Medicare Supplement (Medigap) Plan N is one of the 10 standardized Medicare Supplement insurance policies, meaning it offers the same coverage no matter which insurance carrier you purchase from.
Standardized plans refers to Medigap policies that are identified with the same letter type. These policies must provide the same basic benefits from any insurance company selling Medigap coverage. For example, Insurance Carrier Z selling Medigap Plan G in Texas, must have the same basic benefits as the same policy G sold by Insurance Carrier Y in New Jersey. The key disparity between the policies sold by these different carriers is the cost of the premium. Therefore, Medigap Plan N rates (premiums) may differ from carrier to carrier. Some companies may offer extra benefits with their Medigap policies, however basic benefits must be uniform across all companies. With that being said, Medicare supplement riders can be defined by their premium costs paired with the extra benefit options that they offer.
Medigap Plan N covers 100% of the coinsurance expenses for Medicare Part B. Although Medigap Plan N premiums are low compared to other Medigap plans, it will also require you to make out-of-pocket payments for certain services. These out-of pocket costs could potentially add up, where it might have been cheaper for you to go with a more comprehensive policy at a higher premium.
Medicare Plan N Eligibility
Before going over the benefits for Medigap Plan N 2021, here are the general eligibility requirements:
You are at least 65 years of age and have been a US Citizen or permanent legal resident for at least five consecutive years
You are currently receiving retirement benefits
You are disabled and therefore receiving disability benefits
You have End-Stage Renal Disease
You have Lou Gehrig’s disease or ALS
What does Medicare Supplement Plan N Cover?
Medigap Plan N coverage options:
Hospital coinsurance and costs on Part B up to 365 days after Original Medicare benefits are depleted
Hospice care copayment or coinsurance for Part A
Deductible for Part A
Coinsurance costs for Part B (not for office/emergency room visits)
Preventive care coinsurance for Part B
First three pints of blood
Skilled nursing facility coinsurance
Medicare Supplement Insurance Plan N does not cover:
Part B deductible isn’t covered by Plan N. Also, Medigap Plan N excess charges for Part
When comparing Medigap Plan N cost to that of Plan G, Plan N Medicare Supplement is the less costly plan, and for valid reasons.
Firstly, Medicare Supplement Plan N coverage does not cover excess charges. This extra cost comes into play if a provider wants to be paid more for their services. In such a case, the provider can bill you for excess charges, up to an additional 15% of the original cost.
Secondly, Medicare Supplement Plan N benefits do not include copays. In the event of an office visit or emergency room visit (and not being admitted as an inpatient), you will be responsible for paying up to $20 and $50 accordingly. For outpatient care, you would be responsible for the Medicare Supplement Plan N deductible per say, which is really defined as the Medicare Part B deductible, $198 in 2020, upon your first doctor’s visit.
These comparisons are important to consider. For instance, if you require to visit your doctor frequently or are admitted to the emergency room, then your Medigap Plan N copays can easily accumulate and end up costing more than if you had just purchased a different, more comprehensive policy.
Medigap Plan N vs F:
Medigap Insurance Plan N offers the same benefits as Plan F with the exception of the deductible for Medicare Part B and excess charges associated with Part B. Also, Medigap N pays for 100% of the coinsurance for Part B, however you would be responsible for copays on both office visits and emergency room visits for $20 and $50 accordingly.