When it comes to navigating the maze of Medicare, choosing the right supplemental coverage can make a significant difference in both healthcare coverage and out-of-pocket costs. One option that remains popular is Medigap Plan N. We will outline the benefits of Medigap Plan N and highlight it’s balance of coverage and affordability. This post includes both the benefits and downsides of Medigap Plan N.
Medigap Plan N
Medigap (Medicare Supplement Insurance) helps pay for healthcare costs that Original Medicare (Part A and Part B) doesn’t cover, such as copays, coinsurance, and deductibles. Plan N is one of 10 standardized Medigap plans available in most states. It offers a good blend of coverage and cost savings, making it appealing to Medicare enrollees who want solid protection without having to pay the highest premiums.
Benefits of Medigap Plan N
Lower Monthly Premiums
In general, Plan N has lower premiums than more comprehensive plans like Plan F or Plan G. This makes it a good option for individuals who are relatively healthy and want to save on fixed monthly costs.
Plan N Covers Cost Gaps
- 100% of Part A coinsurance and hospital costs
- 100% of Part B coinsurance (with a few exceptions)
- Skilled nursing facility care coinsurance
- Part A deductible
- Emergency care during foreign travel (up to plan limits)
Nationwide Access
Like all Medigap plans, any provider that participates with Medicare will accept Plan N. Enrollees do not have to worry about provider networks or referrals. Enrollees can see any doctor or specialist who accepts Medicare.
Predictable Inpatient Costs
Because inpatient services are well covered by Plan N, beneficiaries can feel confident with their choice, if they are hospitalized or require skilled nursing care. Their costs should generally be predictable.
Downsides of Medigap Plan N
Copays for Doctor and ER Visits
While most Part B coinsurance is covered by Plan N, beneficiaries must still make some copays:
- Up to $20 for office visits
- Up to $50 for emergency room visits (waived if the patient is admitted)
These copays can add up for anyone who frequently requires the care of a doctor.
Doesn’t Cover Part B Deductible
Like all Medigap plans issued to new enrollees after January 1, 2020, Plan N does not cover the Medicare Part B deductible, which is $257 in 2025.
Excess Charges Not Covered
Plan N does not cover Part B excess charges. These are extra charges from providers who don’t accept Medicare assignment. These providers are allowed to bill up to 15% over the Medicare-approved amount. While this isn’t common, it can be a concern for those who live in or travel to areas where non-participating providers are prevalent.
Not Ideal for High Users of Care
Beneficiaries who require frequent doctor visits, lab work, or outpatient treatments may cause the recurring copays and potential for excess charges to outweigh the savings of the lower premiums. When that is the case, Plan G could be a better value despite higher monthly premiums.
Plan N can be an excellent choice for
- People in relatively good health
- Those who prefer lower monthly premiums
- Individuals who rarely see non-participating Medicare providers
- Enrollees who are comfortable paying small copays in exchange for premium savings
Plan N may not be ideal for
- People who visit the doctor frequently
- Those who live in areas where excess charges are more common
- Individuals who want the most comprehensive coverage available
Watch a video on Physicians Mutual Innovative Plan G
Medigap Plan N is a well-balanced choice for Medicare beneficiaries who want solid protection without paying top-dollar premiums. Its design provides comprehensive healthcare at an affordable rate. As always, choosing the right Medigap plan depends on health needs, budget, and lifestyle. Comparing Plan N with other options like Plan G can help beneficiaries make the most informed decision. A licensed Medicare agent can help compare plans and weigh all the options.