Kelly Blackwell is a Certified Senior Advisor (CSA)®. She has been a healthcare professional for over 30 years, with experience working as a bedside nurse and as a Clinical Manager. She has a passion for educating, assisting and advising seniors throughout the healthcare process.
What is Medicare Supplement Plan N?
Plan N is a Medicare Supplement plan, also called a Medigap plan. As with all Medigap plans, it provides additional coverage on top of that received by Original Medicare Parts A and B. Medigap policies help pay some of the out-of-pocket costs not covered by Original Medicare, such as copayments, coinsurance and deductibles, and some policies may cover services not offered by Original Medicare, like foreign travel emergencies.
Plan N is one of the expanded supplemental options created in the 2010 Medicare Modernization Act, says Chris Alberta, president and CEO of Principium Tactical Wealth Management in Brighton, Michigan. He says it has since become the most popular copay-oriented option: the patient is responsible for 20% of Medicare-approved charges and Part B pays 80% after the Part B deductible is met.
All Medicare Supplement plans are standardized, which means every Plan N in your state will offer the same coverage regardless of which insurance company you use, says John Hill, founder of Gateway Retirement in Rock Hill, South Carolina. The only difference will be in price.
In most states, Medigap Plan N covers 100% of the following benefits:
- Part A deductible
- Part A coinsurance and hospital costs up to an additional 365 days after you’ve used up your Original Medicare benefits
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- The first 3 pints of blood
Plan N also pays 100% of the Part B coinsurance except for a $20 copay for some office visits and up to a $50 copayment for emergency room visits that don’t lead to inpatient admission.
Plan N does not cover your Part B deductible or excess charges when a doctor or other healthcare provider charges more than the Medicare-approved amount. Part N does cover 80% of foreign travel emergency costs.
Note that if you live in Massachusetts, Minnesota or Wisconsin, your available Medigap policies are standardized differently and thus Plan N may provide different coverages. You can read about Medigap policies in your state at Medicare.gov.
How much does Medigap Plan N cost?
While Medigap policy benefits are standardized, each insurance company can set its own premium for the policies it offers. This makes it important to compare the costs of policies across providers and understand how a company prices its policies. Depending on which price rating system the company uses, your monthly premium may go up due to inflation or as you age.
How much Plan N costs will depend on several factors, such as your age and zip code, if you’re a smoker, your gender and the insurance company offering the plan, says Cynthia Pruemm, Investment Advisor, Founder and CEO of SIS Financial Group in Hoffman Estates, Illinois.
For example, a 65-year-old non-smoking female living in Chicago can expect monthly premiums to range from $112.41 to $334.05 in 2021, depending on the insurance company, she says.
“With Plan N there are costs besides the premium,” Hill says. “You will need to pay the Part B deductible, which is $203 in 2021, and a $20 copay at each provider, excluding Part A hospital coverage. You will also be responsible for a $50 emergency room visit, and possible Part B excess charges.”
Still, Plan N is “generally regarded as one of the least expensive coverages,” Hill says.
It’s about 25% cheaper than Plan G, Alberta says. This can make it an appealing option for “budget-conscious folks who are in relatively good health.”
Is a Medicare Supplement Plan necessary?
While a Medicare Supplement Plan is not necessary, it is strongly encouraged, Hill says. “Medicare only pays a portion of your fees, and the remaining charges could be very hard on your resources.”
If you don’t want to pay the 20% of your medical costs that Medicare Parts A and B do not cover, you’ll need a supplement plan like Plan N, Pruemm says.
Be aware that Medigap policies, including Plan N, don’t cover everything. For instance, Medicare Plan N usually does not cover hearing aids, dental, vision, private-duty nursing, or long-term care. It also doesn’t cover prescription drugs, which are covered by Plan D.
What is the difference between Medicare Supplement Plans G and N?
The difference between Medigap Plan G and Plan N is that Plan G has more features but usually comes at a higher cost. Once you pay for your annual Part B deductible, Plan G covers 100% of Medicare-approved costs, meaning you won’t have any copays. “With Plan N, in addition to the Part B deductible, you will have to pay up to $20 for office visits and up to $50 for emergency room visits if you are not admitted,” Pruemm says.
The biggest warning Alberta gives clients who are considering a Plan N supplement is that unlike Plan G, Plan N doesn’t cover any Part B excess charges.
“While most garden-variety procedures and routine doctor visits would not be subject to this, the trend of specialists and more comprehensive surgical procedures that charge beyond what Medicare approves is steadily growing,” he says. “Lower, Medicare-approved reimbursements and higher costs have driven many specialty doctors to need more than what Medicare approves. This is a dangerous area and a terrific reason to utilize Plan G for most folks.”
Cynthia Pruemm, Investment Advisor, Founder and CEO of SIS Financial Group in Hoffman Estates, Illinois
John Hill, founder of Gateway Retirement in Rock Hill, South Carolina
Chris Alberta, president and CEO of Principium Tactical Wealth Management in Brighton, Mich.
Learn More From Our Sources
- Medicare | What’s Medicare Supplement Insurance (Medigap)? | Last accessed June 2021
- Medicare | How to Compare Medigap policies | Last accessed June 2021
- Medicare | Costs of Medigap Policies | Last accessed June 2021
- Healthmarkets | Medicare Supplement Plan N: Is It Right For You? | Last accessed June 2021