A couple of seniors not understanding Medigap Plan N

Understanding Medigap Plan N

Medigap Plan N – While it may not be the most talked-about Medigap plan on the market, Plan N is quickly rising in popularity among Medicare beneficiaries. Some even say that it might just offer the most value, considering the lower premiums as compared to other plans. This article will review what is covered by Plan N, what’s missing from its benefits, and how much it costs. After reading, you will be able to decide for yourself if Plan N is a good option for you.

What is Plan N?

Plan N is one of ten Medigap plans, also called Medicare supplement plans. These plans are used to help fill in the gaps in Original Medicare. Original Medicare (Parts A and B) offers excellent healthcare benefits, but it does leave you with quite a few out-of-pocket costs. You’ll have deductibles, coinsurance costs, and copayments. Plus, neither Part A nor Part B has an annual limit on your expenses. If you have a tough medical year, your expenses could be tens or hundreds of thousands of dollars. That might seem dramatic, but medical bills are the number one cause of bankruptcy in the United States.

If you enroll in Plan N or any other Medicare supplement plan, it will act as your secondary insurance plan. Once a claim has been paid by Medicare, it gets sent on to your Medicare supplement insurance. As long as Medicare approves the claim, your supplement will also approve it.

What coverage is included in Plan N?

Medigap Plan N includes some great benefits. It falls into third place when it comes to the amount of coverage it has, but that’s no reason to ignore Plan N. We’ll go into more details about why third place isn’t something to sneeze about in this case! Let’s look at a breakdown of Plan N coverage.

  • Medicare Part A deductible
  • Part A coinsurance costs
  • An extra 365 hospital days after Part A benefits are depleted
  • Medicare Part A hospice care coinsurance
  • Skilled nursing facility care coinsurance
  • First three pints of blood
  • Medicare Part B coinsurance
  • 80% of foreign travel emergency care (up to plan limits)

That coverage takes care of the majority of out-of-pocket costs left by Original Medicare, but not quite all of them. Next, let’s discuss the costs you’ll be responsible for under Plan N.

What’s not included in Plan N?

Like most other Medicare supplements, if you enroll in Plan N, you will be responsible for the Part B deductible, which is $233 this year (2022). The only supplement that includes this coverage is Plan F, which is not available to newly-eligible beneficiaries.

You will also be responsible for the Part B excess charges. What are those? Part B excess charges are amounts that non-Medicare providers can add to your bill. They can amount to an additional 15% above the Medicare-approved amount. Fortunately, it is rare to run into a provider who does not accept Medicare. More than 95% of all healthcare professionals accept Medicare, and there are eight states who prohibit the practice altogether.

There are also small copays associated with Plan N. When you visit a doctor, you will pay up to $20 per visit. Emergency room visits will cost you up to $50. Your providers can charge less than that, but not more. Emergency room copays are waived if you end up getting admitted as an inpatient.

A Pharmacist giving a prescription not Understanding Medigap Plan N
Even if you are not taking medications, you need to enroll in Part D to avoid penalties later on.

Those were all expenses specific to Plan N. Now, let’s talk about the coverage that is not included in Plan N or any other supplement plan.

Prescription drug coverage is not included. If you enroll in a Medicare supplement plan, you’ll need to enroll in a separate Part D plan as well. Even if you are not taking medications, you need to enroll in Part D to avoid penalties later on.

Routine dental, vision, and hearing services are also not included in Medicare or Medicare supplement plans. Some services are paid for if they are due to trauma or chronic conditions and diseases (like glaucoma), but routine or preventive services are not included. Fortunately, there are plans that include coverage for these aspects of your healthcare. Unfortunately, they come with an additional monthly premium.

How much are Plan N premiums?

On average, Plan N premiums are between $80 and $180 per month. You may find higher or lower premiums depending on a number of things.

No insurance company can change the benefits found in Plan N. The coverage remains the same no matter where you buy it. They can choose their own premiums, though. That is one reason it’s important to work with an independent insurance agent – they will shop at different companies to find you a competitive rate.

Your premium will also depend on where you live, your age, gender, and tobacco use. Premiums tend to increase with age, so you should expect your premium to go up each year. One reason Plan N has become so popular is that the premiums have gone up slower than others. In fact, some states have seen a 0$ increase over the last two years.

Want to learn more about Plan N? Give one of our Medicare advisors a call! We are a licensed health insurance agency and can answer any questions you might have about your Medicare options. There is no charge to use our services, so call to make an appointment today!