in Coverage
The most significant difference between the two plans is that Plan G covers your Part B excess charges. Excess charges happen when your provider charges more for a service than the Medicare-approved amount. In that case, you might be responsible for paying your coinsurance amount plus the difference between the approved and billed amounts. Medigap Plan G will cover these excess charges, while Plan N does not.
The other difference is that Plan G covers your Part B coinsurance amounts completely, while Plan N requires a small copay for doctor visits and emergency room visits.
TIP
Most Medigap plans are standardized across states, making them easier to compare. To determine if a Medigap plan is right for you, it helps to balance the various coverage levels with the total costs of each plan.
Medicare Plan N Costs
So, how much does Medigap Plan N coverage cost? All Medigap plans require the payment of a monthly premium. The average cost of a Medicare supplement plan depends significantly on the coverage details.
Medigap Part N – Premium
Plan N premiums typically average between $86 to $400 per month, depending on a few factors. Even though the coverage details of these plans are standardized, each insurance company is still allowed to set its rates. Rates for these plans also vary depending on your location, gender, age, and tobacco status. For instance, a male smoker in New York is likely to pay much more for a Plan N policy than a female non-smoker in Florida.
Potential Premium Increases
Medigap policies are guaranteed-issue policies as long as you sign up during your initial enrollment period. This means that pre-existing health conditions will not affect your eligibility or rates. However, waiting until later to sign up could significantly affect the cost of your plan.
If you wait until the Medigap open enrollment period in a later year, your application must undergo the entire medical underwriting process. This means that you might pay higher monthly premiums, or your application could be denied altogether. This is why signing up during your initial enrollment period is beneficial if you believe you will use Medigap coverage.
Selecting The Right Medicare Supplement Plan
Perhaps now you are wondering how to select the right Medicare supplement plan for you. Keep in mind that there are around ten different plans to choose from. The coverage details and costs of each plan vary, so you should closely examine each and select the one that best matches your needs.
The plan that works best for you will depend on several factors, such as how frequently you visit the doctor, how often you require a hospital stay, and maybe even how often you travel outside the country.
Medigap Plans – Overview
- Medigap Plan G and Plan F are the most comprehensive plans available.
- However, Plan F is no longer available to new enrollees. This is because Plan F covers your Medicare Part B deductible. Both Plans C and F are unavailable to new enrollees for this reason.
- All other coverage details between Medicare supplement Plan F and Plan G are the same.
- Plan K offers some of the lowest coverage of any Medigap plan, although it usually includes lower premiums.
- Some high-deductible plans require a deductible to be met each calendar year before coverage kicks in.
- These plans are often highly affordable, although you might end up paying more out-of-pocket than you are comfortable with.
When deciding on a plan that is right for you, contacting a licensed insurance agent for assistance is always helpful. You can also use the Medicare plan finder tool to compare Medigap policies. Most Medigap plans help with the out-of-pocket expenses related to Medicare cost-sharing, but some plans provide much more extensive coverage than others.
The Bottom Line
Medicare Plan N is a comprehensive Medigap plan that helps with many expenses associated with medical treatment received under Medicare coverage. Medicare Part N helps pay for copays, deductibles, and coinsurance amounts. Medigap plans are standardized in 47 states today, so Plan N coverage will be the same regardless of which insurance company you select for your coverage.
You will need to pay a monthly premium for the coverage, and you cannot enroll in both a Medigap and a Medicare Advantage plan. You should examine your needs and trends when determining which type of policy will lead to the lowest overall healthcare expenses for your situation.
Frequently Asked Questions
Yes, Plan N covers your Medicare Part A deductible. It also covers many other expenses related to Medicare Part A. This includes coinsurance for hospital stays, hospice care, and skilled nursing facility care.
Plan N also includes an additional 365 days of hospital coverage once your Part A benefits have been used. In addition, Plan N provides payment for expenses related to Part B coverage.
No, Medicare Plan N does not cover prescription drugs. You will need a Medicare Part D prescription drug plan to cover these costs.
No Medigap plans can cover prescription drugs. This rule was implemented in 2006, and Medigap plans have not been able to cover prescription drug costs since then. Many Part D drug plans are available, so you should select one to help with the cost of your medications.
Medicare Part A covers hospitalization. Your Medicare Part A benefits will pay the bulk of the expenses related to your hospital stay. However, you will still have some out-of-pocket expenses related to the stay, like a Part A deductible and coinsurance amount.
Plan N will cover your Part A deductible and Part A coinsurance for hospital stays. So, although Plan N does not directly cover hospitalization, it does help cover the expenses of your stay that Medicare does not pay.
Plan F provides more coverage for out-of-pocket expenses than Plan N. Plan F covers Part B excess charges, your Part B deductible, and all coinsurance amounts related to your Part B coverage.
Plan N does not cover your Part B deductible or excess charges, and Plan N requires a copay for Part B services.
However, you should know that Plan F is no longer available to new enrollees. The law prevents any Medigap plan from covering your Part B deductible. Suppose you want the most comprehensive coverage available today. In that case, you should consider Plan G. Plan G provides the same coverage benefits as Plan F except for the Part B deductible.
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