Medicare coverage can be pretty confusing, especially since there are so many different pieces and parts. Medicare is broken into several different 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, there is also Medicare supplement insurance available. There are approximately ten different supplement plans to choose from 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. These plans help pay for out-of-pocket expenses, like copays, coinsurance, and deductibles. Plan N will help cover your Medicare Part A deductible along with coinsurance for Part A hospital stays, inpatient services, hospice care, or care in a skilled nursing facility. It will also pay for up to 365 days in the hospital after your Part A benefits are used up.
Medigap plans are no longer allowed by law to cover your Part B deductible, although Plan N will cover Part C preventive care coinsurance amounts. Likewise, Plan N uses a $20 copay for doctor office visits and a $50 emergency room visit copay. Plan N covers foreign travel emergencies, but it does not cover Part B excess charges. Some Medigap plans do cover these excess charges, but they are fairly rare as most healthcare providers accept the Medicare-approved amount for their services.
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 find themselves spending money out of their own 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. Medicare supplemental insurance plans are not officially part of the Federal Medicare program. This means that they are not managed by the Centers for Medicare & Medicaid Services (CMS). Instead, they are managed and administered by private insurance companies.
Unlike Medicare Advantage plans, Medigap plans are standardized across 47 states today. This means that a Medigap plan will have the same coverage details across those states, even if it is sold by a different company. For example, a Medigap Plan N sold by Blue Cross Blue Shield will have the same benefits and coverage details as 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 their own rules, including coverage details and costs, as long as they provide at least the same minimum level of coverage as Original Medicare.
Another important thing to remember is the eligibility criteria for Medigap plans. You must be enrolled in Medicare to be eligible for a Medigap policy. You must be enrolled 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.
What Does Medigap Plan N Cover?
We have briefly touched on the coverage details for Plan N, 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. Plan N covers your Part A hospital coinsurance costs and Part A deductible, plus up to an additional 365 days in the hospital once your Part A benefits are used. It also pays for hospice care coinsurance and other coinsurance amounts related to inpatient admission, like skilled nursing facility care. Finally, it 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.
Now we will examine the coverage associated with Plan N and Medicare Part B. 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. There is generally no copay 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 any medical services outside the United States. Plan N does not cover Part B excess charges, although these charges are fairly 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. Both plans provide additional hospital benefits after your Medicare benefits are used, and both of these plans provide coverage for the first three pints of blood in a transfusion. Similarly, Plan N and Plan G both cover your Part B coinsurance amounts, and they both provide coverage for foreign travel emergencies. Neither plan covers your Part B deductible.
The biggest 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 amount and the billed amount. Plan G will cover these excess charges, while Plan N does not cover these amounts. The other difference is the fact that Plan G covers your Part B coinsurance amounts completely while Plan N requires a small copay for doctor visits and emergency room visits.
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 greatly depends on the coverage details. Plan N premiums typically average between $75 to $150 per month, depending on a few different factors. Even though the coverage details of these plans are standardized, each insurance company is still allowed to set its own 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.
As long as you sign up during your initial enrollment period, Medigap policies are guaranteed-issue policies. This means that pre-existing health conditions will not affect your eligibility or rates. However, waiting until later to sign up could have significant consequences on the cost of your plan. If you wait until the Medigap open enrollment period in a later year, your application will need to go through the entire medical underwriting process. This means that you might be paying higher premiums each month, or your application could be denied altogether. This is why it is imperative to sign up during your initial enrollment period if you believe that you will use Medigap coverage.
Selecting The Right Medicare Supplement Plan
Perhaps now you are wondering how to select the Medicare supplement plan that is right 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 the details of each and select the one that best matches your needs. The plan that works best for you will depend on several things, like how frequently you visit the doctor, how often you require a hospital stay, and maybe even how often you travel outside the country.
Medigap Plan G and Plan F are two of 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. In fact, 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 basically the same. Plan K offers some of the lowest coverage of any Medigap plan, although it also usually includes lower premiums. Finally, there are some high deductible plans available that require a deductible to be met each calendar year before the coverage kicks in. These plans are often extremely affordable, although you might have to pay more money out of your pocket than you are comfortable with.
When deciding on a plan that is right for you, it is always helpful to reach out to a licensed insurance agent for assistance. You can also use the plan finder tool at Medicare.gov 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. Plan N helps pay for things like 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 plan and a Medicare Advantage plan. You should examine your needs and trends when determining which type of policy will lead to the lowest overall health care expenses for your personal situation.
Frequently Asked Questions
Does plan N cover Medicare Part A deductible?
Yes, Plan N covers your Medicare Part A deductible. It also covers many other expenses related to Medicare Part A. This includes coinsurance amounts 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 many expenses related to Part B coverage as well.
Does Medicare Plan N cover drugs?
No, Medicare Plan N does not cover prescription drugs. You will need a Medicare Part D prescription drug plan to cover these costs. In fact, 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. There are many Part D drug plans available, so you should select one of these plans to help with the cost of your medications.
Does plan N cover hospitalization?
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 amount for hospital stays. So, although Plan N does not directly cover hospitalization, it does help cover the expenses of your stay that are not paid by Medicare.
Which is better, plan F or plan N?
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. This is because the law now prevents any Medigap plan from covering your Part B deductible. If you want the most comprehensive coverage available today, you should consider Plan G. Plan G provides the same coverage benefits as Plan F with the exception of the Part B deductible.