Did you know that Medicare Plan N could save you hundreds of dollars monthly compared to other Medigap plans while still giving you rock-solid coverage? After helping thousands of folks navigate the Medicare maze for over 25 years, I’ve seen Plan N become the dark horse favorite for smart shoppers who want premium protection without premium prices.
Look, choosing the right Medicare supplement plan feels like trying to pick the perfect avocado at the grocery store – you’re squeezing and guessing, hoping you don’t end up with a dud. But here’s the thing: Medicare Plan N might just be that perfectly ripe option you’ve been overlooking.
What Is Medicare Plan N?
Medicare Plan N is one of ten standardized Medigap (Medicare Supplement) insurance plans that helps cover the gaps Original Medicare leaves behind. Think of it as your financial bodyguard against unexpected medical costs.
Here’s what makes Plan N special: it’s like the middle child of Medigap plans – not the most expensive, not the cheapest, but often just right.
Plan N was actually introduced in 2010 as part of the Medicare Modernization Act. Congress created it to offer folks a lower-premium alternative to the more comprehensive (and pricier) plans. And boy, has it delivered on that promise.
The beauty of Plan N? You get substantial coverage for most of your Medicare cost-sharing responsibilities. We’re talking about coverage for Part A coinsurance, Part B coinsurance (with some small copays), and even that scary Part A deductible that hit $1,632 in 2024.
But here’s where it gets interesting – and where my clients often perk up their ears.
Plan N doesn’t cover everything. It’s got a few strategic gaps that keep the premiums lower. You’ll have small copays for some doctor visits and ER trips. Think of it like choosing a car with manual windows instead of power ones – you’re sacrificing a little convenience for significant savings.
How Medicare Plan N Works With Original Medicare
Original Medicare (Parts A and B) is your foundation – it’s the house. Plan N? That’s your roof, protecting you from the financial storms that can rain down.
Here’s how they dance together:
First, Original Medicare pays its share of your covered services. For Part B services, that’s typically 80% after you’ve met your annual deductible. Then Plan N swoops in to cover most of that remaining 20%.
But – and this is crucial – Plan N has a unique twist.
Unlike some other Medigap plans that cover everything after Medicare pays, Plan N asks you to chip in a bit. You might pay up to $20 for office visits and up to $50 for emergency room visits that don’t result in an admission.
Now, I’ve had clients worry about these copays. “Adam,” they’ll say, “doesn’t that defeat the purpose?”
Not at all. Here’s my take after decades in this business: those small copays are your ticket to lower monthly premiums. For most folks, the math works out beautifully.
Let me paint you a picture. Say you visit your doctor once a month (which is more than most people). That’s $240 in copays annually. But if Plan N saves you $50-100 monthly compared to Plan G? You’re still coming out ahead.
The coordination is seamless too. Your providers bill Medicare first, then automatically send the claim to your Plan N insurer. No paperwork Olympics for you.
Medicare Plan N Coverage Details
What Plan N Covers
Let’s get into the meat and potatoes of what Plan N actually covers. And trust me, it’s a pretty hearty meal.
Plan N covers your Part A hospital coinsurance and hospital costs for an additional 365 days after Medicare benefits are exhausted. That’s a full year of extra hospital coverage – talk about peace of mind.
You’re also covered for:
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance (days 21-100)
- Part A deductible (that hefty $1,632 in 2024)
- Part B coinsurance or copayment (except for those small office and ER copays)
- First three pints of blood
- 80% of foreign travel emergency care (up to plan limits)
That foreign travel coverage? Absolute gold if you’re a snowbird or love cruising. Medicare typically won’t cover you outside the U.S., but Plan N has your back for emergencies abroad.
What Plan N Doesn’t Cover
Now for the “gotchas” – though honestly, they’re not that scary once you understand them.
Plan N doesn’t cover:
- Part B deductible ($240 in 2024)
- Part B excess charges
- Those copays I mentioned (up to $20 for office visits, $50 for ER)
The Part B excess charges are what trip people up. These happen when doctors don’t accept Medicare assignment and charge up to 15% more than Medicare’s approved amount.
But here’s a secret from my 25+ years in the trenches: excess charges are rare. Only about 5% of doctors nationwide charge them. And in eight states (including New York and Pennsylvania), they’re completely banned.
I always tell my clients: if avoiding excess charges keeps you up at night, maybe Plan G is worth the extra premium. But for most folks? Plan N handles the real financial risks just fine.
Medicare Plan N Costs And Premiums
Monthly Premium Factors
Let’s talk money – because that’s what really matters when you’re on a fixed income.
Plan N premiums vary wildly based on several factors. Your ZIP code matters more than you’d think. A 65-year-old in Miami might pay $150 monthly, while someone the same age in rural Kansas might pay $110.
Age is another biggie. Most insurers use one of three pricing methods:
- Community-rated: Everyone pays the same regardless of age
- Issue-age-rated: Your premium is based on your age when you buy the policy
- Attained-age-rated: Premiums increase as you age
Gender matters too (unfair, I know). Women often pay 5-10% more because statistically, they use more healthcare services.
Your health status during initial enrollment is crucial. During your Medigap Open Enrollment Period (the six months after you turn 65 and enroll in Part B), insurers can’t use health underwriting. Miss that window? They can charge you more or even deny coverage.
Tobacco use? That’ll cost you. Insurers can charge smokers up to 10% more.
Out-Of-Pocket Expenses
Beyond premiums, let’s map out your actual out-of-pocket exposure with Plan N.
Your maximum annual exposure includes:
- Part B deductible: $240
- Office visit copays: Up to $20 per visit
- ER copays: Up to $50 (waived if admitted)
- Potential excess charges: Up to 15% of Medicare-approved amounts
So theoretically, if you had 12 doctor visits, one ER visit, and no excess charges, you’re looking at $530 plus your Part B deductible. That’s $770 total.
Compare that to going without any supplement – where you could face thousands in bills – and Plan N looks pretty darn good.
I’ve seen clients save $600-1,200 annually by choosing Plan N over Plan G, and they rarely spend that difference on copays.
Medicare Plan N Vs Other Medigap Plans
Plan N Vs Plan G
This is the heavyweight bout everyone wants to see. Plan G is currently the Cadillac of Medigap plans (since Plan F closed to new enrollees in 2020).
Plan G covers everything Plan N does, plus:
- Part B excess charges
- Those pesky office and ER copays
But here’s the rub – Plan G typically costs $30-60 more per month. That’s $360-720 annually.
Unless you’re seeing doctors weekly or constantly hitting the ER, Plan N usually wins the financial fight. I’ve crunched these numbers thousands of times for clients.
Plan G makes sense if you:
- See specialists frequently
- Live in an area where excess charges are common
- Value predictability over savings
- Can afford the higher premium without stress
Plan N wins when you:
- Are relatively healthy
- Don’t mind small copays
- Want to maximize your retirement dollars
- Live where excess charges are rare or banned
Plan N Vs Plan F
Plan F is the ghost of Medicare past – amazing coverage but closed to anyone who turned 65 after January 1, 2020.
If you’re eligible for Plan F, here’s my hot take: don’t bother.
Plan F premiums are skyrocketing because the risk pool is aging with no new, younger members joining. It’s like being in a country club where they stopped accepting new members – eventually, the remaining members foot increasingly larger bills.
Plan F covers the Part B deductible that Plan N doesn’t, but we’re talking about $240 annually. When Plan F costs $100+ more monthly than Plan N, you’re paying $1,200 to save $240. That math doesn’t work in any universe.
I’ve helped dozens of Plan F holders switch to Plan N during their underwriting windows. Every single one thanked me later.
Who Should Consider Medicare Plan N
After 25+ years of matching people with Medicare plans, I can spot a Plan N person from a mile away.
You’re perfect for Plan N if you’re the type who:
Shops smart, not emotional. You compare unit prices at the grocery store and don’t buy extended warranties on appliances. You understand that insurance is about managing catastrophic risk, not eliminating every small expense.
Maintains good health. You’re not running to the doctor for every sniffle. Maybe you see your primary care physician quarterly and a specialist or two annually. Those $20 copays won’t break your budget.
Values savings over convenience. You’d rather keep an extra $50-100 monthly in your pocket than have every tiny expense covered. That money could go toward your grandkids, travel, or just padding your emergency fund.
Lives in the right location. If you’re in Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, or Vermont, excess charges are banned. Plan N just got even better for you.
But Plan N might not be your cup of tea if:
You have chronic conditions requiring frequent specialist visits. Those $20 copays can add up when you’re seeing doctors weekly.
You’re a worrier who needs maximum coverage for peace of mind. Sometimes paying more for Plan G is worth it for the mental health benefits alone.
Your income is very fixed and unexpected copays would cause hardship. The predictability of Plan G might serve you better.
You travel internationally frequently for extended periods. While Plan N covers foreign travel emergencies, heavy travelers might need more comprehensive coverage.
How To Enroll In Medicare Plan N
Alright, you’re sold on Plan N. Now what?
Timing is everything in the Medicare game. Your golden ticket is the Medigap Open Enrollment Period – those magical six months starting when you turn 65 and enroll in Medicare Part B.
During this window, it’s like Black Friday for Medicare supplements. Insurers must:
- Accept you regardless of health conditions
- Charge you the same rate as healthy applicants
- Cover pre-existing conditions without waiting periods
Miss this window? You’ll need to pass medical underwriting unless you qualify for guaranteed issue rights (like losing employer coverage).
Here’s your enrollment roadmap:
Step 1: Get your ducks in a row. Make sure you’re enrolled in Medicare Parts A and B. No Part B, no Medigap. Period.
Step 2: Shop around. Get quotes from at least three insurers. Prices vary dramatically for the exact same standardized coverage. I’ve seen $40 monthly differences for identical Plan N coverage.
Step 3: Check insurer ratings. Look for companies with at least an “A” rating from AM Best. You want an insurer that’ll be around in 20 years.
Step 4: Ask about household discounts. Many insurers offer 5-12% off if your spouse has a policy with them too.
Step 5: Complete the application. Most can be done online or over the phone in 20 minutes. Have your Medicare card handy.
Step 6: Time it right. Your Plan N should start the same day your Part B begins or when your current coverage ends. No gaps.
Pro tip from my decades of experience: Don’t wait until the last minute. Start shopping 2-3 months before you need coverage. Rushed decisions in Medicare rarely end well.
And please, don’t go it alone. A good broker (like yours truly) costs you nothing – insurers pay us the same whether you buy direct or through us. We can show you options from multiple companies and help you avoid the pitfalls.
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