If you’re eligible for Medicare, a Medicare supplement or “Medigap” plan offers optional supplemental insurance coverage. Medigap Plan N is a “plan” and not a “part” of Medicare, such as Part A and Part B, which cover your basic medical needs.
Medicare Supplement Plan N is one type of insurance policy that you can purchase to help lower your out-of-pocket healthcare costs. These plans can cover 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.
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. 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 which company you purchase a Medicare supplement Plan N from, it must offers the same basic coverage.
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.
Medigap only covers Medicare-approved services. Therefore, it won’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 deductible
- Medicare Part A coinsurance and hospital stays up to 365 days
- Medicare Part B coinsurance for outpatient 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
- 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.
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.
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, although no new Medigap plans do
- 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 initial enrollment period when you turn 65 years old. 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 initial 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.
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 original Medicare with a Medigap plan.
There’s a monthly premium for Medicare supplement plans. Your costs for Plan N can vary depending on where you live and the insurance company you’re buying the policy from.
To get an estimate of how much you will pay for Plan N in your area, you can go to Medicare’s plan finder tool and enter your ZIP code.
Tips on 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. Consider the following questions 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 age 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 popular Medigap plan that covers many of your out-of-pocket costs from Medicare.
Like every Medicare supplement plan, Medigap Plan N has pros and cons, and costs will vary based on where you live.
If you have questions about your options or want to learn more, you can call the free Medicare help hotline at 800-MEDICARE (633-4227) or contact your local SHIP office.
This article was updated on November 20, 2020, to reflect 2021 Medicare information.
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