Medicare Supplement plans, or Medigap, are becoming increasingly popular for those looking to enhance their Original Medicare coverage. Two of the most common Medigap options are Plan G and Plan N, which are known for providing robust coverage while keeping premiums manageable.
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- Plan G provides comprehensive coverage, including nearly all Medicare Part A and B costs, except the Part B deductible.
- Plan N offers lower premiums but comes with some cost-sharing, such as copays for doctor visits and emergency room services.
- The decision between Plan G and Plan N depends on your budget and how you prefer to handle out-of-pocket costs.
Medicare Plans G and Plan N
Medicare Plan G and Plan N are designed to fill the gaps in coverage that Original Medicare (Parts A and B) leaves behind. They help cover out-of-pocket expenses such as copayments, coinsurance, and deductibles, providing more financial stability for healthcare needs.
Plan G is well-known for its comprehensive coverage. It covers almost all the costs left over from Original Medicare, excluding only the Medicare Part B deductible.
Plan N, on the other hand, provides similar coverage to Plan G but introduces some cost-sharing measures, such as copayments for doctor visits and emergency room visits. These cost-sharing features result in lower premiums and make Plan N an attractive option for those who want to save on monthly payments while enjoying substantial coverage.
Comparing Costs
Monthly Premiums
One of the primary differences between Plan G and Plan N is the monthly premium. Plan G typically has higher premiums due to its more comprehensive coverage. Monthly premiums for Plan G can range between $120 and $300, depending on factors like your age, location, and insurance provider.
Plan N often has lower monthly premiums, ranging from $90 to $250. This lower cost makes Plan N an attractive choice for those seeking to save on their monthly healthcare costs.
Out-of-Pocket Costs
In exchange for lower premiums, Plan N involves some out-of-pocket expenses that Plan G does not. With Plan N, you may have to pay copayments of up to $20 for doctor visits and up to $50 for emergency room visits that do not result in an inpatient stay. Additionally, Plan N does not cover Part B excess charges, which could lead to additional costs if your healthcare provider charges more than the Medicare-approved amount.
Plan G, by contrast, covers all of these expenses except for the Part B deductible, providing more predictable out-of-pocket costs.
Here’s how they compare:
| Feature | Plan G (Monthly Cost) | Plan N (Monthly Cost) |
|---|---|---|
| Monthly Premium | $120 – $300 | $90 – $250 |
| Part B Deductible | Not Covered ($240) | Not Covered ($240) |
| Copayments | None | $20 (doctor visits), $50 (ER visits) |
| Part B Excess Charges | Covered | Not Covered |
Coverage Differences
Coverage Gaps
While both Plan G and Plan N cover most out-of-pocket costs under Original Medicare, there are a few differences:
- Plan G: Covers all coinsurance and copayments for Parts A and B, including hospice care and skilled nursing facility care. It also covers Part B excess charges, which occur when a doctor charges more than Medicare’s approved rate.
- Plan N: Covers much of the same as Plan G but does not cover Part B excess charges. Additionally, beneficiaries must pay a copayment for doctor visits and ER visits.
Part B Excess Charges
A key distinction is that Plan G covers Part B excess charges, while Plan N does not. Part B excess charges occur when a healthcare provider bills more than the Medicare-approved amount for a service. With Plan G, these charges are fully covered, whereas with Plan N, you would be responsible for paying the difference out of pocket.
Emergency Room Visit Costs
With Plan N, you may need to pay up to $50 for emergency room visits that do not result in inpatient admission. Plan G does not have this copayment, making it more convenient for those who prefer fewer out-of-pocket surprises.
When to Consider Plan G or Plan N
Consider Plan G if you want comprehensive coverage and prefer to avoid unexpected medical bills. It covers nearly every out-of-pocket cost after you meet the Part B deductible, providing a more predictable healthcare experience. If you frequently visit doctors or specialists or if your provider charges Part B excess fees, Plan G is the more convenient option.
Consider Plan N if you want to lower your monthly premiums and don’t mind managing occasional out-of-pocket expenses. Plan N may provide the best balance of coverage and affordability if you are generally healthy, do not require frequent medical care, and are comfortable with some copays for doctor visits and ER visits.
Still unsure which plan is right for you?
CoverRight offers personalized advice to help you find the Medigap plan that best suits your needs and budget.
How to Enroll in Medicare Plan G or Plan N
Eligibility
To enroll in a Medigap plan like Plan G or Plan N, you must be enrolled in Medicare Part A and Part B. Medigap plans are available to individuals aged 65 and older or those under 65 with certain disabilities, depending on state regulations.
Enrollment Period
The best time to enroll in Medigap is during your Medigap Open Enrollment Period, which starts when you turn 65 and are enrolled in Part B. During these six months, you can purchase any Medigap policy sold in your state without being subjected to medical underwriting, which means you won’t be charged a higher premium or denied coverage due to pre-existing health conditions.
How to Enroll in Medicare Plan G or N:
- Evaluate Your Needs: Consider your budget and how frequently you require medical care to determine whether Plan G or N fits your healthcare needs.
- Compare Plans: Research insurance providers and compare plan premiums, benefits, and customer ratings to ensure you get the best value.
- Gather Required Documents: To simplify enrollment, ensure you have your Medicare Part A and Part B information readily available.
- Consult a Licensed Advisor: Contact a licensed Medicare advisor, like those at CoverRight, who can help you navigate your options and choose the right plan.
- Apply During Open Enrollment: Enroll during your six-month Medigap Open Enrollment Period to avoid medical underwriting and higher premiums.
Making Your Choice: Plan G vs Plan N
Choosing between Medicare Plan G and Plan N depends on your preferences, budget, and healthcare needs. Plan G offers comprehensive coverage with minimal out-of-pocket costs, which is ideal for those seeking peace of mind and fewer surprises. Plan N provides a lower-cost alternative with some cost-sharing features, which may suit those in good health looking to save on premiums.
Whether you opt for Plan G or Plan N, having additional coverage through a Medigap plan can significantly reduce your out-of-pocket expenses and provide greater financial security for your healthcare needs.
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