Medicare Supplement or Medigap plans fill some of the coverage gaps under Original Medicare. Private insurance companies offer them to help beneficiaries with medical costs that Original Medicare doesn’t pay. Such plans can often cover deductibles, copayments, excess fees, and other out-of-pocket expenses.
You need to have Original Medicare, consisting of Part A (Hospital Insurance) and Part B (Medical Insurance), to be eligible for a Medigap plan. There are 10 separate Medigap plans to choose from, labeled as plans A, B, C, D, F, G, K, L, M, and N.
Each Medigap plan comes with distinct coverage options and benefits. In this article, we will explore Medicare Plan N in detail.
What is Medicare Plan N?
Medigap Plan N provides a range of benefits that address certain costs which Original Medicare doesn’t cover. While Plan N doesn’t offer the comprehensive coverage provided by Plan G and Plan F, it presents a cost-effective option with valuable benefits.
Plan N covers Medicare Part A coinsurance and hospital expenses for up to 365 after Medicare benefits have expired. It also covers Part B coinsurance and copayments, but does not extend to the Part B deductible or excess charges. Plan N also covers skilled nursing facility care coinsurance and emergency care for foreign travel.
With Medicare Plan N, you might need to copay around $20 for seeing a doctor and up to $50 for emergency room visits. This helps keep the monthly cost of Plan N lower than some other Medigap plans.
Compare Medigap plans to make an informed decision about your healthcare needs. Federal law stipulates that all Medigap plans must provide the exact same benefits regardless of the insurance provider. The only exceptions are Massachusetts, Minnesota, and Wisconsin, where Medigap plans are standardized differently.
How Does Medigap Plan N Compare to Plans G and Plan F?
There’s frequent comparison between Medigap Plan N and Plan G among Medicare beneficiaries. Although both cover Medicare Part B coinsurance, they do it differently. Plan G pays for the entire Part B coinsurance, while Plan N covers it partially. Plan G also takes care of certain excess charges, which Plan N doesn’t. These features make Plan G more comprehensive, but also more expensive. Plan N balances its coverage in favor of a lower premium.
Another frequent comparison is between Medigap Plan N and Plan F. Medigap Plan F covers Medicare Part A and Part B coinsurance, deductibles, and Part B excess charges, with no copayments for doctor or emergency room visits. Plan F typically costs more than Plan N because of its comprehensive coverage.
Although there are limitations to Medigap Plan N, it is an apt choice if you don’t need frequent doctor visits and can afford the out-of-pocket expenses involved.
Coverage and Benefits of Medicare Plan N
Here’s a detailed look at Medigap Plan N coverage benefits to help you make an informed decision:
- Hospital Care Coverage: Medicare Plan N assists with in-patient hospital expenses by covering Medicare Part A coinsurance. It also covers the costs of your hospital stay.
- Medical Services Coverage: This plan takes care of medical services by helping with the coinsurance or the money you need to pay to see a doctor or receive out-patient medical services.
- Blood Transfusion Coverage: In case you need a blood transfusion, Plan N covers the first three pints of blood you might need while in the hospital.
- Nursing Home Care Coverage: If you require care in a skilled nursing facility, Plan N helps with the cost by paying for 100% of the Part A coinsurance.
- Part A Deductible Coverage: You are liable for Part A deductible when you’re admitted to a hospital. Plan N covers this deductible entirely so you don’t have to pay out of pocket.
- Emergency Care While Traveling: Plan N covers up to 80% of the approved emergency care costs, up to a lifetime plan limit of $50,000 when you’re traveling outside the US.
Cost-Sharing and Out-of-Pocket Expenses
The average monthly premium for Medigap Plan N can range from $120 to $180, depending on factors like your location and the insurer.
Plan N takes care of Medicare Part A deductible for in-patient hospital stays. You’ll likely have to pay coinsurance for visiting a doctor or emergency room.
Plan N sets itself apart from other Medigap plans with its distinct cost-sharing approach that helps keep premium costs down.
Enrollment and Eligibility
Here’s a detailed breakdown of eligibility and enrollment in Medicare Plan N:
Eligibility Criteria for Enrolling in Medicare Plan N
To enroll in Medicare Plan N, you generally need to meet the following criteria:
- You must already be enrolled in both Medicare Part A and Part B.
- You must reside within the coverage area of the plan.
- You cannot already have a Medicare Medical Savings Account (MSA) plan.
Open Enrollment Period and Guaranteed Issue Rights
The best time to enroll in Medigap Plan N is during the Open Enrollment Period. It starts on the first day of the month you turn 65 and lasts for a total of six months. Your issue rights are assured during this period. That means insurance companies can’t deny you a Medigap policy or charge you more based on preexisting conditions during this period. You may have to pay a higher premium and have preexisting conditions taken into account if you enroll outside this period.
Switching from Other Medigap Plans to Plan N
You can do so if you already have a different Medigap plan and want to switch to Plan N. There are a few things to consider:
- You may need to go through medical underwriting, which means the insurance company could ask you health-related questions and use your answers to decide whether to sell you the policy or how much to charge.
- The insurance company can deny or charge you more if you have certain health conditions.
- If you’re switching during your Medigap Open Enrollment Period, you might have more protection against being denied or charged more.
Coverage Limitations and Exclusions
Medicare Plan N has its set of limitations and coverage exclusions. Let us understand them in detail.
Understanding Plan Restrictions and Limitations
Medicare Plan N coverage may not extend to certain items or services. Review plan details carefully to understand plan restrictions and limitations.
Excluded Services and Items Not Covered by Plan N
Medigap Plan N might not pay for your Medicare Part B deductible. It also doesn’t cover Part B excess charges and services like long-term care, dental, vision, and hearing services, private-duty nursing, and prescription drugs.
Situations When a Service Is Not Covered
If you come across a service that Plan N doesn’t cover, don’t worry. You have options! You may be able to use Original Medicare to get the service and pay for what’s not covered. You can also consider other insurance like Medicaid to cover the costs if you’re eligible. Contact your insurance company if you need more clarification.
Reach out to CoverRight to negotiate any aspect of Medicare, from eligibility to enrollment.
Frequently Asked Questions (FAQs)
What is the difference between Plan N and Plan G?
Plan N and Plan G are Medicare Supplement or Medigap plans that provide comprehensive coverage but differ in cost-sharing. While Plan G covers Medicare Part B excess charges, Plan N does not. Plan N requires small copayments for doctor’s visits and emergency room visits.
Does Plan N cover Medicare Part B excess charges?
No, Plan N does not cover Medicare Part B excess charges. These charges might occur if a healthcare provider charges more than what Medicare approves.
Can I keep my preferred doctors with Plan N?
Yes, you can keep your preferred doctors with Plan N. It works with Original Medicare, which means you can visit any doctor provided they accept Medicare patients.