Understanding Medicare Plan N

Understanding Medicare Plan N

Medicare Plan N is one of the 10 standardized Medigap plans that are offered to supplement traditional Medicare. Plan N is one of the options that is typically a lower premium with more cost-sharing. So, it can be a good fit for someone who is in relatively good health or who wants to go with a lower-premium option.

Plan N works just like other Medigap plans. Coverage is Federally-standardized, so one Plan N will be the exact same as any other Plan N in terms of coverage. In addition, you can go to any doctor or hospital that takes Medicare – there are no networks. Also, all claims under Plan N are paid automatically through the Medicare “crossover” system.

What does Plan N cover?

Plan N covers the Medicare Part A (hospital) deductible in full. It also pays in full for the hospital coinsurance, hospice coinsurance, and skilled nursing facility coinsurance (20%). So, it is essentially complete and full coverage under Part A charges, filling in the gaps in Medicare Part A.

The Part B (doctor fees and outpatient) charges are where Plan N differs from other, more comprehensive plans like Plan F, Plan C and Plan G. Plan N does not cover the Medicare Part B deductible, which is $183/year for 2017. Also, after that deductible is met, you have co-pays for doctor visits under Plan N – these co-pays are $20 per visit (primary or specialist) and $50 for a visit to the emergency room. Lastly, Plan N does not cover the Part B Excess charges. In short, Part B excess charges are when a doctor does not accept the Medicare payment schedule as payment in full. Under Plan N, you are responsible for paying these.

You must have Medicare Part A and B in order to purchase any Medigap plan, including Plan N. Rates vary considerably depending on your age and where you live. In some states, Plan N can be a very competitively priced plan and a great value. In other areas, the price difference between Plan N and more comprehensive plans is so small that it may not make sense.

It is advisable to research whether Plan N is right for you and how to choose a Medigap plan prior to turning 65 or selecting a plan. If you are in good health with minimal pre-existing conditions, it may make sense to go with a Plan N. However, it is always a good idea to think about your Medigap selection with a long-term perspective as you may have to “qualify medically” to change plans at a later time.

about the author

Garrett Ball

Garrett is the founder/President of Secure Medicare Solutions, a leading, independent Medicare insurance agency. Since 2007, Garrett has worked with tens of thousands of people turning 65 or already on Medicare to understand, compare and choose Medicare insurance that fits their specific needs and situation.

His latest project is 65Medicare.org, an online hub for people just starting with Medicare, which is focused on distilling difficult Medicare questions into easy-to-understand resources.

Garrett resides in North Carolina with his lovely wife, Celeste, and three spirited children.

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