Medicare Supplement Plan N – Part N
Medicare Supplement Plan N is one of the more popular supplement plans among beneficiaries in 2019. It’s the plan for those looking to have lower monthly premiums, without giving up the best benefits.
In exchange for lower premiums, beneficaries pay deductibles and co-payments. Since Medicare Plan N was introduced, enrollment has significantly increased year over year.
You may have heard this plan referred to as Medicare Part N. The correct term in Plan N, but they’re both the same plan.
Medicare Supplement Plan N – Part N
All Medigap plans come with basic benefits, then each plan has additional coverage benefit(s) added. Plan N covers almost all the additional benefit options.
- 20% of your medical costs that Part B does NOT cover
- Part A deductible
- All hospital copayments, as well as coinsurance
- Emergency medical costs when traveling outside the U.S.
Plan N is Perfect For Those Who:
- Want a lower monthly premium (lower than Plan F)
- Only see the doctor a few times a year
- May travel outside the United States
- Are not concerned with excess charges
Medigap Plan N Coverage for 2019
On top of standard preventive care that’s covered by Original Medicare, Medicare Supplement Plan N will also include coverage for an illness or injury treated at your primary physician’s office, durable medical equipment such as CPAP machines or diabetic supplies, any medically necessary surgeries, home healthcare, diagnostic testing, and much more.
If you end up in the hospital for any reason, you’re responsible for the Part A deductible. With Plan N, your Part A deductible is covered. If your stay in the hospital exceeds the total amount of days covered by Part A, Medicare Plan N will cover an additional 365 days.
Anything that Original Medicare insurance covers, your Medicare Supplement Plan N will pick up the remaining costs left up to the beneficiary to pay. After Medicare pays their 80% share, the remaining 20% is billed to your supplement plan.
Plan N doesn’t cover your Part B deductible or excess charges.
Medicare Plan N Copays & Out of Pocket Costs
One of the reasons Medicare Plan N premiums are so low is due to the small co-pays for doctors’ visits and emergency room visits. Before the beneficiary is eligible to pay the copayment, the deductible must be met.
Plan N Coverage at the Hospital
After the deductible, you pay up to $20 co-payment for doctor office visits & up to $50 co-payment for emergency room visits.
If you’re admitted into the hospital, the co-pay for the emergency room visit is waived.
Coverage at the Doctors Office Under Plan N
Out of pocket costs, you’re left responsible for when enrolled in Medigap Plan N is:
- the co-payments for doctor visits and emergency room visits listed above
- the Part B deductible
- and any excess charges that fall under Part B
The Part B deductible is $185. Excess charges can be up to 15% of your medical costs providers may charge that exceeds the approved Medicare amount.
However, most providers accept Medicare Assignment and don’t charge for excess charges.
Depending on the state you live in, excess charges may not even be allowed.
A quick phone call to your provider asking if they accept Medicare Assignment will let you know if this is something you need to be covered or not.
An office visit is coded on Part B professional claim form for purposes to determine the copayment up to $20. This charge is only for Office Visits; the copayment isn’t applicable for Part B coverage on laboratory, x-ray, or Durable Medical Equipment (DME).
If you schedule multiple doctors visits in a day, the copayment must be paid at each visit. Online, telehealth, and telephone services don’t constitute as “office visits”; these services aren’t subject to the Plan N copayment.
Both specialists visits and office visits can cost up to a $20 copayment. The emergency room copay doesn’t apply to the foreign travel emergency benefit.
The Plan N office visit and ER visit copayments are not applicable to the Urgent Care Facility. So, there is no copayment for urgent care with Plan N.
The other out of pocket costs would be your premiums.
Cost of Medicare Supplement Plan N
All Medicare Supplement insurance plan premiums are determined by the carrier you choose to enroll with. What’s important to remember is all Medigap Plans are standardized. This means it does not matter which carrier you choose, the benefits will be exactly the same.
The only difference between the different letter plans across all carriers is the premium they charge for those same exact benefits. Carriers use three different pricing methods to determine the premium they will charge.
They also take your personal information and use it as a premium determining factor such as age, location, gender, etc. The cost for Medigap Plan N for one person in a specific state can be completely different than it is for another person in a different state.
The average premium for Medicare Supplement Plan N is anywhere between $80-$200 a month. Again, it completely depends on your unique factors… it could be less or more.
That’s why it’s important to speak to a licensed agent that can compare premiums side by side with all the top carriers in your area.
Example of How Plan N Works
Sheryl explains to her agent that she rarely visits the doctors’ office. Due to this, she doesn’t feel it’s necessary to go with a Plan G or F.
Her agent explained to her that if she’s will to pay some copays than she’ll save somewhere around 30% on her premiums.
With Plan N, Sheryl’s inpatient care deductible will be covered 100%.
For her outpatient care, she’ll be responsible for the Part B deductible, which is $185 for 2019. She’ll also have a $20 copayment each time she visits her primary physician.
Let’s say Sheryl has met her deductible for the year. If her doctor doesn’t accept Medicare assignment, they can charge an additional 15% of the total Medical costs above the approved Medicare amount.
(Keep in mind, most doctors do accept Medicare assignment)
Since Plan N doesn’t cover excess charges, Sheryl would be responsible for the 15% additional her doctor charges for a service. If the service has a Medicare assigned rate of $200, then she would be responsible for $30 + the $20 copay.
If excess charges are a concern for you, but you still need a plan with a lower premium, you might want to take a look at Plan G. Excess charges are covered by Plan G.
When to Enroll in Medicare Supplement Plan N
You can enroll in Medigap Plan N at any time of the year, as long your Part B is in effect. Unlike Original Medicare, there are no specific time periods to enroll.
However, there’s a better time to enroll that will guarantee your acceptance into the plan. During the first six months your Part B is in effect, your Medicare Supplement Open Enrollment Period begins.
During this six-month time frame, you’re granted guaranteed issue. This means a carrier cannot deny you coverage due to any pre-existing conditions or health concerns. It also means they cannot charge you more in premiums due to your age.
Again, you can enroll in Medigap Plan N at any time as long as you have Medicare Part B. If your Open Enrollment Period has passed, you’ll have to answer some medical questions to apply.
Medicare Plan N Eligibility
To be eligible for Medicare Supplement Plan N, you must be enrolled in Medicare Part B and at least 65 years old. There are some carriers that offer Plan N to those on Medicare due to a disability. However, this is dependent on the state you live in.
Beneficiaries losing creditable coverage won’t have access to Plan N with GI rights. Although beneficiaries eligible for Medicare prior to 2020 can select Plans A, B, C, F, K, or L. Beneficiaries eligible after 2020 can’t enroll in Plan C or F; however, Plan D and G are an option.
Medicare Plan N Carriers
That’s why you need a licensed agent that can view what carriers offer Plan N in your state. Also, just because a well-known carrier offers the plan does not mean it’s the best price available.
Many smaller carriers, that also have great ratings, will offer the same Plan N that the well-known carriers offer, but at a much lower premium.
Alternative Medigap Insurance Plans Comparable to Plan N
If you’re comfortable with paying a higher monthly premium in order to get lower out of pocket costs, there are a few other plans that may be of interest to you. This includes Plan G & Plan F.
In addition to covering 100% of your Part B coinsurance & copayments, both of these plans will cover any Part B excess charges. You won’t have to worry about the small co-pay required for office and emergency room visits.
The only out of pocket costs left up to the beneficiary to pay when enrolled in Plan G is the Part B deductible.
Plan F will cover your Part B deductible, leaving you with zero out of pocket costs. However, this plan is considered a first-dollar coverage plan. All first-dollar coverage plans are going away to beneficiaries who become eligible for Medicare after 2020.
Prescription Drug Coverage
Plan N insurance will cover any leftover out of pocket costs for medications that are administrated during a hospital stay or at the doctor’s office. Medigap Plans do not provide coverage for prescriptions you fill at your local pharmacy and administer yourself. This is where your Medicare Part D comes into play.
Dental, Vision & Hearing Benefits
Medigap Plans do not include coverage for routine dental, vision or hearing services. There are stand-alone plans that can be added as a supplement to Plan N to fill in these gaps in coverage.
Medigap Plan N vs Medicare Advantage Plans
You’ve probably seen the commercials that say you can get Medicare Advantage insurance plans with a zero dollar premium. If it seems too good to be true… that’s because it is.
These commercials are deceiving, and end up putting beneficiaries in a tough position. There are many reasons why beneficiaries would choose a Medigap Plan over a Medicare Advantage plan. One big reason is having the freedom to choose your own doctor.
The dental, vision and hearing benefits they claim to include are extremely limited. Again, you can only see their in-network doctors, and the out of pocket costs quickly add up.
On another note, these plans replace your Original Medicare. The same Medicare insurance you’ve paid into your entire working life.
Medicare was forced to bring back a specific enrollment period for Medicare Advantage beneficiaries starting in 2019. Why? Because so many new enrollees ended up stuck in a plan they didn’t want.
They had to wait until the next Annual Enrollment Period to switch back to Original Medicare & pick up a Medicare Supplement Plan instead. Now, if you find yourself in this position, you have a new enrollment period to make changes.
Compare Medicare Supplement Plan N Rates
Comparing rates for Medicare Plan N side by side with all the different carriers can be an extremely daunting task. Staying up to speed on all the constant Medicare changes is a challenge in itself.
Our rate comparison tool is simple to use, and our agents can make sure you’re educated and informed on all your Medicare insurance benefits. You can also read reviews for Plan N here.
Not only can our agents compare Plan N rates across carriers that offer it, but they can also compare all Medigap Plans across all carriers in your area.
Plus, our services do not cost you anything. Our Client Care Team will make sure the entire process goes smoothly. Not just your application, but also any Medicare claim issues you may have going forward.
Call us today, or if you prefer you can use our online rate comparison tool here. Remember, all premiums are determined based on your individual information. Once we collect that information, we’ll be able to send you the rates that are specific to you.