Medigap Plan N Explained

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Medigap Plan N – You don’t hear about Plan N as often as a couple of the other Medigap options (Plans F and G), but it actually has the fastest-growing pool of beneficiaries. Some say it offers the best value for the price. Today we’re going to take a deeper dive into Plan N so you can see if you agree with that opinion.

What is Medigap Plan N?

Medigap Plan N is one of the Medicare supplements available to anyone who is enrolled in Parts A and B of Medicare. All Medicare supplements work the same way; they just have varying levels of coverage. (We’ll talk bout Plan N benefits next.) Medicare supplement plans act as your secondary form of insurance, with Original Medicare as your primary insurance. After a claim has been paid by Medicare, it gets sent to your Medicare supplement plan.

What does Plan N cover?

If you know anything about Medicare Parts A and B yet, you know there are a ton of out-of-pocket costs. If you don’t get supplemental coverage, you’ll have deductibles, coinsurance costs, and copayments to pay. Plus, there is no out-of-pocket limit on what you’re responsible for under Parts A and B, so your bills will add up very quickly.

Plan N covers the Part A deductible, as well as all of the Part A coinsurance costs. It also tacks on an additional 365 days of coverage after your Part A benefits are exhausted. This also includes coinsurance for skilled nursing facility care and hospice care. Plan N also covers the Part B coinsurance expenses, the first three pints of blood used in an approved procedure, and 80% of any emergencies that occur in a foreign country.

Middle aged couple paying financial bills online using computer at home wondering how much does Plan N cost?
One thing that has many people so interested in Plan N is the low rate increases.

What does Plan N not cover?

So, what’s left out of Plan N coverage? There are three things you should expect to pay if you enroll in Plan N.

First is the Part B deductible, which is $233 in 2022. The only Medigap plan that does pay the Part B deductible is Plan F. However, that plan is only available to people who turned 65 before 2020.

Next, you’ll also be responsible for any Part B excess charges. Healthcare professionals who do not accept Medicare assignment are allowed to charge an additional 15% above the Medicare-approved fee for services. Fortunately, there are very few providers who do not accept Medicare, and there are even eight states that prohibit excess charges. Therefore, these are not a major disadvantage to Plan N.

The last thing you will have to pay is the doctor’s visit and emergency room copays. The copay for a doctor visit will cost up to $20, and an emergency room visit will cost up to $50. (Charges could be less, but never more than these amounts.) Your emergency room copay is waived if you get admitted to the hospital. If you are not someone who goes to the doctor often and are relatively healthy, your copays could be infrequent enough not to matter a whole lot. However, if you see a doctor monthly or even more often, Plan N might not be the best choice for you.

There is one more thing to note about Plan N that also applies to every other Medicare supplement plan. They do not include prescription drug coverage or routine dental, vision, and hearing services. Instead, you will need to enroll in a Part D prescription drug plan and also consider a DVH (dental, vision, hearing) plan to round out your healthcare insurance.

How much does Plan N cost?

Premiums for Plan N (and other Medicare supplement plans) vary by the insurance company, zip code, gender, age, and tobacco use. The average premium for Plan N runs between $120 and $180.

The first thing to know is that all Medicare supplements are standardized. That means Plan N with one company is exactly the same as Plan N with another company. Since that’s the case, there is no reason to choose a big-name carrier if they charge higher premiums. That being said, you should work with an agent to make sure that the carrier you choose is trustworthy and has good ratings.

Premiums are higher for men than women and increase as you get older. Since our medical needs tend to increase, so do our healthcare premiums. Also, tobacco users will pay more than non-users. If you live in a zip code that has a higher cost of living, you can also expect to pay more for your supplement plan.

One thing that has many people so interested in Plan N is the low rate increases. While you can expect your premiums to increase over time, some increase faster than others. Plan N has one of the lowest rate increases and has even shown a 0% increase in some states over the last couple of years.

If you’d like to learn more about plan N or just Medicare in general, call us and speak with one of our licensed insurance agents. We’re happy to answer your questions and compare plans to find the one you need.

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