Medicare Supplement Plan N covers Part A deductibles, Part B coinsurance, and the remaining costs for hospital stays, blood transfusions, hospice care, and some international healthcare after Original Medicare pays its portion.
If you’re eligible for Medicare, you can get optional additional insurance coverage through a Medicare supplement plan, also called a Medigap plan.
Medigap Plan N is one such supplement plan. It is not a part of Original Medicare, like Part A and Part B, which cover basic medical needs. Instead, it’s a plan you can choose to have in addition to your Original Medicare coverage.
Choosing a Medigap plan can be confusing. Various plans offer different levels of coverage and benefits. Understanding these benefits can help you choose a plan that works for you.
There are 10 Medigap plans. Like the other nine Medigap plans, Plan N is a privately administered type of Medicare supplement insurance that helps you cover your remaining out-of-pocket costs after your Original Medicare (Medicare Part A and Part B) coverage kicks in.
You can only use a Medigap plan with Original Medicare, which means you cannot use Medigap with a Medicare Advantage plan (Part C).
The law also requires that companies standardize Medigap plan policies. That means that no matter which company you purchase a specific Medigap plan like Plan N from, this plan must offer the same basic coverage.
However, not every Medigap plan is available in every location. Plan N doesn’t have to be sold in every state, and insurance companies that sell Medicare supplement policies can choose where to sell it. In addition, if you live in Massachusetts, Minnesota, or Wisconsin, the standardization of Medigap plans may differ.
Medigap covers only Medicare-approved services. Medicare Supplement Part N covers the cost of the following:
- Medicare Part A deductible
- Medicare Part A coinsurance and hospital stays up to 365 days
- Medicare Part B coinsurance for outpatient care and procedures
- Medicare Part B copays at doctors’ offices
- blood transfusion (up to the first 3 pints)
- hospice care and skilled nursing facility coinsurance
- 80% of healthcare costs while traveling outside the United States
Medicare terms to know
- Out-of-pocket cost: This is the amount you pay for care when Medicare doesn’t pay the total amount or offer coverage. Costs can include deductibles, coinsurance, copayments, and premiums.
- Premium: This is the amount of money you pay each month for Medicare coverage.
- Deductible: This is an annual amount you spend out of pocket within a certain period before Medicare starts to fund its treatments.
- Coinsurance: This is the percentage of treatment costs that you self-fund. For Medicare Part B, coinsurance is 20%.
- Copayment: This is a fixed dollar amount you pay when receiving certain treatments and using insurance. For Medicare, this usually applies to prescription drugs.
That said, Plan N doesn’t cover the deductible for Medicare Part B. This is because of a change in Medicare law that prohibits all Medigap plans from covering the Medicare Part B deductible.
While Medigap Plan N covers 100% of your Plan B coinsurance, you’re responsible for doctor’s visit copays of up to $20 and emergency room visit copays of $50.
Plan N is similar to plans F and G, but it can be significantly less expensive. For some people, Plan N may be a cost-effective solution for Medigap coverage.
Note that Plan N will not cover out-of-pocket costs remaining after long-term care and private-duty nursing, nor for the following treatments, which aren’t covered by Original Medicare.
- vision
- dental
- hearing aids
- eyeglasses
You pay a monthly premium for Medicare supplement plans. Your costs for Plan N can vary depending on where you live and the insurance company you’re buying the policy from.
To get an estimate of how much you will pay for Plan N in your area, you can go to Medicare’s plan finder tool and enter your ZIP code.
The Kaiser Family Foundation (KFF) reported that in 2023, people enrolled in Medigap plans paid an average monthly premium of $217.
If you’re enrolled in Medicare parts A and B, you’re eligible to purchase Plan N if it’s available in your state. As with all Medigap plans, you must meet enrollment standards and deadlines.
To determine whether Medigap Plan N is a good fit for your needs, consider the following pros and cons of selecting this option.
Advantages of Medigap Plan N
One benefit of Plan N is that its monthly premiums are less than those of Medigap Plan F and Plan G, even though they all offer similar coverage.
Plan N also completely covers your Medicare Part A deductible, which is one of the more expensive deductibles in Medicare and repeats for each benefit period throughout the calendar year.
If you travel abroad, Plan N might be a good option since it covers 80% of your healthcare costs if you need it outside the United States.
Therefore, if you spend a lot each year on coinsurance and copays, Medicare Supplement Plan N may pay for itself pretty quickly.
Disadvantages of Medigap Plan N
Plan N is one of the few Medigap options that doesn’t fully cover Part B copay and coinsurance costs. With Plan N, you’ll pay $20 for some doctor’s visits and $50 if you go to the emergency room.
Plan N also doesn’t cover Part B excess charges, which you pay if a healthcare practice charges more than Medicare will pay for services.
How to shop for a Medigap plan
Choosing a Medigap plan can be difficult since you can’t always anticipate your future healthcare costs. Consider the following questions when you review Medicare supplement plans:
- Do you typically hit or exceed your annual Medicare Part A deductible? The total cost of a year of Plan N premiums may be more or less than the deductible you usually pay.
- If you add up expenses like copays, emergency room visits, and blood transfusions, how much do you typically spend in a year? If you divide that number by 12 and it’s more than the monthly premium for Plan N, the supplement plan may save you money.
- Are you currently in the Medicare open enrollment period, which happens when you turn age 65? Signing up for a Medigap plan during open enrollment may be your only opportunity to purchase Medigap coverage when your health status and medical history can’t be used to refuse your application.
Medicare Supplement Plan N is a popular Medigap plan that covers many out-of-pocket costs from Medicare.
Like every Medicare supplement plan, Medigap Plan N has pros and cons, and costs vary based on where you live.
If you have questions about your options or want to learn more, you can call the free Medicare help hotline at 800-MEDICARE (800-633-4227) or contact your local State Health Insurance Program office.