Medicare Plan N is a Medigap plan. These supplemental insurance policies cover some of the out-of-pocket costs of original Medicare. Private insurers administer Medigap plans, so costs can vary.
Medicare Plan N is a type of health insurance policy that works alongside original Medicare.
Medigap plans are administered by private insurance companies and offer standardized benefits to Medicare members. Plan N may cover medical costs, deductibles, outstanding coinsurance, and copayments that original Medicare does not cover.
In this article, we learn more about the costs of Medigap Plan N and the benefits the plan offers.
We may use a few terms in this piece that can be helpful to understand when selecting the best insurance plan:
- Deductible: This is an annual amount that a person must spend out of pocket within a certain time period before an insurer starts to fund their treatments.
- Coinsurance: This is a percentage of a treatment cost that a person will need to self-fund. For Medicare Part B, this comes to 20%.
- Copayment: This is a fixed dollar amount that an insured person pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.
Original Medicare Part A and Part B pays for most, but not all of the costs for Medicare-approved health services and supplies.
A Medigap policy can help pay for some remaining medical costs, such as:
Medigap policies usually do not cover:
- long-term care
- vision care
- dental care
- hearing aids
- private-duty nursing
Getting the best price for Medigap Plan N coverage depends on several factors, including:
- marital status
- the part of the country in which a person resides
- whether or not a person smokes
Insurance companies that provide Plan N policies must sell a policy at the best available rate, regardless of a person’s health status.
A person can verify whether the insurance company they have contacted has offered them the best rate by contacting their state State Health Insurance Assistance Program (SHIP).
Plan N covers 100% of:
- Part A hospital costs and coinsurance, including up to an additional 365 days after Medicare benefits are exhausted
- Medicare Part B coinsurance and copayment
- the first 3 pints of blood a person may need
- Medicare Part A hospice care, coinsurance, and copayment
- skilled nursing facility care and coinsurance
- Part A deductible
Plan N pays 100% of the Part B coinsurance except for:
- a copayment of up to $20 for some doctor office visits
- a copayment of up to $50 for emergency room visits that do not result in admission to a hospital
In addition, Plan N covers 80% of the cost of emergency care when traveling abroad. This benefit, known as foreign travel exchange, covers up to the plan limits only.
As of 2020, Medigap Plan N has no yearly out-of-pocket limit.
For Medicare enrollees who visit the doctor often or require certain routine health services, the out-of-pocket costs can add up quickly.
Even with a Medigap policy, a person will still have certain out-of-pocket costs associated with their coverage. Costs may vary depending on:
- the type of plan a person chooses
- the insurance company selling the plan
- where a person lives
- the amount of plan coverage
Typically, the only out-of-pocket expense related to a Medigap plan is the monthly premium.
Firstly, a person must be enrolled in Medicare Part B to be eligible for Medigap enrollment.
Each individual has a 7-month initial enrollment period (IEP) which starts the first day of the month they turn 65 years old.
The best time to sign up for Medigap Plan N, or any Medigap policy, is during the IEP because an insurance provider may refuse to sell a policy after this time, or they may apply rules surrounding preexisting conditions. A person could have to wait 6 months before the Medigap plan covers any preexisting conditions.
In addition, if the insurance provider does agree to sell a policy, the enrollee may have to pay a higher monthly premium.
What if a person misses their IEP?
The Medicare open enrollment period (OEP) runs from October 15–December 7 each year.
If a person misses their IEP, they can contact an insurance provider to inquire about enrolling during this time.
However, a person may not be able to purchase a plan, premiums may be higher, and rules around preexisting conditions may be applied.
Although Medigap Plan N does pay Part B coinsurance and copayments in some circumstances, it does not cover Part B deductibles or Part B excess charges.
If a person prefers a plan with coverage for Plan B expenses, they may like to consider other Medigap plans.
An individual can compare different Medigap policies by viewing a comparison chart.
If an individual has a Medicare Advantage plan, it is not possible to have a Medigap plan at the same time.
It would be illegal for anyone to sell a Medigap plan to a person that has a Medicare Advantage plan unless they are switching to original Medicare.
Plans C and F
Plans C and F provide extensive coverage, but they have now been discontinued for those newly eligible for Medicare.
A person who already has one these plans may keep it, and it may be possible for someone to switch to either Plan C or Plan F if they were eligible for Medicare before January 1, 2020.
The Medicare website has a plan finder tool that may help when comparing plans in a person’s local area.
Medicare Plan N is a Medigap plan. This supplemental insurance works in conjunction with original Medicare to cover remaining medical and out-of-pocket costs.
As private insurance companies administer Medigap plans, costs can vary. Getting the best price for Medigap Plan N coverage also depends on several factors, including age and marital status.
Private insurance companies must sell Medigap policies at the best available rate, regardless of a person’s health status, if they enroll within the Medicare IEP.
Typical out-of-pocket expenses for Medigap plans include monthly premiums only.
Medigap Plan N does not cover the Part B deductible or Part B excess charges, so if a person would like to look at other plan options, they can do so online or by contacting their local SHIP office.