Understanding Medigap Plan N: Pros and cons

03-07-2025

Medigap Plan N is a supplemental insurance policy for Medicare. It offers a balance of extensive coverage and affordable premiums.Medigap, or Medicare supplement insurance, is a form of private insurance that helps cover the out-of-pocket expenses that come with Original Medicare.After Medicare pays its share for a given service, beneficiaries still have various out-of-pocket costs for the services they receive. These include deductibles, copayments, and coinsurance.Medigap plans will cover these additional costs for people who would like more predictability in their healthcare costs in exchange for a monthly premium payment, which a person pays on top of the Part B premium.Glossary of Medicare termsOut-of-pocket cost: This is the amount a person must pay for care when Medicare does not pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.Premium: This is the amount of money someone pays each month for Medicare coverage. Deductible: This is an annual amount a person must spend out of pocket within a certain period before Medicare starts to fund their treatments.Coinsurance: This is the percentage of treatment costs that a person must self-fund. For Medicare Part B, coinsurance is 20%.Copayment: This is a fixed dollar amount a person with insurance pays when receiving certain treatments. For Medicare, this usually applies to prescription drugs.About Plan NMedigap Plan N is one of 10 Medicare supplement insurance plans available in the United States.Although different insurers offer Plan N policies, the coverage of these plans is standardized across the country, except in Massachusetts, Minnesota, and Wisconsin, which have different rules regarding Medigap.According to the health policy research nonprofit KFF, Plan N is one of the more popular Medigap policies. In 2023, the most popular plans (and their corresponding percentages of all policies sold that year) were:Plan G, with 39%Plan F, with 36%Plan N, with 10%Plan N offers similar coverage to plans G and F, although it is not quite as comprehensive. As a result, Plan N typically carries a lower monthly premium cost than these alternatives.Pros and cons of Plan NAll Medigap plans have advantages and disadvantages. Plan N is no different. The following list highlights some of the pros and cons of Plan N as it relates to other Medigap plans.Advantages of Plan N:It offers comprehensive coverage for most major medical services and procedures, including the Part A deductible and coinsurance and the Part B coinsurance.It covers the coinsurance for skilled nursing facility care and hospice care.It has a lower monthly premium than Plan G, which offers similar (though slightly more extensive) coverage.Disadvantages of Plan N:It does not cover Part B copayments. With Plan N, a person will still have copayments for some doctor's visits and emergency room visits that do not result in hospital admission.It does not cover Part B excess charges. If a person's doctor does not accept Medicare assignment, they may charge up to 15% more than the Medicare-approved amount for given services. This is called a Part B excess charge.It does not cover the Part B deductible. Only plans C and F cover this cost, and these plans are not available to people who became eligible for Medicare after January 1, 2020.Since Medigap works with Original Medicare, all plans include flexible provider access, allowing beneficiaries to see any healthcare professionals nationwide who accept Medicare.Plan N coverageWhat Plan N coversWhat Plan N does not coverPart A coinsurance and hospital costs Part B copayments Part B coinsurance Part B excess charges blood (up to 3 pints) Part B deductible Part A hospice care coinsurance dental, vision, and hearing care skilled nursing facility care coinsurance prescription drugsPart A deductible —emergency care while abroad—Medicare.gov offers a useful chart that compares the benefits of Medigap plans side-by-side.Who should consider Plan NPlan N may appeal to people with Original Medicare who are looking for broad coverage with slightly lower monthly premiums than other similar Medigap plans.These individuals may have moderate medical needs and would accept making modest copayments when they visit a healthcare professional.It may also suit those who routinely visit healthcare professionals and medical facilities that accept Medicare assignment, as they would not face excess charges for the services they receive.When to buy Plan NWhen people ages 65 years or older sign up for Medicare Part B, their Medigap open enrollment period (OEP) begins. This is a 6-month window during which they can sign up for any Medigap plan they wish without being denied or charged more due to a preexisting health condition.This process of examining an applicant's health status and lifestyle to determine whether to offer coverage, and at what rate, is known as medical underwriting.If a person wishes to sign up for Medigap Plan N, the best time to do so is during the Medigap OEP. If they wait until after this period, there is no guarantee that an insurer will accept their application.However, if someone does miss the Medigap OEP, they can still apply for Plan N by contacting the insurance carrier offering their desired plan.Medicare.gov offers a tool that individuals can use to compare Medigap plans available in their area.»Learn more:When is the Medigap open enrollment period?TakeawayMedigap Plan N is a supplemental insurance policy. It covers a wide range of expenses related to Original Medicare, including the Part A deductible and coinsurance, and Part B coinsurance.However, Plan N's coverage has some gaps. It does not cover Part B excess charges, and it requires copayments for certain doctor visits.A person may wish to consider the pros and cons of Plan N as they weigh their insurance options.

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