Medicare Plan N has been popular since it was first introduced in 2010. Also called Medigap Plan N, this option was created for consumers who like the idea of paying a lower premium in exchange for taking on a small annual deductible and some copays.
Here’s a graph that demonstrates what Medicare Supplement Plan N covers, and what is left for you to cover:
What Does Plan N Cover at the Doctor’s Office?
First and foremost, your standard preventive care is covered entirely by Medicare. This includes services like screenings for cancer and diabetes and cardiovascular conditions. It also includes annual physicals, colonoscopies, vaccines and a variety of other normal tests. You will pay nothing for any of the standard Medicare preventive care services.
Your Medicare Supplement Plan N coverage will also includes visits to the doctor for injury and illnesses, durable medical equipment, ambulance, surgeries, home health, lab-work and other imaging tests, diabetes supplies, and many more services. The main thing to remember is that if Medicare Part A or B covers it, then your supplement will also cover it. Medicare pays 80%
If your doctor does not accept Medicare assignment, you will pay a 15% excess charge. Read more on this below.
What Does Plan N Cover in the Hospital?
Your Medicare Part A hospital benefits provide coverage for inpatient hospital services, skilled nursing, home health, hospice and blood transfusions. While you would normally owe a deductible, your Medigap Plan will pay that for you. Here’s a quick list of items coverage in the hospital by Medicare Supplement Plan N:
- The Part A Hospital deductible (in 2017, this is $1316) and your coinsurance (20%)
- An extra one year (365 days) of hospital benefits after Medicare’s coverage runs out
- Hospice care at any certified hospice center
- Coverage for the first 3 pints of blood
Your Medigap Plan N Costs
Medicare Supplement Plan N offers identical basic benefits like the more popular Plan F, but you agree to pay a share of a few things that you wouldn’t pay on Plan F. First, you agree to pay the small annual Part B deductible ($183 in 2017). You will also pay co-payments up to $20 for doctor appointments. Emergency room visits have a $50 copay.
Finally, people with Medigap N also pay excess charges to some medical providers. Providers can charge 15% more than what Medicare allows. This is called an excess charge. Plan N does not cover this for you like Plan F or G would. This can result in small bills from time to time.
However, you can avoid this by simply asking your providers up front if they accept Medicare assignment. If they do, you need not worry about excess charges.
Sometimes people who enroll in Plan N also look at Plan G as an alternative. Plan G covers the little copays and excess charges so there are less bills showing up in your mailbox.
Plan N – Let’s look at an Example
Karen tells her agent that she visits the doctor only once or twice a year. She feels that a full coverage Plan F isn’t really necessary due to her low usage. Her agents explains that Plan N has premiums that are about 30% less than Medigap F if she would be willing to take on copays for a few minor things.
For inpatient care, Medicare Supplement Plan N fully covers her hospital deductible. For outpatient care, Karen will pay the Part B deductible ($183) upon her first doctor visit of the year. She then pays a co-payment of up to $20 when she sees her physicians during the rest of the year. She may pay an excess charge if her doctor is not a participating Medicare doctor. Let’s look at how these expenses on Plan N might affect her.
Let’s say Karen visits her podiatrist in the middle of the year, after her deductible has already been met. Medicare’s assigned rate for a visit to this foot specialist is $100. If the doctor does not accept assigned rates, he can balance bill Karen for up to 15% beyond the approved rate for this visit, or a maximum of $15 in this case.
Karen owes her $20 copay, and her supplement will pay the remainder of the approved charges.
If you find that Plan N hard to understand because of the excess charges and copays, but you still like the idea of lower premiums, then you might check out Plan G. On Plan G, excess charges are covered by your Medigap plan. On Plan G, your cost-sharing is limited to the Part B deductible only.
Medicare Plan N Eligibility
You are eligible to enroll in Plan N as long as you have Medicare Parts A and B. You must also live in the plan’s service area. The best time to enroll in Medicare Plan N is during your Medigap open enrollment period. This six-month window starts with your Part B effective date. It’s your one chance to enroll in any Medigap plan without health underwriting. No insurance company can turn down your application due to health conditions.
If you’ve missed your one-time Medigap open enrollment period, you can still apply for a Medigap Plan N. We can explore the health questions on various company’s applications to see if you are able to pass.
Medigap Plan N Insurance Companies
Though Medicare Plan N is one of the 10 federally standardized Medicare supplement options, each insurance company can choose whether to sell it or not. Fortunately, this policy is fairly easy to find since many carriers offer it.
Boomer Benefits sells Medicare supplement Plan N policies for numerous different insurance companies, such as Blue Cross Blue Shield Medicare Supplement Plan N, Aetna Medicare Supplement Plan N, and Mutual of Omaha Plan N among many others.
Medicare Supplement Plan N Reviews
In our popular Medicare Plan F Reviews blog post, our Medicare expert explains why all Medicare supplements get high marks. Medicare is the entity that decides which claims get paid. If Medicare approves a claim, your Medicare supplement Plan N must pay it’s share.
However, as an agency that has tens of thousands of policyholders, we get lots of feedback from our policyholders. Some Plan N members complain that the excess charges feel like they are being nickled-and dimed. If this concerns you, ask our team to compare Medicare Plan N vs Plan G for you. Quotes for both plans may help you decide which is right for you.
Need Plan N quotes? Our software provides not just rates but also a comparison of insurance company financial ratings and their history of rate increases too. Call us today or you can use the link below to request quotes via email for Medicare Plan N.
**Sometimes you will hear people call this Medicare Part N Supplement. The phrase “Part N” is incorrect. Original Medicare has Parts. Medigap options have Plans. So instead of saying Part N, call it Plan N, and you’ll be using the correct terminology.