Sorting through Medigap plans can be a challenge if you shop on your own. There are many choices available, but how do you know which one is right for your needs? Medicare Supplement Plan N can be a good choice for those looking for near-comprehensive coverage. Below, we discuss Medicare Supplement Plan N’s main features and benefits.
A Brief Review of Medicare Supplement Plans
When you turn 65, you’re eligible to enroll in Medicare, a federally facilitated health insurance program. Original Medicare (Parts A and B) will cover some, but not all, of your medical expenses. The portion not covered is often referred to as a “gap.” Medicare Supplement plans, also called Medigap plans, are policies sold by private insurance companies to help pay for the expenses Medicare does not cover.
About Medicare Supplement Plans
Medigap plans are standardized by the federal government. This means that plans of the same letter offer the same benefits, no matter who you buy it from. But keep in mind that insurance companies are allowed to offer additional benefits, so compare plans carefully before you purchase a policy. You are eligible to purchase a Medicare supplement insurance plan if you are 65 years old or older and enrolled in Medicare Part B. If you are under 65 and disabled, you will likely be limited as to which Medigap plan you can purchase.
There are 10 Medigap plan options in total. But we are going to focus on Medicare Supplement Plan N.
What Is Medicare Supplement Plan N?
Medicare Plan N is coverage that helps pay for the out-of-pocket expenses not covered by Medicare Parts A and B. It has near-comprehensive benefits similar to Medigap Plans C and F (which are not available to new enrollees), but Medicare Plan N has lower premiums. This makes it an attractive option to many people.
What Does Medicare Supplement Plan N Cover?
Medigap Plan N has coverage for four basic areas:
- Hospitalization: pays Part A coinsurance and provides coverage for 365 additional days after Medicare benefits end.
- Medical Expenses: pays Part B coinsurance (excluding copays for office visits and ER) and 20% of Medicare-approved expenses or copayments for hospital outpatient services.
- Blood: pays the first three pints of blood annually. Original Medicare pays for any pints beyond 3.
- Hospice Care: pays Part A coinsurance.
Additionally, Medicare Supplement Plan N pays for skilled nursing facility care and the Medicare Part A deductible for hospitalization.
What Does Medicare Supplement Plan N Not Cover?
Medigap Plan N does not cover the Medicare Part B deductible or excess charges, which are the difference in cost between what a health provider charges for a medical service and the Medicare-approved amount. Medicare Plan N will not cover the copay or coinsurance for doctor’s office and emergency room visits.
How Much Does Medicare Supplement Plan N Cost?
The premiums associated with Medicare Supplement plans differ by location and insurance company. As a general reference, in 2021, a non-smoking 65-year-old woman living in Florida’s 32162 ZIP code would pay between $124 and $182 for Medicare Supplement Plan N monthly premiums.1
But how do companies set these prices? They use one of three price rating systems to set premiums:
- Community-rated: everyone with the policy pays the same price regardless of age. Pricing can still change based on inflation but cannot increase due to your age.
- Issue-age-rated: the premium is based on the age you are at the time of purchase. Therefore, it costs less for people who buy at a younger age. The price cannot increase after the issue date due to age.
- Attained-age-rated: the premium starts low and increases as you age.
There can be a wide variance in cost. Differences may exist based on whether or not the insurance company selling the policy offers discounts or uses medical underwriting.
Pro Tip: When shopping for a Medicare Supplement policy, always compare apples to apples. You want to be make certain you are comparing a Medigap Plan N from one company to a Medicare Plan N from another company. You don’t want to compare Plan N at one company to Plan B at another because you won’t get a clear comparison between the prices and benefits.
Want an easy way to shop for Medicare Plan N prices? Start comparing Medigap plans with HealthMarkets!
Enrollment for Medigap Plan N
Enrollment begins the first day of the month you turn 65 and are covered under Medicare Part B and ends six months after your birthday month. Applying for benefits during this time is the most beneficial, as insurance companies are not permitted to use medical underwriting. That means you could get the lowest prices available.
Applying for benefits outside of the six-month time window could mean higher premiums or a denial of coverage due to your health.
How Does Medicare Supplement Plan N Compare to Other Medigap Plans?
Medicare Supplement Plan N provides more coverage than Plans K and L. For example, it covers 100% of the Medicare Part B coinsurance and copayments, whereas K and L only pay 50% and 75%, respectively. The same is true with the Medicare Part A deductible.
Additionally, the only out-of-pocket expenses beyond the monthly premium are a $20 copay for office visits and a $50 copay for a trip to the ER.
The chart below will help you make comparisons.
|Part A coinsurance and hospital costs up to an extra 365 days after Medicare benefits are used up||100%||100%||100%||100%||100%||100%||100%||100%||100%||100%|
|Part B coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%***|
|Blood: first 3 pints||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A hospice care coinsurance or copayment||100%||100%||100%||100%||100%||100%||50%||75%||100%||100%|
|Skilled nursing facility care coinsurance||No||No||100%||100%||100%||100%||50%||75%||100%||100%|
|Part A deductible||No||100%||100%||100%||100%||100%||50%||75%||50%||100%|
|Part B deductible||No||No||100%
|Part B excess charge||No||No||No||No||100%||100%||No||No||No||No|
|Foreign travel exchange up to plan limits||No||No||80%||80%||80%||80%||No||No||80%||80%|
|**The plan pays 100% of the costs for covered services for the calendar year after the out-of-pocket yearly limit and yearly Part B deductible has been met.
***Plan N’s Part B coinsurance is covered at 100%, except for up to $20 in copayment for some doctor’s office visits and up to $50 in copayment for emergency room visits that don’t require inpatient admission.
With Medigap plans, there is no insurance network limiting you. Medicare Plan N covers you no matter where you go throughout the country – as long as your provider accepts Medicare.
Only certain Medigap insurance plans cover emergency medical services outside of the United States. Plan N has foreign travel benefits that will pay for up to 80% of the treatment costs.
What to Know Before Enrolling in Medicare Supplement Plan N
If you are interested in enrolling in Medicare Supplement Plan N, or any Medigap plan, there are five things you should know beforehand:
- You must be enrolled in Medicare Parts A & B.
- You can have a Medicare Advantage plan or a Medigap policy, but not both. You can apply for a Medigap policy if you currently have Medicare Advantage, but you must cancel the Medicare Advantage plan before your new Medigap policy begins.
- A Medigap policy only covers one individual. Therefore, your spouse will need to purchase a separate policy.
- Medigap policies are guaranteed renewable even if you have health problems. Your Medigap policy cannot be cancelled as long as you continue to pay your premiums.
- Medigap policies, including Medicare Plan N, do not cover everything. Medicare Plan N typically excludes long-term care, vision or dental care, hearing aids, private-duty nursing, and most importantly, prescription drugs. If you need prescription drug coverage, you can join a Medicare Prescription Drug Plan (Part D).