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Medicare Supplement Plan N

Medicare policy holders that are looking for a lower cost alternative to the more comprehensive Medicare Supplement Plan F or Medicare Supplement Plan G will find comfort knowing that Plan N exists. Medicare Supplement Plan N is basically all the basic benefits of a Medigap policy bundled in a package that charges lower monthly premiums. If you are in generally good health and would like to be prepared for the incidentals, many insurance providers will suggest that you sign up for Plan N as opposed to one of the nine other Medigap policies available.

Medicare Supplement Plan N is only available if you already have a Medicare Part A and Part B. This is a standardized policy across the U.S. Before we jump into the pros and cons of signing up for a Plan N, you must first be clear about what you already have with your existing Medicare so you don’t unknowingly shell out precious retirement money for things you do not need.

Who Is Medicare for?

Medicare is a government provided health insurance program designed for individuals who are 65 years old and up, those with End-Stage Renal Disease (ESRD), and younger people with certain types of disabilities. This program is the government’s way of helping citizens during the times when they need medical attention the most but do not have the financial ability to meet the financial demands of a healthcare expenses on their own.

There are four parts to Medicare. Part A covers inpatient hospital admissions, hospice care, services in skilled nursing facility, and some types of home-based health care. Part B covers outpatient care, medical supplies, certain preventive services, and doctors’ fees. Part C, also called Medical Advantage Plan, is offered by private companies in conjunction with Medicare. Part D is a prescription drug coverage package applied in addition to the original Medicare and other related programs.

To purchase any of the 10 Medicare Supplement Plans, you will need to already have Part A and Part B.

Why Do You Need a Medicare Supplement Plan?

Medicare offers plenty of hospital and outpatient services, but it cannot take care of everything that you might need. This is why Medigap Plans were created — to fill the “gap” that Medicare does not cover. Medigap can be bought only through private insurance providers across the U.S. and you can use this to pay for the balance of the cost of services that the original Medicare does not. The ultimate goal is to reach zero-billing for any medical need or procedure.

At this point, it is important to note that if you have already enrolled in Medicare Part C (Medical Advantage Plan), you are not eligible for Medigap. You may dis-enroll from your Medicare Advantage plan and enroll in Medigap during your Annual Election Period.

What Are the Benefits of Medicare Supplement Plan N?

The decision on which of the 10 Medicare Supplement Plans to choose will depend largely on your current health status, your financial status, and the ability to budget premiums. At 65 years of age, most people have already entered the stage of retirement and, hence, will not have a regular source of discretionary income. More likely than not, these people will only have either passive income from previous investments or their Social Security.

If you find yourself to be generally in good health and have a pretty active lifestyle, then you might not feel you need a Medicare Supplement Plan that pays 100%. If you only visit your doctor a few times a year for a regular office visits, you will find that Medigap Plan N, which is less costly, offers a good deal. Here are the key benefits that you can enjoy by enrolling in a Medicare Supplement Plan N policy.

Medigap Plan N Benefits

Part A coinsurance (up to an additional 365 days after the original Medicare benefits are used up)

Part A hospice care coinsurance of copayment

Part A deductible

Part B coinsurance or copayment

* except for a copayment of up to $20 for some doctors’ visits and up to $50 for E.R. visits that do not result in inpatient admission

Skilled nursing facility care coinsurance

Blood (first 3 pints)

Foreign travel emergency care (80%, up to plan limits)

What Does Medigap Plan N Not Cover?

Given the Medigap Plan N is a lot more affordable than its more extensive counterparts, like Plan F or Plan G, you can expect the coverage to be less comprehensive, as well. As mentioned earlier, Plan N is more for people who are comparatively physically fit and will likely do not need medical attention and services as often (if, at all). But, just to be clear, here are the things that Medigap Plan N does not cover, that Plan F and Plan G do.

Medigap Benefits	Plan F	Plan G	Plan N
Medicare Part B deductible	Yes	No	No
Medicare Part B excess charges	Yes	Yes	No

Things You Should Know Before Getting a Medicare Supplement Plan N

With Medigap Plan N, 100 percent of your Part B coinsurance fees are covered, except for a copayment fee of $20 for each visit to the doctor and $50 for emergency room visits. Plan N requires you to pay the Medicare Part B deductible ($183 in 2018), after which your physician will have the right to charge an additional $20 maximum copay. When you think about it, both fees are a small amount to pay IF you ever need any of those services. We place an emphasis on IF because it is assumed that you are in pretty good health.

Medicare Supplement Plan N covers 100 percent of skilled nursing facility coinsurance and Part B coinsurance. Even if you’re in great health, needing services from a skilled nursing care facility might come up given your advancing age, so it’s best to be prepared for such instances. Fees for skilled care facilities and services can be extremely high. This is why it should always be considered when you choose a Medigap policy.

One of the differences Medigap Plan N is that is does not cover Part B excess charges although, very few hospitals or physicians bill in excess of the Medicare approved amount. “Excess charges” refer to the amount that goes beyond the pre-approved Medicare ceiling that Part B will shoulder. Legally speaking, hospitals and doctors can charge up to 15% above the Medicare limit, although this is very rare.

When Should You Get Medigap Plan N?

The best time to purchase a Medigap Plan N, or any Medigap policy for that matter, is during your six-month open enrollment period. This starts on the day you turn 65 years old. During this period, you will not be required to undergo medical underwriting and insurance providers are required to sign you up for any Plan you want. After the six months, insurers have the right to decline your application or charge you higher premiums because of your health status.

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