Are you looking for a Medicare Supplement plan (aka Medigap Plan) but are unsure which is right for you? It can be stressful sifting through the range of options and understanding the nuances between one Medicare supplement plan and another.
Almost 80% of Medicare supplement insurance plans purchased in the U.S. are either Medigap Plan G or Medigap Plan N. This article will help you when comparing Plan G and Plan N to decide which Medicare supplement is right for you.
In this article I cover the process of medical underwriting approval, detail the differences between Medigap policies Plan G and Plan N, and provide information about restrictions when switching between plans. I also explore the long-term coverage considerations that should be taken into account when selecting between these two supplemental Medigap plans.
Summary
Medicare Supplement Plans are private insurance policies that supplement Original Medicare part A and B, providing supplemental coverage for out-of-pocket costs and preventive care services.
Plan G is the most comprehensive supplemental coverage for Original Medicare, while Plan N has a lower monthly premium but does not cover Part B excess charges.
Supplement Plan N does not insure against Medicare Part B excess charges. As such, you need to be certain your doctors accept Medicare assignment. Doctors who accept Medicare assignment cannot charge an excess charge.
When deciding between Plan G and Medicare supplement Plan N, it is important to consider the cost and coverage of each plan, potential future health care needs, and budgetary constraints in order to make an informed decision that best suits individual needs.
The benefits of all Medicare supplement plans are standardized and guaranteed renewable. That means all Plan N’s offer the same benefits. All Plan G’s offer the same plan benefits. And the benefits of all supplement plans never change.
What is a Medicare Supplement Plan?
A Medicare Supplement Plan is a type of private insurance policy that works hand-in-glove with Original Medicare to provide coverage for and limit out-of-pocket costs. Medigap G and Medigap N are among the most popular Medicare Supplement plans, accounting for about 80% of all supplemental Medicare plans sold.
These plans are designed to fill gaps in coverage left by Original Medicare. They provide coverage for some or all of the costs associated with Medicare Part A and Part B, such as deductibles, copays, and coinsurance that are not covered by Original Medicare. They also provide coverage for certain preventive care services.
Medicare Supplement Plans are offered by private insurance companies that are approved by Medicare and meet certain standards set by the federal government. The monthly premium for these plans vary from one insurance company to the other and depending on the plan chosen.
During initial enrollment, Medicare Supplement Plans do not require medical underwriting and can be purchased without answering medical questions. However, after your Medicare supplement plan initial enrollment, medical underwriting may be required, and the insurance company can deny you coverage.
What are the differences between Plan G and Plan N?
Plan G provides the most comprehensive coverage of all supplement plans available to new Medicare beneficiaries. However, it usually has higher monthly premiums than Medigap Plan N. On the other hand, Plan N is a cost-effective Medicare Supplement plan, providing a balance between affordability and coverage. Plan N has a $20 copayment for doctor visits and a $50 copayment for non-admission emergency room visits.
Plan G covers all Part A and Medicare Part B copays, and coinsurance, as well as Part B excess charges. Plan N does not cover Part B excess charges. In addition, doctors that do not accept Medicare assignment may charge excess fees of up to 15%, which are not covered by Plan N.
What does Plan G cover?
Medicare Plan G offers full coverage that includes coverage for Part B excess charges, doctor visits, inpatient care, hospice care, emergency room visit, and even some foreign travel emergency expenditures. Medicare Parts A and B plus Medicare Plan G is often considered the best health insurance available in the Medicare program.
Medicare Plan G, like most Medicare supplemental insurance plans adds to your Original Medicare. You have full inpatient coverage. You can spend up to a year as an inpatient in a hospital and it should not cost you a dime. You have 100% Part A hospital insurance coverage.
Medicare supplement Plan G offers the same coverage as Medicare Plan F, with the exception of the Part B deductible. With Medicare Plan G you must be pay the annual Part B deductible out of pocket. Plan F is only available to those who were first eligible for Medicare prior to 2020.
Plan G is a great option for those seeking a comprehensive plan that allows them to be flexible in choosing their healthcare provider. I call it the “Peace of Mind” Medicare plan because you do not have to worry about medical bills. If monthly premiums are not a consideration, this is the plan you should choose.
What is the Plan G Maximum out-of-pocket?
The Medicare supplement Plan G annual maximum out-of-pocket is equal to the total amount that you will be required to pay for covered services in a given year. The total of the Plan G Maximum out-of-pocket expenditure for the year 2023 is $226, the Medicare Part B deductible. While the dollar amount of the annual Medicare Part B deductible will change from year to year, your annual maximum out of pocket for Medicare inpatient and outpatient services will always be the amount of the Medicare Part B deductible.
This means your Medicare plan and Medigap policy combined will pay 100% of all other Medicare bills for inpatient and outpatient services.
What does Plan N cover?
Medigap Plan N is often considered the best value for your monthly premium. Medicare supplement Plan N will have a lower premium than Medicare Plan G, but the Medicare coverage is nearly the same. The lower monthly premiums can make this plan the better value and help you save money.
When we compare Medicare supplement Plan N and G we find they both have 100% Part A inpatient coverage. Also, with both plans you must pay the annual Part B deductible.
There are no significant differences between the plans, but Medigap Plan N has two copays found in no other supplement plan. Supplemental Plan N has an office visit copay of up to $20 and an emergency room visit copay of up to $50.
The office visit copay is for visits with the intent of either diagnosing or evaluating a medical issue. This can include Urgent Care visits and, more recently, telehealth visits. It does not include physical therapy or chemotherapy infusions.
What is the Plan N Maximum out-of-pocket?
To determine the maximum out of pocket for Plan N we must assume that you do your due diligence and only see doctors that accept Medicare assignment. By ruling out doctors that do not accept Medicare assignment, we can rule out Medicare excess charges.
Considering that fewer than 3% of all doctors that accept Medicare do not accept assignment, and that nearly 50% of those doctors are in the mental health field, it should be easy to avoid excess charges.
For all practical purposes your Plan N annual maximum out of pocket should be the amount of the Part B deductible, plus office visit copays. It is reasonable to expect that amount to be comfortably under $500 annually.
What should I consider when choosing between Plan G and Plan N?
When deciding on the best Medicare supplement for your needs, it is important to consider budgetary constraints over the long-term. It is important to consider the long-term implications of selecting either plan, as a change in policy may not be possible after enrollment. Please do not get in the rut of considering your needs as only your current health dictates. Our health can change without warning. I strongly advise you get the supplement plan that will cover the medical costs as you would find acceptable when sick or injured.
In addition to considering long-term coverage needs, one should also consider the cost of each plan. Plan G is generally more expensive than Plan N, but it offers more comprehensive coverage. Plan N may be a better option for those on a tighter budget. However, it is important to note that even though Plan N may be cheaper in the short-term, it may not be the best option for long-term coverage needs.
It is important to weigh the cost and coverage of each plan when deciding between Plan G and Plan N. Furthermore, it is important to consider potential future health care needs and budget in order to make an informed decision that best suits your individual needs.
Are there any restrictions on switching between Plans?
During your Medicare supplement Initial Enrollment Period (your first 180-days of Part B coverage) you can change Medigap plans at will, and cannot be denied coverage. After your Medicare Supplement Initial Enrolment Period you can still change plans any day of the year, but the insurance carriers will likely require you answer medical questions. Depending on your health history, you can be denied coverage.
Is Medicare Supplement Plan G going away?
No. There are no plans or discussions to eliminate Medicare supplement Plan G. But even if Medicare supplement Plan G was discontinued, Medicare beneficiaries can keep the plan, just as they can with the phased out Medigap Plan F.
Summary
In conclusion, finding and choosing the right Medicare Supplement Plan can be a stressful yet critical decision to make given the extent of coverage and potential financial implications. Medigap Plans G and N are two of the more popular Medigap plans that offer full Medigap coverage for those enrolled in Original Medicare. While both cover Part A and Part B coinsurance, the main difference between these plans is that Plan G offers more coverage and includes coverage for Part B excess charges, while Plan N does not. However, Plan N may be more cost-effective in terms of premium costs compared to Plan G.
Ultimately, individuals should weigh their economic budget with their medical needs in mind to determine which plan best suits them. Lastly, while transitioning between Medigap Plans is possible, policyholders must contact their current insurer to deactivate their previous policy and seek medical underwriting approval before signing up for a new one.
All in all, it’s important to carefully research and select the right plan carefully. Now that we have compared Plan G and Plan N, we hope you feel more equipped and informed to make an educated decision on which Medicare Supplement Plan best suits you.
Frequently Asked Questions
What is the difference between Plan N and Plan G?
The main difference between Medigap Plan G and Plan N is that Plan G covers all of Medicare’s hospital and medical expenses, and excess charges. With Plan G, beneficiaries have no additional copayment costs, while Plan N has a small copay associated with physician and emergency room visits.
Additionally, Plan G has a slightly higher premium than Plan N and higher expected price increases over time.
Is Plan G more expensive than Plan N?
In general, Plan G is more expensive than Plan N. This can be attributed to the fact that Plan G tends to include more extensive coverage than Plan N. Plan G has lower out of pocket expenses for medical bills.
What are the disadvantages of Plan N?
Plan N is often considered the best value among Medigap policies because of its full inpatient coverage and lower monthly premiums relative to Plan G.
Plan N, however, does not cover Medicare excess charges. While such charges are rare and preventable, this could result in unexpected costs.
Overall, Plan N is a great option for those looking for a more affordable Medigap plan and don’t mind the small copays.
What does a Medicare Supplement Plan N cover?
Medicare Plan N provides comprehensive coverage for Part B coinsurance costs. It pays 100% of the cost, with exception of a $20 charge for office visits and $50 for emergency room visits.
Plan N ensures you will have financial protection for your medical needs.
What is the advantage of Plan G over Plan N?
The main advantage of Plan G over Plan N is that it provides more comprehensive coverage, with no copays for doctor and emergency department visits. Generally, this means Plan G will save you money in the long run if you visit multiple physicians each year or need to make frequent trips to the emergency room.
Plan G also offers coverage for Part B excess charges, which are not covered by Plan N. This means that if you visit a doctor who charges more than the Medicare-approved amount, Plan G will cover the difference. Additionally, additional information is provided below.
Matthew Claassen
Matthew Claassen, CMT and CEO of Medigap Seminars Insurance Agency. Medigap Seminars is an award winning premier national Medicare Insurance Brokerage, ranked among the top in the U.S.A. Matthew is considered a leading national expert on Medicare and Social Security. Mr. Claassen is a distinguished member of the Forbes Business council, an invitation only organization of business leaders and entrepreneurs. He and his team have received awards from many of the countries largest insurance companies including Mutual of Omaha, Aetna, Humana, Cigna, United American, United Healthcare and others. His videos have become the most popular Medicare educational videos on YouTube with millions of views. As a financial analyst Matthew lead a team of researchers to win the 2009 Best Equity Research & Strategy Award from The Technical analysis magazine.
