Medicare supplement plans, also called Medigap plans, are designed to help you manage your healthcare costs.
For an additional monthly premium, these plans cover much of what original Medicare doesn’t. Medigap Plan N is one of the most popular of these plans.
If you have Medicare, Medigap plans are optional supplements. Medigap Plan N is a “plan” and not a “part” of Medicare. Medicare “parts” refer to specific pieces of legislation that organize the rules of Medicare.
Plan N, and any other Medicare supplement plan, are policies from approved private insurance companies that you can purchase to help lower your out-of-pocket healthcare costs. These Medigap plans help with costs like premiums, copays, and deductibles.
Choosing a Medigap plan can be confusing since various plans offer different levels of coverage and benefits. Understanding these benefits can help you choose a Medigap plan that’s right for you.
This article will explain what’s included in supplemental Medigap Plan N insurance.
Like the other nine Medigap plans, Plan N is a privately administered type of Medicare supplement insurance. It’s designed to help you cover specific out-of-pocket costs for your healthcare that Medicare Part A and Medicare Part B don’t cover.
Plan N covers things like Medicare Part A coinsurance, an amount you must pay out-of-pocket for services and for hospital care, as well as Medicare Part B coinsurance for outpatient care.
It also covers the coinsurance you might owe for hospice care or a skilled nursing facility under original Medicare. If you spend a lot each year on coinsurance and copays, Medicare supplement Plan N might pay for itself pretty quickly.
Medigap Plan N policies are required by law to be standardized. That means that no matter who you purchase a Medicare supplement Plan N from, it must cover the same things.
Not every Medigap plan is available in every location. Plan N doesn’t have to be sold in every state, and insurance companies that sell Medicare supplement policies can choose where to sell their Plan N policies.
If you live in Massachusetts, Minnesota, or Wisconsin, the standardization of Medigap plans may differ.
By law, you may not purchase a Medigap plan if you have Medicare Advantage. However, within the first year you enroll in Medicare Advantage, you may switch from Medicare Advantage to Medigap.
Medigap doesn’t cover things like long-term care, vision, dental, hearing aids, eyeglasses, or private-duty nursing.
Medicare supplement Part N covers the cost of the following:
- Medicare Part A coinsurance and hospital stays up to 365 days
- Medicare Part B coinsurance for care and procedures
- Medicare Part B copays at healthcare providers’ offices
- blood transfusion (up to the first 3 pints)
- hospice care and skilled nursing facility coinsurance
- Medicare Part A deductible ($1,408 as of 2020)
- 80 percent of healthcare costs while traveling outside the United States
Medicare supplement Plan N doesn’t cover the deductible for Medicare Part B. This is because of a change in Medicare law that prohibits all Medigap plans from covering the Medicare Part B deductible. As of 2020, the Plan B deductible is $198.
While Medigap Plan N covers 100 percent of your Plan B coinsurance, you’re responsible for doctor’s visit copays up to $20 and emergency room visit copays of $50.
Because of this change in Medicare law, as of January 1, 2020, Medicare beneficiaries who don’t already have Plan F, the most popular Medigap plan, can’t purchase Plan F.
Another option, Plan G, is still offered, and it’s nearly identical to Plan F, with the exception that it doesn’t cover the Part B deductible.
Plan N is similar to plans F and G, but it can be significantly less expensive. For some people, Plan N may be a cost-effective solution for Medigap coverage.
Advantages of Medigap Plan N
- monthly premiums cost less than Medigap plans F and G, which offer similar coverage
- completely covers your Medicare Part A deductible
- covers 80 percent of your costs if you need healthcare while traveling outside the United States
Disadvantages of Medigap Plan N
- possible copays of $20 at the doctor and $50 at the emergency room
- doesn’t cover your Medicare Part B deductible, though no Medigap plan does
- may still have to pay “excess charges” if your healthcare provider charges more than Medicare will pay
If you’re enrolled in Medicare parts A and B, you’re eligible to purchase Plan N if it’s available in your state. As with all Medigap plans, you must meet enrollment standards and deadlines.
You can enroll in any Medicare supplement plan, including Plan N, during the open enrollment period when you turn 65. If you buy Medigap during that time, your insurance provider can’t decline to sell you a policy based on your medical history.
Theoretically, you can purchase a Medicare supplement plan at any time. After your open enrollment period is over, there’s a chance that an insurance provider will decline to sell you Plan N .
There are no fees or fines from the federal government associated with Medicare supplement plans. However, if your doctor doesn’t take Medicare assignment, you may be responsible for charges over the amount that Medicare would have paid, even if you have a Medigap policy.
Plan N doesn’t cover Medicare Part D (prescription drug coverage) costs.
There’s a monthly premium for Medicare supplement plans. The Plan N premium can vary depending on the state in which you live and the insurance company you’re buying your policy from.
Average costs for Plan N are between $100 and $200 per month. You can compare the price of plans in your area on Medicare.gov.
Tips for how to shop for a Medigap plan
Choosing a Medigap plan can be difficult since you can’t always anticipate what your healthcare costs will be in the future. Answering these questions may help when you review Medicare supplement plans:
- Do you typically hit or exceed your annual Medicare Part A deductible? The total cost of a year of Plan N premiums may be more or less than the deductible you usually pay.
- If you add up expenses like copays, emergency room visits, and blood transfusions, how much do you typically spend in a year? If you divide that number by 12 and it’s more than the monthly premium for Plan N, the supplement plan may save you money.
- Are you currently in the Medicare open enrollment period that happens when you turn 65? Signing up for a Medigap plan during open enrollment may be your only opportunity to purchase Medigap coverage when your health status and medical history can’t be used to refuse your application.
Medicare supplement Plan N is a Medigap plan that covers your Medicare Part A deductible in addition to some copays and coinsurance.
By law, Plan N can’t cover Medicare Part B deductible. Like every Medicare supplement plan, Medigap Plan N has pros and cons.
If you have questions about your coverage and want to learn more, you can call the free Medicare help hotline at 800- MEDICARE (633-4227) or visit Medicare.gov.
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