Medicare plans N and F are both supplement insurance policies offering similar benefits. Also known as Medigap, the plans pay for some coverage gaps in original Medicare left by out-of-pocket expenses.
Original Medicare is federally funded health insurance coverage for adults aged over 65 and younger adults with specific medical conditions.
Medicare includes parts A and B, which cover inpatient hospital stays and outpatient services, such as diagnostic tests, certain procedures, and preventive care.
Although original Medicare covers certain healthcare needs, it does not cover the costs entirely, and out-of-pocket costs usually apply.
That is where a Medigap plan can help. Medicare Plan N and Plan F offer very similar benefits, but there are some differences and rules to note.
This article will look at Medigap plans, both Plan N and Plan F coverage, and alternative options that may be available.
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.
Medicare coverage is extensive, but it does not pay for all healthcare expenses. A person may be required to cover some costs themselves.
Out-of-pocket costs can include:
- excess charges
Medigap plans, also known as Medicare supplement insurance, pay for some of these expenses, and an individual may purchase a Medigap plan to supplement costs.
To qualify for Medigap, an individual must have original Medicare coverage.
Private insurance companies administer Medicare supplement plans, and a person that chooses Medigap will pay a monthly premium to the insurer. The Medicare Part B premium is still payable to Medicare.
Currently, 10 different Medicare supplement plans are available. Letters of the alphabet indicate different plans.
The federal government sets standards for Medicare supplement plans in most states meaning that regardless of the location, the same lettered plan must offer the same benefits.
All states are standardized in the same way, except for:
Coverage varies by plan, but two of the plans that offer similar coverage include Medicare Plan F and Plan N.
Medicare Plan F covers many of the costs not provided by Medicare Part A and B. Costs covered with Plan F include:
- Medicare Part A deductible
- Part A coinsurance
- Medicare Part B deductible
- Part B copays and coinsurance
- Part B excess charges
- skilled nursing care coinsurance
- heath coverage outside of the United States up to 80%
- first 3 pints of blood used in a procedure
Medicare Plan N offers similar coverage to Plan F with a few exceptions.
Healthcare providers may charge up to 15% more than Medicare allows. Medicare will cover the costs up to the approved amount, and some supplement plans cover the remaining excess amount. Medicare Plan N does not cover these excess charges.
Additionally, Plan N does not cover the Medicare Part B deductible.
Part N covers 100% Part B coinsurance except for up to $50 for emergency room visits that do not lead to an inpatient hospital admission and $20 for some doctor’s office visits.
When choosing the right Medigap plan, an individual may like to consider budget, health conditions, and medical requirements.
A side-by-side comparison of Medicare Plan N and Plan F may help a person determine the best plan for their needs.
|Plan Benefits||Plan N||Plan F|
|Part A coinsurance||yes||yes|
|Part B Coinsurance||yes||yes|
|first 3 pints of blood||yes||yes|
|Part A hospice coinsurance||yes||yes|
|skilled nursing care coinsurance||yes||yes|
|Part A deductible||75%||yes|
|Part B deductible||no||yes|
|Part B excess charge||no||yes|
|foreign travel exchange||80%||80%|
Starting in January 2020, Medicare made a few adjustments to Medigap plans, and they are no longer able to cover Medicare Part B deductibles.
Due to the change, those newly eligible for Medicare can no longer choose Plan F, since it covers the Part B deductible.
People who were already enrolled in Plan F before the 2020 change may keep their plan.
Medicare Plan N is available for purchase to new enrollees, as well as people already enrolled.
Individuals who live in Wisconsin, Minnesota, and Massachusetts should check plan availability with their state due to the difference in the standardization of supplemental insurance.
For a person who is unable to enroll in Plan F or who decides that Plan N is not appropriate, there are alternative options.
Several other Medicare supplemental plans are also available, including A, B, D, G, K, L, and M.
Plans differ in coverage, including the percentage of Part B coinsurance covered. A person can compare plans using the online tool on the Medicare website.
A popular alternative to Plan F is Plan G.
Plan G covers all the same benefits as Plan F, except it does not cover the Medicare Part B deductible.
Instead of a Medigap plan, a person may choose to enroll in Medicare Advantage.
As with Medigap plans, private insurance companies that Medicare has approved administer Medicare Advantage plans.
In some cases, Medicare Advantage plans cover more services than original Medicare.
A person is unable to have a Medicare Advantage plan with a Medigap policy.
Medicare supplement plans (Medigap) provide additional coverage and fill in the gap for services that original Medicare does not cover.
Various plans are available that cover deductibles, coinsurance, and copays.
When comparing Medicare Plan N and Plan F, many similarities exist, but Plan N does not cover the Medicare Part B deductible or excess charges that Plan F does.
In 2020, rules changed, and Medicare supplemental plans can no longer cover the Part B deductible. This means that new enrollees cannot select Plan F, but other options are available.