Medigap Plan N: Navigating Lower-Cost Coverage

A man receives $20 copayment bill from his doctor. The man hands his doctor his credit card with a simile because he has a Medigap Plan N policy with low premiums.

Medicare health insurance can feel overwhelming, especially when you’re new. You’re likely hearing about things like Part A and Part B, but then there’s another side to Medicare called Medigap. To make matters more confusing, there are lettered plans, like Medigap Plan N.

But is Plan N right for you, and what are its pros and cons? This comprehensive guide explores Medigap Plan N to determine if it fits your situation and healthcare needs well.

What Is Medigap Plan N?

Plan N is a Medicare Supplement Insurance plan sold by private insurance companies. Unlike Medicare Advantage (Part C) plans that provide an alternative to Original Medicare health insurance, Medicare Supplement plans work alongside Medicare Parts A and B. Medigap plans, like Plan N, help “fill the gaps” in Original Medicare coverage.

How Does Medigap Plan N Work?

Plan N works by helping to cover some of the costs that Original Medicare doesn’t fully pay for, such as:

  • Coinsurance.
  • Copayments.
  • Deductibles.

By reducing out-of-pocket costs, Plan N can help provide you with more financial predictability and peace of mind regarding your healthcare expenses.

Medigap Plan N Coverage

This plan covers many of the same benefits as other popular Medicare Supplement plans, such as Plan G. However, Plan N is unique because it offers a different cost-sharing structure. With this plan, you’ll generally pay lower monthly premiums but also have some out-of-pocket expenses.

Plan N provides several essential benefits, including:

  • Part A coinsurance and hospital costs: This covers additional days you’re in the hospital (up to an extra 365 days after your Medicare benefits are used up).
  • Part B coinsurance or copayment: Helps pay for your share of the costs for covered services.
  • Blood: Covers the first 3 pints of blood you need each year.
  • Part A hospice care coinsurance or copayment: Covers hospice care if you have a terminal illness.
  • Skilled nursing facility care coinsurance: This covers part of the cost if you need to stay in a skilled nursing facility.

However, this plan also comes with several notable out-of-pocket costs, such as:

  • Part B deductible: With a Medigap Plan N, you are responsible for paying your Part B deductible each year, while other comprehensive plans (like Plan G) cover this.
  • Copayments: Unlike some more comprehensive Medicare Supplement Insurance plans, Medicare Supplement Plan N requires copayments of up to $20 for office visits that don’t result in an inpatient admission and up to $50 for emergency room visits.

This structure gives you, the policyholder, more financial responsibility, but in return, you pay a lower monthly premium than other options. It can often be a more cost-effective choice for people who rarely need to use their Medicare over the long term.

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Who Should Consider Medigap Plan N?

Determining if Plan N is a good fit for your healthcare needs and budget involves weighing various factors:

Those Wanting Savings

As you can probably guess, Plan N typically has lower monthly premiums than most other Medigap options (especially Plan G, which has the same benefits minus the copays and Part B deductible). So, if you want to save on your monthly premiums, are generally in good health, and don’t require frequent doctor visits or hospitalizations, Medicare Supplement Plan N may be an option.

Medicare Supplements are generally more expensive when they have less out-of-pocket costs and less costly when they cover fewer things. Keep that in mind as you compare various options.

Turning 65 or New to Medicare

This option is ideal for people turning 65 or new to Medicare, as they may qualify for lower premiums. If you aren’t turning 65 but want to prepare for Medicare supplement open enrollment, you can use our free Medicare Supplement service to get rates and a full analysis of plans in your zip code.

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Weighing the Pros and Cons of Plan N

Like every healthcare decision you need to make, Plan N has its pros and cons that you’ll need to assess before deciding which plan is right for you.

Pros of Plan N

There are several noteworthy benefits to having Plan N, such as:

  • Lower monthly premiums compared to more comprehensive options (like High Deductible Medicare Supplement Plan G, Plan F, or Plan G).
  • Predictable out-of-pocket costs can make it easier for people to budget for healthcare.

Cons of Plan N

But it would be best if you also considered these cons before you choose a Plan N policy:

  • Out-of-pocket expenses: Unlike some Medicare plans (Plan N), this doesn’t cover your Part B deductible. This means you’ll need to pay it yourself until it’s met. You are also responsible for paying copays. Many people prefer to avoid this, which is the primary disadvantage of Medicare Supplement insurance.
  • Potential for higher costs: If you have a lot of medical expenses, you could spend more overall due to copays, even with lower monthly premiums. This is especially true if you require Nascentia Skilled Nursing Facility care.
  • Not available in all states: Medicare Supplement Plans vary in each state. Be sure to confirm Plan N is available in your service area. You might consider looking at a Plan L, too.

FAQs about Medigap Plan N

What Is Plan N in Medigap?

It’s a Medicare Supplement plan available in most states. Like all Medicare Supplement plans, it is sold by private insurance companies to help cover the out-of-pocket healthcare costs associated with Original Medicare (Parts A and B).

What are the disadvantages of Plan N?

The primary drawback of this plan is that it doesn’t cover the Medicare Part B deductible. It also requires paying copays for some doctors and emergency room visits, whereas plans like Medigap Plan A and Medigap Plan B would. This can lead to higher out-of-pocket costs than some other plans.

How much is Medicare Plan N per month?

Unfortunately, the exact cost of premiums varies because many different insurance carriers offer it. Where you live is also a factor that determines premiums. To give you an idea of the national average, however, the monthly premium for a 65-year-old is typically around $100–$150 per month but could be as low as $60 per month in certain areas and with discounts factored in. There are resources available, like what is the average cost of Medicare Supplement insurance, to compare pricing among carriers to make it easier for you.

Is Medicare Plan N Better Than a Medicare Advantage Plan?

A Plan N Medigap policy works with your Original Medicare benefits to help pay some of your healthcare costs.  Like Medigap policies, Medicare Advantage plans (sometimes called “Part C” or “MA Plans”) are offered by private insurance companies. There are some key differences between Medicare Plan N and Medicare Advantage.

Medicare Plan N has a monthly premium. But you may have lower out-of-pocket costs throughout the year. Plan N picks up costs like coinsurance and copays after Medicare pays its share. Medicare Plan N also offers more flexibility when choosing healthcare providers. You can generally see any doctor that accepts Medicare.

What is the difference between N & G for Medicare?

Although Medicare Supplement Insurance, Plan N, and Plan G help reduce out-of-pocket expenses not covered by Original Medicare (Parts A and B), they differ in crucial areas. Here’s what you need to know.

Both plans offer identical benefits for most healthcare services, but a key distinction lies in their cost-sharing structures:

Medigap Plan NMedigap Plan G
Requires you to pay your Part B deductibleCovers the Part B deductible
It comes with copayments for some doctor and ER visitsDoesn’t have copayments for doctor and ER visits (once your Part B deductible has been met)

Conclusion

A Medicare Supplement Plan N strikes a balance between affordability and coverage. It appeals to beneficiaries comfortable with some out-of-pocket costs for a lower monthly premium. However, understanding the plan’s intricacies and weighing your health and financial needs are crucial before making enrollment decisions.

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