If you are eligible for Medicare and are looking for a supplement to fill in the coverage gaps, a Medicare Supplement Plan (Medigap) should be on your to-do list.

Since there are currently ten plans to choose from, you might feel a little overwhelmed sorting through all the available data.

 

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For most seniors, understanding Original Medicare is challenging enough without throwing Medicare Supplements (Medigap) in the mix.

For those of you who may be doing your own research, keep reading to learn about Medicare Supplement N and what it does and doesn’t cover.

 

A Quick Overview of Medicare Supplement Plans (Medigap)

When a senior turns 65-years-old, he or she becomes eligible to enroll in Original Medicare, and start getting affordable health insurance that most have paid into over their lifetime.

Original Medicare Part A and Part B will cover the majority of your healthcare costs but there are some gaps in the coverage that you will need to either pay out-of-pocket or transfer to an insurance company that sells Medigap policies (Medicare Supplement insurance).

These Medicare Supplement plans are sold by private insurance companies that have been approved by the folks at Medicare and all of the Medigap plans are standardized, meaning every company must offer the same coverage in each of the Medigap plans they offer.

The difference between one insurance company and another is the monthly premiums of the plans and any additional services they offer.

Currently, there are ten different plans available to purchasePlan A, Plan B, Plan C, Plan D, Plan F (not available if you turned 65 on or after 1/1/2020), Plan GPlan K,  Plan L, Plan M, and Medigap Plan N. Plan F and Plan G are also available as a high deductible plan.

 

Medicare Supplement Insurance Plan N – What it Covers

Medicare Plan N is one of the most comprehensive plans available and is a great fit for Medicare enrollees who prefer to pay as little out-of-pocket as possible in exchange for a low monthly premium.

Medigap Plan N covers the following:

  • Covers Part A hospital coinsurance and hospital costs for up to 365 days after your Original Medicare benefits are exhausted.
  • Covers the Part A hospice care copayment or coinsurance charges.
  • Plan N pays the annual Original Medicare Part A deductible
  • Covers the Part B coinsurance charges (excluding doctor office visits and ER visits.
  • Plan N pays the coinsurance costs for Part B preventive care.
  • Covers the cost of the first three pints of blood used in a medical procedure.
  • Plan N pays your coinsurance charges for Skilled Nursing Facilities (SNF)

 

What Plan N Does Not Cover

Although Medicare Plan N is very comprehensive in terms of filling gaps found in Original Medicare Part A and Part B, some gaps are excluded:

  • Medigap Plan N will not cover your Medicare Part B Deductible of $203 for 2021.
  • Does not cover Part B excess charges
  • Does not pay the copayment of up to $20 charges for some office visits
  • Does not pay the copayment of up to $50 for ER visits (will be waived if you are admitted to the hospital following the visit)

Here is a reference chart for Medicare Supplement Plan N:

Part A Coinsurance & Hospital Costs
(Up to an additional 365 days of coverage after Medicare benefits are exhausted)
Yes
Medicare Part B Coinsurance or Copayment
(You pay up to $20 for some office visits and up to $50 for the ER if not admitted)
YES
First 3 Pints of Blood YES
Part A Hospice Care Coinsurance or Copayment YES
Skilled Nursing Facility Coinsurance YES
Medicare Part A Deductible YES
Medicare Part B Deductible NO
Medicare Part B Excess Charges NO
Foreign Travel Medical Emergency (up to plan limits) YES

 

Example of Plan N at Work (Hypothetical)

Rebecca is on a Zoom call with her agent, Randy. She is explaining to Randy that she’s pretty healthy and only visits her doctor once or maybe twice a year.

After reviewing Plan F and getting the price, Rebecca believes that Plan F is not the best fit because she just doesn’t feel she would use it that often.

Randy explains to Rebecca that she should then consider Plan N because it’s very similar to Plan F but about but the insurance company will charge about 30% less because she would be responsible for the Part B deductible which is only $203 and a few other minor copayments for visiting the doctor or for emergency room visits.

Now then, let’s say that Rebecca had some flu symptoms and decided to visit her doctor that winter, and her deductible had already been met for the year.

And, let’s say that Medicare’s assigned rate for the visit was $125. If Rebecca’s doctor does not accept assigned rates, she can send Rebecca a balance bill for up to 15% beyond the assigned rate for the visit, or a maximum of $18.75.

However, in Rebecca’s case, she lives in a state that doesn’t permit physicians to bill for excess charges so she’s out the door without a worry.

 

Who is Eligible to Purchase Medicare Supplement Plan N?

Any person can enroll in Plan N as long as they have enrolled in Medicare Part and Part B. and companies offer plans in your area.

The optimal time to enroll in Plan N is during your Medigap Open Enrollment Period which begins the day your Medicare Part B plan is in force.

During the Open Enrollment Period, the company will not consider medical underwriting and you cannot be denied coverage.

If you miss your Open Enrollment Period, you can still apply for a Plan N under certain circumstances.

 

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Founder & CEO at HealthPlans2Go
I am an Independent Insurance Agent specializing in Life, Health, and Medicare Insurance. During my 20 years of practice, I've helped thousands of individuals and families secure the best insurance coverage for their needs.
Josh Docktor