- Plan N is a Medicare supplement (Medigap) plan that helps cover the costs of medical care.
- Federal law ensures that no matter where you purchase your Medigap Plan N, it will include the same coverage.
- The cost for Medigap Plan N may vary based on where you live, when you enroll, and your health.
- Enrolling in Medigap when you’re first eligible, around your 65th birthday, is the easiest way to get the lowest cost.
Medicare Supplement Plan N, also called Medigap Plan N, is a type of supplemental insurance to help cover some of the out-of-pocket costs from Medicare. While the plan has standardized coverage, the costs vary by the insurance company and geographic area where you live.
In this article, we’ll discuss the costs you can expect if you choose Medigap Plan N.
Private health insurance companies sell Medigap Plan N. The cost and availability of these plans vary based on your geographic location.
The following are some examples of cost ranges for Medigap Plan N monthly premiums in different cities across the United States in 2021:
|Location||Plan N monthly premium|
|New York, NY||$190-–309|
|San Diego, CA||$93–$228|
As you can see, the costs vary quite a bit based on where you live. The prices shown above are also based on a 65-year-old man who doesn’t use tobacco. To find prices specific to your situation, enter your ZIP code in Medicare’s Medigap plan finder tool.
Plan N monthly premiums
Because private insurance companies sell Medigap policies, monthly premiums will vary by policy. Companies can choose to set their premiums in a variety of ways. The three main ways they set premiums are:
- Community rated. Everyone with the policy pays the same monthly premium, regardless of his or her age.
- Issue-age rated. Monthly premiums are set based on how old you are when you purchase your policy. Individuals who buy at a younger age will have lower monthly premiums.
- Attained-age rated. Monthly premiums are set based on your current age. Because of this, your premiums will increase as you get older.
Plan N deductibles
Plan N copays and coinsurance
Plan N covers copays and coinsurance associated with Medicare parts A and B. If you have a Plan N policy, you won’t be responsible for these costs.
Plan N out-of-pocket costs
There are some things that Medigap typically doesn’t cover, although this can vary by policy. When a service isn’t covered, you’ll need to pay the cost out-of-pocket.
Some examples of servicesthat often aren’t covered in Medigap policies are:
It’s also important to note that there’s no set out-of-pocket limit with this plan.
The Centers for Medicare & Medicaid Services (CMS) mandate that Medigap plans are standardized. This means no matter who sells the plan, the basic benefits are the same.
Plan N coverage includes:
- Part A coinsurance and hospital costs for up to an additional 365 days after you use your Medicare benefits
- Part B coinsurance or copayments, with some exceptions: Plan N may require you to pay $20 for some doctor’s office visits and $50 if you have to go to the emergency room, but aren’t admitted to the hospital
- the first 3 pints of blood you may require
- Part A hospice care coinsurance or copayment
- coinsurance for skilled nursing facility care
- Part A deductible
- 80 percent of foreign travel exchange (plan limits apply)
Note that some states standardize Medicare plans differently. These states include Massachusetts, Minnesota, and Wisconsin.
You can enroll in a Medigap plan when you are age 65 and enrolled in Medicare Part B. You can only have a Medigap plan if you have original Medicare. You can’t have both Medicare Advantage (Part C) and Medigap at the same time. You must choose one if you want additional coverage.
Generally, the least expensive time to buy a Medigap policy is when you are in your Medigap initial enrollment period. This is a 6-month period that begins the month you are both age 65 or older and enrolled in Medicare Part B.
A company can not use medical underwriting during this initial enrollment period to sell you a policy. This means they cannot consider your overall health and medical conditions when they sell you a policy. The insurance company must sell you the policy for the same price they sell it to people who are in general good health.
You can still purchase a Medigap policy after your Medicare open enrollment period. However, you may have to complete a physical exam or answer other questions about your health before they allow you to purchase the policy. It’s also possible the insurance company could charge you more for the policy than they would to an otherwise healthy person.
People under age 65 also have Medicare. This is true if you have a disability or certain medical conditions, such as end stage renal disease. Your ability to purchase a Medigap policy under age 65 depends on the insurance company and your state’s insurance laws.
The government doesn’t sell Medigap policies. You’ll have to buy the policy from a health insurance company. Once you’ve identified an insurer you may like to purchase the plan from, contact the company directly to apply for a policy.
The insurance company will then let you know what information they may need (such as for medical underwriting if you aren’t in an open enrollment period). If they approve you, they should give you an estimate of how much the monthly premium will be.
help choosing a Medigap plan
If you aren’t sure where to start in purchasing a Medigap plan or have questions along the way, there are many resources out there to help you, including:
- CMS. Call 800-633-4227 and ask for a copy of the CMS publication “Choosing a Medigap Policy: A Guide to Health Insurance for People With Medicare.”
- Your State Health Insurance Assistance Program (SHIP). The SHIP program offers free counseling on Medicare concerns, including Medigap policy purchases. Click here to find your local SHIP phone number.
- A trusted health insurance agent. Ask a local insurance agent about available Medigap Plan N policies in your area.
Medigap Plan N is one example of a standardized Medicare supplement plan. The plan may help you avoid out-of-pocket costs associated with Medicare.
You can compare plans through sites such as Medicare.gov and by contacting private insurance companies. The most cost-effective time to do this is when you are in your Medigap initial enrollment period in the first 6 months when you have Medicare Part B.