With the advent of Medicare Plan N (and M) in 2010, the landscape of the Medicare Supplement market changed significantly. At the time, all companies who were marketing and selling Medicare Supplement plans were required by the US Government to abide by the newly upgraded and modernized Medigap chart. Also part of this modernization process included supplement plans M and N and they promised to be better alternatives for both new and existing Medicare beneficiaries. The question now is, “are these plans ideal for you?”
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Areas of Coverage
Although Medicare Plan N is similar to Medicare Plans D and F, it adopts a system for sharing costs so as to keep the premiums of a beneficiary as low as possible. Unlike Plans D and F, all or a part of the deductibles incurred in Medicare Parts A and B will be covered by this plan. As an exchange for insurance premiums that could be up to 30% lower than what they were, a new co-pay structure was implemented. Under Plan N, emergency room visit co-pays are $50 and doctor visit co-pays are $20.
As an addition to the modification in the co-pay structure, the $50 co-pay will be waived if a hospital admission is needed because of the visit to the ER. Under Part A, Medicare supplement Plan N offers 100% coverage for deductibles but no coverage for Part B deductibles. The basic core Medicare benefits are not covered under Plan N including:
- all expenses after Medicare benefits run out for in-patient hospital care
- Part A co-insurance for palliative medication in hospice care
- Part B co-insurance expenses
- coverage for in-patient hospitalization charges under Part A
- initial 3 pints of blood
- emergency benefits when traveling internationally
The premium incurred under Medicare Plan N is estimated to cost about 70% of Plan F and 77% of Plan D premiums. For individuals who are concerned about budget, it is most likely that Plan N will be better than any of the Medicare Part C Advantage plans on offer.
The costs associated with Medigap Plan N may differ depending on the carrier just like all Medigap plans. Depending on how a particular insurance carrier “rates” the premiums on Medigap Plan N, it would determine how much an individual will have to pay to obtain a policy. The Medigap Plan N could be an attractive option for those in need of broad coverage. Plan N is not the most comprehensive Medicare Supplement insurance plan, hence it is advisable that you examine the details of all of the Medigap plans so you can find a Medigap policy that works best to meet your needs.
You may still apply for a Medigap plan outside your OEP, but you may have to undergo medical underwriting, and generally speaking, you may not be guaranteed an acceptance. In some cases however, you may have a guaranteed issue right to sign up for a Medigap plan after the end of your OEP.
Plan N is not offered by every healthcare insurance provider. If you want this coverage, search for those companies who do offer it. Do your research before committing to an insurance provider.