Medicare Supplement Plan N Review In 2021
Behind Plan G, Medigap Plan N plan is currently the most popular Medicare Supplement Insurance Plan.
While premiums are attractively low, Medicare Plan N is the only one that has copays when you see a doctor.
On the bright side, you’ll be able to see any doctor nationwide who accepts Original Medicare. You’ll also get access to the Medicare Supplement Well-Being Program, a set of services designed to boost seniors’ health.
Let’s dive in and check out the details.
What Are Medicare Supplement Plans?
Medicare is the federal health insurance program that provides coverage for people who are 65 and older and those with specific disabilities.
Medicare supplement insurance (Medigap) is designed to help cover some of the costs not covered by Medicare, like co-pays, deductibles, and other out-of-pocket expenses.
There are several things you need to know about Medicare Supplement Insurance.
Medigap Plans Do NOT Provide Additional Benefits
This is one of the most misunderstood things about Medicare Supplement Insurance plans.
Medicare Supplement Insurance provides NO additional benefits compared to Original Medicare. The role of Medigap is to cover the financial exposure that Original Medicare leaves you with.
Medigap Policies Are Standardized Across Companies
Every Medicare Supplement Insurance policy must follow federal and state laws designed to protect consumers and be identified as “Medicare Supplement Insurance.”
No matter which state you live in or which company you purchase from, similarly-labeled Medigap policies will have the same benefits.
A Medigap Plan N from Aetna in Nevada will have the same benefits as a Plan N policy from Transamerica in New Mexico.
Private Health Insurers Sell Medigap Plans
While the Federal Medicare Program administers Original Medicare (Medicare Parts A & B), a private insurance company (e.g., Cigna, Aetna, Humana, etc.) provides your Medigap plan.
If you’re in the market for a Medigap plan, the best way to buy one is from an independent insurance agent. Insurance policies must be priced the same, no matter who sells them, so there is no benefit to buying directly from the carrier.
Independent agents will let you see your price across a handful of insurers at once. Since benefits are standardized across companies, why pay more for the same thing?
What Is Medicare Supplement Insurance Plan N?
Like the other nine Medigap plans, Plan N is a form of Medicare Supplement Insurance sold by private insurance companies. These plans aim to help Medicare beneficiaries cover their out-of-pocket costs from their Part A & Part B coverage (e.g., copayments and deductibles).
What Does Plan N Cover?
Here are some of the highlights of what Plan N covers:
- Your deductibles and coinsurance from your Part A (inpatient hospital services) coverage
- Your Medicare Part B coinsurance (outpatient care, like doctor visits)
Plan N Copayments
While Plan N covers 100% of your Plan B coinsurance, it charges copays for each visit to the doctor or emergency room that you make. The copayments are $20 for doctor’s visits and $50 for ER visits where you are NOT admitted.
Why Buy Plan N?
Plan N offers good value for those looking for lower monthly premiums and predictable out-of-pocket costs.
With Plan N, you are responsible for the copayments described above.
You are also responsible for any “excess charges” that you may incur while receiving Part B-covered services. In other words, the additional amount a doctor may charge you, above what Medicare covers for that service.
Note that these charges are possible only when seeing doctors who have opted out of Medicare (only 1% of doctors have chosen to).
Additional out-of-pocket expenses like these (copays and excess charges) are the trade-off for lower monthly premiums
Medigap Plan N Benefits Cheat Sheet (Printable PDF)
If you understand things better on paper as we do, we’ve put together a printable, one-page cheat sheet to help you get your head around Plan N’s benefits.
In the sections below our PDF cheat sheet, we’ll go through each of these benefits in more detail.
Covered Services and
What You Owe
|Part A Inpatient Hospital Deductible||0% ($0)|
|Annual Part B Deductible||100% ($203)|
|Out of Pocket Maximum||N/A|
|Part B Excess Charges||Not Covered|
The essential item to focus on here is the Part A deductible ($1,484). Plan N covers the entire amount, similar to Medicare Supplement Plan G.
The other notable item here is that Medigap Plan N does not cover Part B excess charges. What are these charges?
While most providers accept medicare assignments (meaning, they charge the medicare-approved amount), some providers charge above this amount. This excess amount is called a Part B excess charge.
Per our research, over 95% of providers do NOT charge excess charges, so this is not a benefit to be very concerned about.
|Primary Care Visits||Up to $20 Copay|
|Specialist Visits||Up to $20 Copay|
|Referral To Specialist Required?||No|
|Provider Network Required?||No|
When you have Medicare Plan N, you can visit any doctor you want and are not restricted to a provider network like Medicare Advantage.
While you do not need a referral to visit a specialist, with Plan N, you will be required to pay a $20 copay each time you visit the doctor.
If you go to the doctor twice a month, as many seniors do, this will total a whopping $440 per year.
|Emergency Care||Up to $50 Copay|
|Ground Ambulance Services||$0|
|Air Ambulance Services||$0|
|Foreign Travel Emergency||$250 Annual Deductible then |
20% ($50,000 Lifetime Max)
Similarly, for emergency care, you will be responsible for a $50 copayment.
This copayment applies only if you are NOT admitted to the hospital.
|Inpatient Hospital Care||For Days 1-60: $0; |
For Days 61-425: $0;
Then: All costs
|Skilled Nursing Facility||For Days 1-100: $0 |
For Days 101+: $0
Here’s what happens with your inpatient hospital or skilled nursing facility benefits:
- First, your Medicare Part A hospital benefits are used
- When these are exhausted, your Medigap Plan N insurer pays for an additional 365 days
During this time, the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.
A benefit period begins when you are admitted to a hospital as an inpatient and ends when you have been out of the hospital for 60 days in a row, having received no skilled care in any other facility.
|Ambulatory Surgical Center||$0|
|Outpatient Hospital Services||$0|
|Mental Health - Outpatient||$0|
Plan N has you covered through and through when it comes to outpatient care.
You will pay nothing for treatment at ambulatory surgical centers, outpatient hospital services, and outpatient mental health services.
Lab & X-Ray
|Diagnostic Radiology Services||$0|
|Durable Medical Equipment||$0|
Lab services are not subject to the Part B deductible and are paid at 100% by Medicare.
Frequently Asked Questions
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 costs from Medicare.
While Plan N does have a potential of fees that the patient is responsible for, its rate increase history has and will remain low as it is not a guaranteed issue plan. This secures your client in a stable plan for a longer amount of time.
Like all Medigap plans, Medicare Supplement Plan N coverage does not include prescription drugs. If you want prescription coverage you can purchase Medicare Part D. Medicare Plan N also does not cover dental, vision, or hearing. If you want coverage for these services, consider a Medicare Advantage plan.
We hope you found this overview helpful! If you have a question we did not cover, however, don’t hesitate to leave a comment or send us an email at firstname.lastname@example.org. We’ll be sure to get back to you within 24 hours.
The GetSure Team