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Medicare Supplement Plan N

Several Oranges and One Green AppleWhat 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 the following year. 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 Advantage plans.

If you have never been insured through a Medicare supplement and have always be covered by a Medicare Advantage plan, get out * Part video Mini-Course to help you understand the plan differences.

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 $183 annually
  • Up to a $20 co-pay for a doctors visit
  • Up to a $50 co-pay for an emergency room visit
  • Any Part B Excess Charges will be your responsibility

Comparing Plan N between companies couldn’t be easier. Since benefits are standardized all companies will be offering the identical plan. It just comes down to price and how you feel about a particular company. You can compare Plan N by visiting the eHealthInsurance website.

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. Unlike a Medicare HMO, you have more freedom to choose your providers. 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 or any other company’s 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 does not renew for the following year you are guaranteed acceptance into a Medicare supplement plan.

 

Learn More About Medigap Guaranteed Issue Rights


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.

63 comments

  1. 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.

  2. 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

  3. 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!!!!

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Thanks Ken. I appreciate the positive feedback.

  9. 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

  10. 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.

  11. Grayson Reinhard

    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

  12. 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.

  13. Grayson Reinhard

    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

  14. 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.

  15. Grayson Reinhard

    Thanks again, David. Very helpful information.

    grayson

  16. 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 🙂

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  21. 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.

  22. 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

  23. 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.

  24. 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?

  25. 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.

  26. 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.

  27. 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.

  28. 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!!

  29. 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.

  30. 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.

  31. David, I am turning 65 in July,2012 and I am so confused as to what to do for additional protection besides my medicare. My biggest problem is that I have no savings at my age due to problems with my children. Therefore, can you tell me which I should choose? As of August I will receive about $150.00 a month from a job I worked at. In addition I have my SS and a small pention from my late husband. Those two total about 2200.00 per month, before my monthly medicare will come out. What is your best advice for me? I am on perscriptions so I do need that protection also. Thank you for this column.

  32. Jan, Anyone advising you would take into consideration both your health and total budget. If you consider budget for a minute, you can see how difficult it would be to offer advice based on an income figure alone. For instance, are you debt free or do you need the majority of your income to get by month to month? Another consideration would be; what types of Medicare Advantage plans are available where you live? Some counties may have a couple dozen and others one or two. I would recommend that you meet with an agent in your area who can do a needs assessment and guide you based on your circumstances and what is available locally.

  33. David,

    I am new to medicare. I am 69 and my wife is 68 so all the plan premiums etc are x 2. I have had employer coverage until now. I am looking at both the advantage ppo plans and supp plans F, F*, N and G. The advantage plans are quite lower as my wife and I are in fairly good health. If I join an advantage plan and decisde a few years later that a supp plan would be better can I switch and what are the pitfalls. I heard I cannot switch with out undrwritng and could be refused. Unlike the supp plans which are guaranteed issue and no premium increase except for attained age.

  34. Harry, If you join an Advantage plan and wait more than one year to buy a Medigap policy you will lose the guaranteed issue rights that allow you to join an Advantage plan (if it’s your fist time in such a plan) and then change your mind and buy a Medigap policy. So the main draw back (other than the difference in plan benefits) will be the underwriting after the first year.

  35. Great site David.I am 56 and have been disabled 22 yrs now.Back then they didn’t have all the plans out they do today.I just bought a medigap plan N this month.As I was in the hosp 1 1/2 mo ago,for 3 days.I will have to pay this one out of pocket $24,000.But medicare will pay their part.So,being it was my 1st time ever in a hosp for being sick(They found a GIANT ulcer and kidney stones,said was due to my diclofinic and meloxicam)my anti-inflamitories,so was med related.I am worried about the stones,so just got insurance.Will start the 1st of April.The price wasn’t bad $166.31 for under age 65.But I saw in the policy,they had a 6 mo waiting period on pre-existing conditions.But called them (Anthem) and they said NO,I had credible coverage having medicare for so long.So,now I don’t know what to believe.My doc wants another upper GI to check for lymphoma cancer,but in the hosp,I had it done by the GI doc,and they checked 2 biopsies and said NO cancer.But don’t know if that was checked.That cost $4500. I feel I should wait the 6 mo out,cause I know they lie and say it’s covered,then WHAM!Oh,No it wasn’t.What do you think? I loved plan N for me,cause they wanted $350.a mo. for plan F.Thanks and I love this site.

  36. Xylie, I wouldn’t take a chance. It sounds as though your procedure will be covered. Ask anthem to send you a letter in writing that you are not subject to the pre-existing condition clause. Even if it wasn’t, $4500 is minor cost compared to your health.

  37. I will be going on medicare in July, and am trying to decide on a supplement plan. Have done some research but might as well be written in Greek!! My income is around 2200. a month and pretty much debt free. I live in Northeast Texas, so can you point me in the right direction?? Would like to get the best plane without breaking the budget. Please help!! Thanks……..

  38. Carol, If you haven’t signed up for our free mini-course, I would do that. It will eliminate a lot of confusion. I don’t recommend specific insurance companies, but if you are leaning towards a supplement rather than a Medicare Advantage plan it may help you to know that more people buy Medicare Supplement Plan F than any other plan. It is the most comprehensive. Benefits will be the same with all companies because the plan is standardized. This makes it easy to compare between companies because it mostly comes down to differences is premium. Some companies such as United Healthcare and others will include some health related discounts (i.e. vision etc.) but unless premiums are the same I wouldn’t let that drive my decision. Also, keep in mind that you will need to enroll in a separate Part D plan, as supplements do not include drug coverage.

    If you are leaning more toward a Medicare Advantage plan, you can visit medicare.gov to locate plans in your area. A local insurance agent may be able to help you or you can speak with someone from your local Area Council on Aging office that can offer unbiased advice.

  39. David, I’m not sure what the out of pocket max is for Plan N. Would you happen to know?

  40. Charles, As a Medigap policy Plan N does not have a maximum out-of-pocket. The concept is really not relevant in the way maximum out-of-pocket is with Medicare Advantage plans. Your share of covered expenses are paid by the plan. The exceptions are your responsibility to pay the Part B deductible which will be $147 for 2013 and up to $20 co-pay for an office visit and $50 for an ER visit. There is no limit on how many co-pays you will pay, but at $20 and $50, unless you are in the doctors office or ER every week it should be manageable for most people who would choose the plan.

  41. David, I believe you are wrong with your advice on Plan N. You state “…and up to $20 co-pay for an office visit and $50 for an ER visit. There is no limit on how many co-pays you will pay, but at $20 and $50, unless you are in the doctors office or ER every week it should be manageable…” Claim Departments of two Plan N providers have confirmed the following: the $20 copay is for every medicare-billed visit by a doctor, including doctor visits while you are in the hospital! For example, if 4 doctors see you daily, for 7 days you are an inpatient, your copay is $560 (4x7x$20) under Plan N! In short, the $20 copay under Plan N is not limited to outpatient office visits. It also includes inpatient visits by doctors. When I called Medicare to confirm this, I was told I should contact Plan N providers for more information.

  42. Gary, Thanks for your comment. It seems somewhat strange that when you called Medicare they could not answer a question about a standardized insurance policy. You would think that given the standardized nature of Medigap they could have answered a simple question.

    I’m basing my advice on what I found in the Medicare publication, “Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare“. Section 2 page 11 states below the benefits chart, “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.”

    In my opinion there is a difference between an office visit and an inpatient physician’s visit. Either the definition of an office visit is open to interpretation or the two insurance company claims departments have both made a simple error or are really good at what they are commissioned to do… i.e. get your money! You may want to consider Plan F if anything you have learned about Plan N or the companies you spoke with concerns you.

  43. I will be 65 in November and need to select a medicare supplement plan. I want drug coverage for sure with the lowest co-pay possible for meds and doctor visits. What should I be looking at? I live in California and am still working.

    Looking forward to your replyl

  44. Alejos, A Medicare supplement will not include drug coverage. Plans that include drug coverage are Medicare Advantage plans, which are available County by County. given your reference to drug coverage and Dr. visit copay you may want to explore available medicare advantage plans. Visit medicare.gov and click Find Health and drug Plans. Also, sign up for my free mini-course on Medicare plans to learn more about your options.

  45. Walter Haulenbeek

    I’m almost 65, living in NC and I’ve enrolled in Med. part A and B. My income is limited, but I’m in good health. I’m thinking about an advantage plan because of the lower monthly cost, but I’m concerned that the out of pocket costs could be really high if I need care. Would a plan N be a wise choice? Thanks for the advice!

  46. Walter, Many people consider Plan N to be a good alternative to an Advantage plan, but keep in mind that you will also have the added expense of a stand-alone Part D plan. I would recommend that you consult a local agent licensed in NC who can do a thorough needs analysis.

  47. Walter Haulenbeek

    Thank you for responding so quickly! I’ve decided to go for a Blue Advantage plan with a premium of about $16 per month which also gives part D coverage. I would pay about $100.00 for plan N and about $30.00 – $40.00 for part D. My monthly premium costs will be on the order of $120.00 for part B plus the Advantage plan, or about half the supplement plan alternative. At this point, I’m going to bet on my continuing good health and not needing the medical establishment. Fortunately we have the option to change in a year if need be. Thank you for shedding light on what can be a really confusing topic. I’ll continue to check in to see how the conversation is unfolding.

  48. David,

    I am just starting to look into medicare, I will be eligible in September. I am confused by this statement you made “If you join an Advantage plan and wait more than one year to buy a Medigap policy you will lose the guaranteed issue rights that allow you to join an Advantage plan (if it’s your fist time in such a plan) and then change your mind and buy a Medigap policy. So the main draw back (other than the difference in plan benefits) will be the underwriting after the first year.” Can you explain this, thank you

  49. Lynn, I’m sorry, that statement is a little convoluted. If you enroll in a Medicare Advantage Plan when you’re first eligible for Medicare Parts A and B and it has been less than one year since you joined, you will have Guaranteed Issue Rights to buy a Medigap policy. When you have these rights the company cannot use medical underwriting to either deny you coverage or charge you more.

    If you are not in your Medigap Open enrollment Period or have Guaranteed Issue rights, companies can (and do) consider your health as a means of qualification. If you are becoming eligible in September and would like to buy a supplement, you should do so in your Open Enrollment Period, it’s the best time to buy.

  50. Walter Haulenbeek

    I enrolled in Medicare part A and B this year as of my birthday in March, and I elected to take an advantage plan. So I pay $104.00 for part A, and my Blue Advantage plan premium is $16.00 per month, which covers the prescription drug part. I have heard that advantage plans may become unfunded, so I’m considering taking a supplement plan, maybe plan N. Should I start looking into this soon, or should I wait a little longer?

  51. Walter, You can buy into a Medicare supplement during your Medigap Open Enrollment Period which lasts for 6 months from your Medicare effective date. So I wouldn’t wait if you want to change. If you wait past the 6 months but are still within one year of enrolling in Medicare Advantage and would like to buy a supplement, you can because you are entitled to Guaranteed Issue Rights as longs as it hasn’t been more than a year that you were in the Advantage Plan. The only issue with Guaranteed Issue Rights is that the insurance company can limit which plan you buy and they may not sell you Plan N. So, make your move prior to the end of September.

  52. Hi Dave,
    Reading with interest – great info. Regarding O-care to begin 01-2014 – any info on how Medicare Advantagep plans will be affected? Also, I will be 65 in April 2014 – are they going to fine me if I wait until April when I can be on Medicare? This all sucks!!

  53. Angie, Since funding was not cut for 2014 plans I don’t think there will be major changes, but what may happen in the years to come does not look as certain.
    I’m not sure about the fine being that you will be so close to 65. I think the whole thing is going to be a nightmare for those who would like to assert their will on the population. The fine for 2014 will be very small if they do go through with it and will surely be less than the premium for a 64 year old.

  54. KRIS, you have totally misunderstood Plan N, where do you get the idea that it will only pay up to $2600.00 in a year ??? Part B benefits has absolutely no upper dollar limit with plan N and it pays Part A benefits exactly as plan F…I think you must be confusing it for something else. And by the way, Plan N for the money may just be the best value out there. I have been offering medicare supplement plans for over 30 years Math is my strong suit.

  55. Dave,
    What is the basic difference between Plan F and Plan N?

  56. Dave, Plan F will pay your share of all covered Medicare expenses. With Plan N you will be responsible for: up to a $20 copay for doctor’s visits, $50 for ER and will also pay the Part B deductible… currently $147 per year.

  57. Dear Dave
    I think you need to point out that Plan “N” does not cover Medicare Excess charges, especially since a lot of Doctors are not accepting medicare approved amounts
    Drs that do not accept medicare approved amounts can and will charge more for services, which plan “n” will not pay for, this can and will be more of a problem in the future

  58. As a follow up, you are leaving people to believe that plan “n” is the same as “F” or “G” except for small copays, and that is not true unless you happen to live in a state with “MOM” laws

  59. Bill, You make a valid point. I’ve modified the article to reflect the policyholders responsibility for Part B excess charges. Thank you.

  60. Hiiii,
    What r the 20% coinsurance amounts mean. Can this be avoided.
    Can the excess charges also be avoided?
    I am turning 65 in March.
    Paula

  61. Paula, The 20% coinsurance amount is the amount that is your share of medicare covered expenses for outpatient services. For example, if you go to the doctor and the approved medicare charge is $100, you will be responsible for $20. Some Medigap policies (Medicare supplements) will pay the 20% coinsurance. Additionally, you can enroll in a Medicare Advantage Plan and avoid paying the 20%, although you will generally pay copays or some coinsurance for outpatient services. Sign up for my Free 8 Part Video Mini-Course if you haven’t already done so, it will answer many of your questions.

  62. I dropped my supplemental insurance several years ago (aarp) when I enrolled in the VA hospital where I lived.

    Now (age 73) I feel the need to return to having a supplement due to the VA back log and long wait for appointments.

    I would like to do this asap and I also need to know if I might be eligible for Cover California coverage as a medicare enrollee. Also, I am not sure whether plan F or N is best. I never paid a co-pay at a doctor’s office or hospital before.

  63. Nancy, You should be able to purchase a Medicare supplement policy as long as you can pass medical underwriting. I believe Cover California is for people under 65 and not eligible for Medicare. Both plan’s F and N are good plans. If you don’t mind the copays with Plan N you’ll get a little lower premium.

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