Medicare Supplement Plan N
What makes Medicare supplement plan N a good alternative to an Advantage plan?
Your Medicare Advantage plan can change every year. The benefits can change, the premium can increase or the plan may not renew for the following year. What if you don’t like the changes? Or maybe your Medicare Advantage plan is not renewing for 2012. Take a look at Medicare supplement plan N as a viable alternative.
Medigap plan N was introduced in June 2010 as one of the new Modernized Medicare supplement plans. Plan N offers more freedom than an Advantage plan, as well as lower premiums than most supplements. In some cases, plan N will have lower premiums than some of the Advantage plans being offered for 2012.
What Does a Medicare Supplement Cost?
Plan N benefits
Medicare Part A:
- Part A hospital deductible
- Part A hospital coinsurance
- Skilled nursing facility coinsurance
- Blood
- Hospice co-payment/coinsurance
Medicare Part B:
- Part B outpatient coinsurance
- Blood
Other Benefits
- Foreign travel emergency – 80% to lifetime max of $50,000 after $250 calendar year deductible
Premiums for Medicare supplement plan N are less than other supplements because the policy holder will share some of the outpatient costs. If you purchase plan N, you will be responsible for:
- The Part B deductible – currently $162 annually
- Up to a $20 co-pay for a doctors visit
- Up to a $50 co-pay for an emergency room visit
The reasoning behind Medigap Plan N as an alternative to a Medicare Advantage plan
You are not bound by any network restrictions with a Medicare supplement. These plans offer standardized benefits from one company to the next, (unlike an Advantage plan) and are readily accepted by medical providers. Because these are standardized plans, it is easy to compare one company to another. AARP Medicare supplement plan N. for example, will include identical benefits as Mutual of Omaha plan N. The difference is price and the perceived level of customer service.
Other than the small co-pays for doctors visits and ER visits, you will have very little out-of-pocket expense. No deductibles or daily co-pays for inpatient hospital stays are required. You may have less out-of-pocket expenses for some outpatient procedures. Many Advantage plans require the same coinsurance levels as original Medicare for outpatient surgery and other medical services. Your plan N supplement will cover the 20% coinsurance for outpatient surgery.
Unlike an Advantage plan, Medigap plan N is not an annual plan and you are not subject to enrollment periods. Many providers are offering plan N with limited underwriting and pre-existing conditions are not relevant in many cases. If your Medicare Advantage plan is not being renewed for 2012 you are guaranteed acceptance into a Medicare supplement plan.
What are you missing?
Supplements fill in the gaps left by Medicare. You are generally not afforded additional benefits, like dental, vision or gym memberships. So you need to determine the importance of these ancillary services compared to the freedom and level of coverage offered by the supplement.
Medicare supplements do not include Part D drug coverage. You will need to purchase a separate drug plan. You will still be subject to Part D enrollment periods.
Whether or not the plan will fit your budget is obviously a huge factor. But that said, there are Advantage plans with higher premiums than plan N.
One benefit of a standardized plan, is that it lends itself to being easy to shop for online. Unlike an Advantage plan, you don’t need to meet with countless agents to learn about the different benefits. The benefits are the same with Medicare supplement plan N and you should be able to compare plans online with little trouble.
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Comments
Greta, Often call center employees don’t have the information that you are looking for. Also, keep in mind that the article was referring to Medicare Direct not renewing for 2011. To my knowledge this blanket issue will not effect Secure Horizons AARP Medicare complete for 2011.
David
I looked into the medigap part N for my mom who can barely afford food. Are you kidding? What a joke this plan N is! To pay $1200 a year in addition to medicare for “peace of mind” and get only a $2600 a year potential benefit is insurance robbery! Her max. out of pocket for 2011 w/Aetna is $3400. We’ll take our chances, thank you! People on a fixed/low income can not afford this. Does anyone realize that for low income families, it is easier to come up with the occassional $35 office visit (which this plan does not cover fully) vs the $100 a month fee for insurance that has limited benefits? Am I missing something? How could a senior who paid into medicare all their working lives afford $196.40 a month for health insurance with less then $1000.00 monthly income, living in the metropolitian area? Some may be empathetic to what is happening to the middle class in America but I wonder if they really understand. The government and big businesses need to wise up or pretty soon most all middle class Americans will be doing the ER thing and it will cost everyone big time! I understand a company making a profit, but, for crying out loud, we need to stop the corporate greed in this country!!!!
Actually I have Blue Cross & Blue Shield PLUS value Medicare Supplemental insurance for $186 a month or $2232 a year. After wasting $4464 out from my pocket for 2 years, I decide not to trust Health Care Insurance Brokers and to search in internet by MYSELF. Soon I discovered that:
The Hospitals Accepting Medicare patients are the same as for the coverage by Medicare Complete, that pay $0.0 premium per month and not more than $3400 out of pocket for year in catastrophic situation. A $20/40 copayment per visit is acceptable.
Ironically The medicare Complete accept the same facility, where actually I am enrolled.
The agent of Anthem, he might be at 100K per year profit, didn’t care for me because he was very busy, pretending to help to many customers that he was not able to serve. After hi got my Insurance Card he failed to mail to me. After called 3 times, the forth time a got him and mailed the card with an apology. Called Anthem to change the agent and they refused. Two years under Anthem was a nightmare, they keep you in complete dark. Now I’m changing the provider AARP medicare complete or Humana. I AM DOING THE HOMEWORK BY MYSELF IN INTERNET.
George, More and more people on doing their own research, especially as it relates to Medicare Advantage Plans and Part D Plans. I think you’re smart to do your own research given the resources and tools that are available online. Everybody’s needs are different and unfortunately some agents don’t recognize this but rather just concentrate on selling policies. In most cases an agent can be of service after the sale helping with customer service, so there is a value to using an agent. Also, there are many people who are not adept at using the internet. Sounds like you are doing your homework. Good luck.
Kris, Yes you are missing something. Your point would be completely valid were there not another alternative for your mom other than Medicare supplement Plan N. Just because your mom cannot afford Medicare Supplement Plan N does not make it a joke, any more than a Lear jet is a joke because I cannot afford one. Blaming a fixed income, although popular in the media, is absurd given the relative nature of income in general. Shouldn’t you be blaming poverty? I know many seniors who are on a fixed income in the form of pensions, annuities or long term investments. Their income is fixed but that doesn’t by default mean they are poverty stricken.
A Medicare Advantage plan sounds like a good option for your mom. She’s lucky to have you looking out for her. And yes, I would tell someone who said a Medicare Advantage plan was a joke, that they were missing something! Just because you have to stay in network and maybe not have access to the best specialists, have to renew your plan each year or find a new one because of non-renewal and wonder what new regulations will be enacted by the government that affect your ability to get an Advantage plan, doesn’t mean that there is not a market for such a product. Rather than ranting about big business and the government, we should look around the world and be happy that we have options to choose from and the freedom of choice to do what we believe is in our best interests.
Amen David!!! I don’t know what your profession is. But you certainly make a lot of sense to me. I appreciate the information you provide—as I am new to the Medicare Insurance and the supplement game. Starting Jan.1,2011 I will be on Medicare and Humana supplement-Plan N. Humana’s Plan N is quite reasonable where I live, in Western Oregon, at $ 80.42. I’m going to try it for a year and I’ll comment on how well the plan and Humana perform,at a later time. Thanks! Ken
David,
Thank you for all of the great feedback. I have learned a lot just reading your column today. I am a 41 year old woman….I am also a brain tumor survivor. I have several residual challenges as a result, but my glass remains half full anyway. Long story short, after almost 3 years from originally filing and also after hiring a legal representative, I qualified and was granted disability benfits this January. I am new to the Medicare program and am trying to muddle thru all of the differences between Medicare Advantage and Supplemental policies. Any advice?
Thanks ever so much.
Jodi
Jodi, Thanks for the kind words. Sign up for my free mini course by entering your first name and email on any page of this blog. Also, visit http://www.medicare.gov as there is a lot of information if you have the patience to sift through it. The Medicare and You handbook is an excellent reference as well.
Hi David,
I have been reading the comments and responses from your column and have learned more here than from actual insurance sites. I am 30yrs old and am very new at this medicare/medigap thing but I am POA over my mom who will become elligable soon and am trying to learn as much as possible to make the right decision. I am leaning towards plan G through Forethought Insurance and am wandering if plan G is the same across the board or is it worth looking at different medigap insurance companies that offer plan G other than Forethought. I am also leaning to NOT enroll mom in Part D (drug Plan?) because she is fortunate to not be on any medications at this time….is this wise? I know there may await a penalty for late enrollment should she have to be on medication but does this outweigh the additional costs of enrolling her in Part D now?
Thankyou,
grayson
Hi Grayson, I’m glad this site is helping you get a grip on Medicare options. Your mom is lucky that you are doing your homework. Plan G will afford you the same benefits no matter which company you choose. Medigap plans are standardized. Although I’m an advocate of saving money if I was in your shoes I would enroll mom in a Part D even though she is not currently on medications. The purpose of insurance is to protect yourself from the unexpected. I have automobile insurance but haven’t filed a claim in over 20 years. But I’m protected. I own a cancer policy that will pay a fixed amount at first diagnosis but I don’t have cancer and it doesn’t run in my family. You get my point. Choose a Part D with a low monthly premium to protect your mom just in case. I’m not advocating any specific company but the lowest Part D premium nationally for 2011 is with Humana Walmart-Preferred Rx Plan at $14.80 per month.
Hi David,
Just a couple more questions if I may, 1. With a medigap plan I can expect to pay (monthly) 115.00 part B premium + the medigap plan G premium (monthly) + a plan D premium (monthly)+ 162.00 deductible (yearly) should my mom have a medical need, and most other costs would be covered. Is this correct? 2. With a part C advantage plan.. I could expect to pay 115.00 part B premium (monthly) with a plan D included, and more out of pocket expenses. Is this correct?
Thankyou for answering my previous questions and I see your point on the plan D insurance and beleive I need to look into which drug plan would best suit mom’s needs. If I went with a low premium now, I take it I cann’t move into a “better” plan at a later date without jumping over hurddles? So should I consider a plan with a higher premium.
I ‘m not complaining, but I never thought I would be learning about medicare ins. at this stage in life!
most appreciative,
grayson
Hi Grayson, Yes you are correct on your first question. Your second question should be addressed a little further. Depending on what Medicare Advantage Plans are available where your Mom lives you may find some premiums to be almost as high as a Medigap policy. Part D is often included but many plans do not include Part D. You also need to consider network issues. A HMO may have a low premium but in certain circumstances she may not be able to receive the coverage she needs if the network is not adequate. Honestly, If budget is not a huge concern I would opt for my Mom to have the Medigap and Part D.
You can change Part D Plans annually with little hassle. In my previous response I was recommending a low premium plan because you mentioned that she didn’t require medication. If she enrolled now she would need to renew that plan, if available, for 2012 or choose another during the Part D Annual Enrollment Period. Annual enrollment for plans with a 2012 effective date begins October 15, 2011 and ends December 7, 2011. I hope that helps.
Hi David… I HOPE you are still answering questions!! All of this Medicare, Advantage and Medigap is just confusing, so I will try to be very specific with information so that you can hopefully give me a very informative reply.
I have talk to benefit counselors, Ins. Agents, Medicare, you name it, I’ve talked to them! And yes you guessed it, not once did I get the same answer twice!
My husband is a Cancer patient. Our state of residence is Texas. My husband is 55 yrs old. He is on SSDI and will be eligible for Medicare on Nov. 1, 2011. At this time, he is not on any treatment or medications as he has been NED for 2 yrs. He does have CT Scans and a Brain MRI every 4-6 months (it has been every 3 months, but because he has no insurance now the Doctor has agreed to go a little longer).
It is my understanding that NONE of the Plan F supplement plans will cover individuals under 55. Do you know if that is correct information? I was also told that supplement plans and advantage plans will not cover the 20 percent on treatments, scans, hospitalization and this expense is up to the policy holder.
With that being said, how do they expect individuals under the age of 65, that only have the income from their SSDI, which is over the poverty limit yet nowhere in the range of financially secure to pay that 20 percent when ONE chemo treatment is in excess of 10 thousand dollars!! Venting 
Hi Jeannie, I’ll give it my best shot. First the Medicare Advantage plan option. Most Advantage plans require a copay or coinsurance for outpatient services. In the case of scans for cancer detection I’d guess most will require coinsurance, probably 20%. Insurance companies don’t pay retail for anything. It’s highly unlikely that a scan is a $10,000 charge to an insurance company so you will benefit from the re-pricing. Also Advantage plans have a maximum out-of-pocket amount. For 2012 plans it is $4700 max on your part.
If your husband had an Advantage plan in Texas the providers will generally provide the service knowing that they are getting 80% from the insurance company. It’s up to them to bill you for the balance. You could more than likely pay that over time. The most liability you could incur for 2012 would be $4700. States that do mandate insurance companies to provide Medigap to those under 65 can charge a higher premium than they do for someone just turning 65. If you could get Plan F you could find yourself paying a very high premium.
The other option is the Texas Health Insurance pool. Visit http://www.txhealthpool.com to learn more. It may be worth exploring this option a little deeper. I hope that helps.
I tried to enroll in part D last year but they wanted to what medications my wife and I were on, since we were not on any I could not complete the application.
Gerald, Being on medications is not a condition of enrolling in a Part D plan. If you seem to encounter a similar problem this year meet with a local insurance agent who can help you complete the application.
David.. Thank you for your reply.. I did check on the Texas Health Insurance Pool, unfortunately my husband does not qualify i.e. Eligibility II “with no gap in coverage greater than 63 days”. His COBRA ran out June 1, 2011. And, I had checked on the Pool previously, the premiums were extremely expensive, in excess of 800 dollars a month and up to 1000 dollars.
I have been told twice now he does not qualify for Plan F being he is under the age of 65.
Jeannie, I’m sorry it didn’t work out. At least the Medicare Advantage plan would give him the protection of the out-of-pocket maximum.
I was wondering if we are already on medicare, if we ,just can’t stay on what we have already.we have part A&B..do we have to change or just leave it the way it is ????ty Gerry
Gerry, You are not required to either join a Medicare Advantage plan or purchase a Medigap policy. Your also not required to join a Part D plan but that is highly recommended so you don’t incur a late enrollment penalty at some point in the future when you may need it. here’s an article on original Medicare and Part D that may be helpful.
My husband and I have been on medicare for three years. We also have a health insurance plan with his former company which is about $600 mo plus paying for part B mo. We have been discussing changing to an advantage plan. We have an out of pocket of $1500yr increasing to $3000 this year. We have never been near the top so they never pay for anything except drugs which are not very much. Another option is to just keep medicare part A &B and get a drug plan. We have concerns about how well advantage plans pay, are they obligated to follow medicare rules?
Kathleen, Great question. There has probably never been a more regulated insurance product than Medicare Advantage plans. They are required to follow rules set by CMS and you will generally not have an issue with a plan paying for a covered service. The key will be for you and your husband to find a plan that will meet your needs and budget.
When choosing a plan consider the provider network, out-of-pocket costs, maximum out-of-pocket and what additional benefits are included. The three most important plan documents are; Provider Directory, Summary of Benefits, Part D Formulary.
You might also consider a Medigap policy. You will more than likely have lower premiums than you do with your current policy. Medicare Supplement Plan N is a good alternative to a Medicare Advantage policy.If you go that route you will need to purchase a stand-alone Part D plan as well.
Gerry,
If my husband (not in good health) annual premium on Anthem’s Plan F is $1,990 versus $1,373 on Plan N, isn’t Plan N a better choice even if he has to pay the Medicare Part B deductible of $162? His only other cost would be $20 per dr. visit and $50 for ER? He will still need Part D — he requires a lot of maintenance medication. This year we are already in the catastrophic stage. We now have the Anthem Medicare Advantage but no longer available for next year.
Winnie, On the surface, as you have explained it, it would seem that Plan N will require less out of pocket unless your husband has an inordinately high amount of doctor’s visits and trips to the ER.
Hello David:
I have been looking into the Supplemental Plans for dear friends of mine. They currently have Plan F through Horizon Blue Cross Blue Shield along with the RX Plan 2. Their premiums are quite high each month so I looked into trying to see other plans costs. Please correct me here, it seems that even though their premiums are high they have great coverage, no co-pay, 100% of pretty much everything. I did look at Plan N for them and even though that plan appears to be pretty good given the husbands previous healthcare I want to recommend to them to stay where they are?? That’s where I need your expertise please. The wife is 76 and in great shape with minimal Dr.’s visits so clearly on her it would save to go to the less expensive plans per month while still no laying out co-pays, etc. I do see a year end cost savings, however her husband is 83 and last year had quite a few tests done, etc. due to diminishing health. My fear is to advise that she go to another plan such as N or even that she go to another insurance provider since he does have pre-existing conditions. With all this said and my research I have read that even though all plans whether it’s F, N, etc. are suppose to be the same on the same website it also states that premiums are not because some insurance companies plans do have a bit of extra coverage which to me would mean that all plans are in fact not exactly the same?? I haven’t even gotten into looking at their RX plans yet , she has very little drug needs while her husband has a good amount and some that there is not a generic offer for. I know she only goes to the local pharmacy so perhaps if she tried Walmart or CVS that could help. Thoughts and advice please David. Thank you!!
Denise, Your friends are lucky to have someone like you trying to help. All Medicare supplement / Medigap policies are standardized. If a company does offer extras, it’s normally nominal such as discounts on eye exams and such. Plan N normally has a lower premium because the policy holder is responsible for the Part B deductible and will incur copays up to $20 for a doctor’s visit and $50 for ER. Also excess charges are not covered.
The wife may see some premium savings but usage could negate that with the above mentioned out-of-pocket expenses. Switching plans outside of Open Enrollment (first turning 65) and Guaranteed Issue Periods (losing employer group etc.) will require underwriting. It sounds questionable given your description that the husband will qualify. Unless there is an extreme hardship I would be very cautious in changing people from Plan F.
Given the fact that there is so much variation in Part D coverage, you may find after doing some research that you can make the biggest impact on their budget in that area. Open Enrollment for Part D ends December 7th.
Thank you so much for the quick response. I have looked into the Rx Plan’s and with her husbands medicine needs I think they perhaps should stay with what they have. It’s a couple more dollars but the coverage is pretty good. Thank you again for helping me make this make sense.
Thanks for the knowledge of secure horizon not renewable I did not get a notice and I HAVE CALLED THEM SEVERAL TIMES WITH NO ANSWERS TO MY GUESTION OF WHEN I WOULD RECEIVE MY INFO ABOUT MED,COMPLETE.