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Medicare Supplement Insurance Plan N

Medigap Plan N is one of 10 standardized Medicare Supplement Insurance options available in most states. (Massachusetts, Minnesota, and Wisconsin have different options.) Learn more about this relatively new Medigap policy type and compare with other plans below.

Medigap Plan N: An Overview

Plan N was introduced to the Medigap insurance market in 2010, alongside Plan M.

It is the third most popular Medigap plan. About 9% of Medigap policyholders had Plan N in 2014, according to data from America’s Health Insurance Plans (AHIP).

Keep reading for details on Plan N’s benefits and enrollment statistics, in addition to how the benefits compare to other plan options.

Benefits

Plan N includes 7 out of 9 available Medigap benefits. Plan N covers the Part B co-insurance fully except for two conditions. It is subject to two co-payment structures, requiring up to $50 for certain emergency room visits and up to $20 for physician office visits.

Plan N benefits

Standard Medicare Supplement Insurance benefits

Plan N

Medicare Part A co-insurance and hospital costs

Medicare Part B co-insurance or co-payment

√*

First 3 pints of blood

Part A hospice care co-insurance or co-payment

Co-insurance for skilled nursing facility

Medicare Part A deductible

Medicare Part B deductible

 

Medicare Part B excess charges

 

Foreign travel emergency

80%

Medicare Part A co-insurance: Medicare Part A is known as hospital insurance and it includes cost-sharing measures like co-insurance. Inpatient hospital stays covered by Medicare Part A require co-insurance fees if they exceed 60 days. Medigap Plan N pays for all of these co-insurance fees.

Medicare Part B co-insurance and co-payment: Medicare Part B usually charges a co-insurance and co-payments for doctor visits and other outpatient care. Medicare Part B typically pays for 80% of the Medicare-approved amount for covered services, leaving a 20% co-insurance in most cases.

*As explained above, Plan N will fully pay for the Part B co-insurance, except for a co-payment of up to $20 for some office visits. A second co-payment of up to $50 could be required for emergency room visits that do not result in an inpatient admission.

First 3 pints of blood: Original Medicare only covers the fourth pint of blood and beyond. If you need blood while in the hospital, Medigap plans cover the cost of the first 3 pints.

Part A hospice care co-insurance or co-payment: Hospice care provides medical treatment and care during a terminal illness. Medicare covers these services, but it requires co-payments. These co-payments include $5 for each symptom and pain relief prescription drugs and 5% of the Medicare-approved amount for inpatient respite care. Plan N covers these costs completely.

Co-insurance for skilled nursing facility: Co-insurance for medical care provided at skilled nursing care facilities is fully covered by Plan N.

Medicare Part A deductible: Medicare Part A comes with a deductible, which is $1,364 per benefit period in 2019. Medigap Plan N will cover your deductible in full for each benefit period you require.

With Plan N, you still have to pay the Medicare Part B deductible, which is $185 in 2019.

Foreign travel emergency: This benefit provides coverage for medical care provided outside of the United States. This insurance benefit pays for 80% of the billed charges. Coverage is provided after a $250 deductible has been met for the year.

For more detailed information, read our page about Medicare Supplement Insurance benefits.

Plan option comparison

Plan N is identical to Plan D, except for the Medicare Part B co-insurance coverage. It covers more benefits than Plan A, but fewer benefits than Plan F, for example.

To see the difference between Medigap Plan N and the other standardized plan options, review the chart below.

Plan N vs. other Medigap plan options

Medicare Supplement Benefits A B C D F1 G K2 L3 M N4
Part A co-insurance and hospital costs
Part B co-insurance or co-payment 50% 75%
First 3 pints of blood 50% 75%
Part A hospice care co-insurance or co-payment 50% 75%
Co-insurance for skilled nursing facility     50% 75%
Medicare Part A deductible   50% 75% 50%
MedicarePart B deductible              
Medicare Part B excess charges              
Foreign travel emergency     80% 80% 80% 80%     80% 80%
1. Plan F offers a high-deductible plan. This plan requires you to pay a $2,300 deductible in 2019 before it covers anything.
2. Plan K has an out-of-pocket yearly limit of $5,560 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
3. Plan L has an out-of-pocket yearly limit of $2,780 in 2019. After you pay the out-of-pocket yearly limit and yearly Part B deductible, it pays 100% of covered services for the rest of the calendar year.
4. Plan N pays 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.

Plan N Enrollment Statistics

Plan N was created in 2010. By 2016, 54% of Medigap insurers offered it. According to data from AHIP, Plan N represented 9% of the 2016 market.1

Plan N is the third fastest growing Medigap plan, behind Plan M and Plan G. From 2015 to 2016, enrollment for this plan increased by 18%, growing from 966,887 to 1,143,035 enrollees.


1 https://www.ahip.org/wp-content/uploads/2018/06/State_of_Medigap18_FINAL.pdf

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