Medicare Supplement Plan N is one of the plans available under Medicare Supplement Insurance (or Medigap, as it’s sometimes called).
Original Medicare (Medicare Part A and B) pays for a lot of healthcare. But there are still some costs for Medicare beneficiaries. A Medigap policy is supplementary insurance that you buy from private insurers to help fill those coverage gaps in Original Medicare.
Plan N can help you with costs like coinsurance and deductibles. And regardless of the health insurer you choose, the benefits in all Medigap Plan N policies are the same.
What does Plan N cover?
Plan N pays for all your Medicare Part A deductible and coinsurance costs.
Plan N covers your Medicare Part B 20% coinsurance . However, it does not pay for your Part B deductible and excess charges, and you still owe copayments for doctor’s office and emergency room (ER) visits.1
What are examples of Plan N coverage?
Part A (hospital visits, hospice, blood)
- Hospitalization: Plan N pays for your Medicare Part A deductible every benefit period. Additionally, it covers all your Medicare-approved expenses during hospital stays for up to 365 days after your Original Medicare benefits end.
- Skilled nursing care: Plan N covers all your coinsurance costs for up to 100 days in a skilled nursing facility. After 100 days, you cover all expenses yourself.
- Hospice: Plan N pays all hospice care coinsurance.
- Blood: Your first 3 pints of blood each year are paid for by Plan N. The rest, if any, are covered by Medicare.
Part B (doctor or ER visits)
Plan N pays your Medicare Part B 20% coinsurance ; however, you make copayments for visits to the doctor’s office and to the ER. Copays for doctor’s office visits are up to $20, and can go up to $50 for ER visits.
Foreign emergency travel
Plan N pays for emergency care for the first two months of any trip you take outside the U.S. It covers emergency services or supplies for up to $50,000 spread over your lifetime.2 This coverage requires you to pay a $250 deductible before it kicks in, as well as 20% coinsurance. Once you reach the lifetime limit, you’re responsible for 100% of your costs.
What does Plan N cost?
Your costs under Plan N include:
This monthly premium varies by insurer, and it’s different from the standard monthly Part B premium that Medicare collects.
Part B deductible
You are required to pay the annual Part B deductible before Plan N starts to cover your coinsurance costs. In 2020, the deductible is $198.3
You pay up to $20 for doctor’s office visits and up to $50 for ER visits.
Some healthcare providers are allowed to charge a bit above (up to 15%) the amount that Medicare covers for services. Providers who do not accept Medicare’s approved amount as full payment are allowed to charge this additional amount known as “excess charge.” Plan N does not cover excess charges, and you’ll be responsible for them yourself.
Who can sign up for Plan N?
Some requirements need to be fulfilled before you can sign up:
Part A and B requirement
You must have Original Medicare (Medicare Part A and B) to sign up for Plan N.4
Plan service area requirement
Not all Medicare Supplement plans are available everywhere. It is possible that insurance companies in your service area do not offer Plan N. You can find out which insurance companies sell Medigap policies in your area, and which specific plans they sell, by using this Medicare tool.
When can you enroll in Plan N?
Medigap Open Enrollment Period
Your Medigap Open Enrollment Period starts the month your Medicare Part B coverage becomes effective. You can apply for a Medigap policy before the OEP begins and ask your insurance company to make it effective on the same date as the Part B effective date. It lasts for 6 months.
You can enroll in Plan N anytime during this open enrollment period, as long as it’s offered in your state/area. The insurer you’re buying Plan N from can’t turn you down, and they can’t charge you more because of any health condition you may have. This means you can buy Plan N for the same price as people who are in good health — making it the best time to enroll in Plan N (or any other Medigap policy). 5
Outside open enrollment (subject to underwriting)
You can attempt to buy Plan N after your open enrollment period ends, but there’s no assurance that you’ll get it. Insurance companies that offer Medigap policies are allowed to use medical underwriting when deciding whether to sell a plan or not. This means they can look at your medical history and decide not to sell you Plan N. Or, they can choose to let you enroll in Plan N, but at a higher monthly premium.6
Why should you consider Plan N?
Plan N may or may not be the right choice for you. Here are the major pros and cons.
Plan N covers your entire Part A deductible, and is one of the six out of 10 Medicare Supplement plans that pay for emergency medical services outside the U.S. It also covers your skilled nursing facility coinsurance.
With Plan N, you still owe copays when you visit the doctor’s office or ER. The plan also does not cover excess charges or your Part B annual deductible.
Other popular options
Plan F (no longer available to new enrollees)
If you are comparing Plan F and Plan N, the two key differences are: One, Plan F covers your Part B deductible and excess charges.7 Two, Plan F also doesn’t require you to make copayments for visits to the doctor’s office and ER.
It’s important to note that Plan F is not available to people who newly enroll in Medicare on or after January 1, 2020. However, if you were already eligible for Medicare before January 1, 2020 but didn’t enroll, you may be able to buy Plan F.8
This plan shares some similarities with Plan N, but it offers more coverage. Unlike Plan N, Plan G covers Part B excess charges. Under Plan G, you also don’t need to make copayments for doctor’s office and ER visits.
High-deductible versions of Plan F and G are available in some states. These plans have higher deductibles but lower premiums. The deductible for the year 2020 is $2,340, and you receive all the benefits of the original plans once it is met.
Considering your finances, your present and anticipated future medical needs, as well as other plan options should help you decide whether Plan N is right for you.