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Understanding Medicare Plan N

by Garrett Ball
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.

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