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Medicare Supplement Plan N reduces how much Original Medicare enrollees have to pay out of pocket for health care. For example, Plan N pays 100% of the coinsurance for hospitalization (Medicare Part A) and medical care (Medicare Part B).
Plan N, one of 10 Medicare Supplement or Medigap policies, provides greater coverage than most of the other supplemental plans on the market. This includes Plans A, B, D, K, L and M.
It isn't the most comprehensive plan available. However, Plan N is a great choice for those who are willing to pay an average of $152 per month to have most medical expenses covered by the policy.
How does Plan N work?
Like other supplemental policies, Plan N fills coverage gaps in traditional Medicare, thus making it easier for beneficiaries to meet their overall health care expenses. Because only about 80% of medical costs are covered by Medicare Part A (hospitalization and inpatient care) and Medicare Part B (outpatient services), supplemental plans can help pay for the remaining 20% of costs.
Among other benefits, Plan N covers the entire coinsurance costs for Medicare Part A, Medicare Part B, hospice care and skilled nursing facility. This means that instead of an enrollee being charged 20% of the bill as would happen with Original Medicare, the supplemental plan would pay that 20% of the bill.
One of the most important features of Medigap Plan N is its copays — you pay a $20 copay for each physician visit and a $50 copay for each emergency room visit that does not result in hospitalization. Even though the supplemental plan pays the coinsurance charged by Original Medicare, the supplemental policy has its own copayments for these services. Most Medigap Plan N policies do not charge for visits to urgent care centers, though.
Beneficiaries buy supplemental Medigap plans through private insurance companies such as Aetna, Cigna and UnitedHealthcare, among others. Each supplemental plan category bears a distinct letter, denoting differences in coverage, monthly premiums and out-of-pocket expenses.
It is important to note, however, that policies sold by insurance companies are standardized across the country, meaning a Plan N policy sold by Aetna covers the same core benefits as a Plan N sold by Cigna and other carriers.
How supplemental policies work
- Medicare Parts A and B pay their share of medical expenses, usually 80% of costs.
- Supplemental plans then pay their share, filling in gaps of Medicare Parts A and B based on the plan's level of coverage.
- Beneficiaries then pay the remainder of the costs, if any.
What does Plan N cover?
Plan N covers the Medicare Part A deductible of $1,556, coinsurance for Parts A and B, three pints of blood and covers 80% of medical costs incurred during foreign travel.
Plan N does not provide coverage for the Medicare Part B deductible ($233 in 2022). Moreover, its copays do not count towards meeting the Part B deductible. Most Plan N policies do not carry a separate deductible aside from the Part B deductible.
Plan N also does not cover Medicare Part B excess charges — the amount providers can charge over and above Medicare costs if they do not accept Medicare-approved rates. And there are no out-of-pocket limits for Plan N.
Plan N coverage
|Part A coinsurance (hospital care)|
|Part B coinsurance (medical care)|
|Blood (first 3 pints)|
|Part A hospice care coinsurance|
|Skilled nursing home coinsurance|
|Part A deductible|
|Part B deductible|
|Part B excess charges|
|Foreign travel emergencies|
Costs of Plan N
Monthly premiums for Plan N can average between $120 and $180, climbing over $200 in some states and dropping as low as $80 in other states. Rates are determined by location, age, gender and in some instances, current health status.
This monthly cost is on top of the cost of Original Medicare (Parts A and B). Most enrollees get Part A for free, and in 2022, Part B costs $170.10 per month.
Plan N does have copays for some medical services: $20 per physician visit and $50 for each hospital emergency room visit that doesn’t result in admission.
Medigap Plan N vs. Plan G
Plan N and Plan G are frequently compared to one another. We recommend Plan N if you want lower monthly costs and are willing to have some expenses for medical care like doctor appointments. However, Plan G is a better option if you're willing to pay more each month for a plan that provides the most comprehensive coverage for new enrollees. Note that neither plan covers the Medicare Part B deductible.
|Medicare Part B coinsurance for medical care|
|Medicare Part B excess charges|
The cost structures may determine which plan is better for you.
The standard Medicare Supplement Plan G has higher monthly premiums than Plan N, making Plan N a budget-friendly choice. Plan G, however, does not impose copays for physician office visits or trips to the ER that do not result in hospitalization, a major difference from Plan N, thus appealing to beneficiaries who do not like shelling out copays for these services. Conversely, other beneficiaries may not mind paying more in copays, especially if they do not make frequent trips to physician offices or ERs.
With Plan N, low-end users of health services may come out ahead. High-end users of health care services will have a different experience.
Let’s say, for example, that a Plan N costs $150 in monthly premiums while a Plan G costs $200 a month, resulting in $50 savings for Plan N. But if a beneficiary with Plan N visits the physician three times in a month, that beneficiary will pay an extra $60 in copays. That's $10 more than what would have been saved that month by choosing Plan N over Plan G.
Similarly, if that same beneficiary visits the ER and the visit does not result in a hospitalization, the beneficiary will pay a $50 copay, resulting in the same total cost that month for Plan N as they would pay for Plan G.
It is difficult, if not impossible, to predict how many times you are going to have to visit a physician or an ER in the course of a year. But based on these sample plans with a $50 monthly difference in prices, it would be worth it for someone expecting to visit a physician more than 30 times a year to upgrade from Plan N to Plan G.
High-deductible Plan G is a low-cost alternative
Insurance companies sell two types of Plan G plans: one called a standard plan, and the other a high-deductible plan, which requires beneficiaries to meet a yearly deductible of $2,370 before the plan begins to pay. Once the deductible is met, the plan pays 100% of covered services.
With the high deductible Plan G, beneficiaries pay low monthly premiums, averaging $40 or $20 a month and even less in some cases. The amount paid toward the plan’s deductible counts toward the Part B deductible. In other words, as beneficiaries meet the plan’s own deductible, they are also satisfying the Part B deductible.
Plan costs can vary. For example, a 65-year-old non-smoking woman living in suburban Virginia, just outside of Washington, D.C., would pay $43 in monthly premiums for a high-deductible Plan G policy through UnitedHealthcare (UHC). That same woman would pay $112 a month in premiums for the standard Plan G or $89 a month for a Plan N policy.
The high-deductible Plan G may be a viable alternative for healthy Medicare beneficiaries who want low monthly Medicare premiums associated with the high-deductible plan.
Many beneficiaries look at the high-deductible Plan G as a catastrophic plan because the beneficiaries who require little in the way of medical services and may never come close to meeting the $2,370 deductible. But if they have a catastrophic event or illness, the deductible is quickly met, and the plan then pays 100% of covered services for the calendar year.
The standard Plan G has monthly premiums running as high as $250 to $300 in some states such as New York and Florida. In Iowa, the monthly premiums for the standard Plan G policy can be as low as $80 a month.
Like Plan N, neither the standard nor high-deductible Plan G has out-of-pocket limits. Plan G policies, like Plan N, also travels, picking up 80% of medical costs incurred during trips abroad.
Is Plan N or Plan G more popular?
Medigap Plan G is the most extensive and popular plan available to beneficiaries who first enrolled in Medicare after 2019. Plan N is the second most popular plan behind Plan G.
(Plans C and F provide greater coverage than both Plans N and G, but are not an option for beneficiaries who first enrolled in Medicare after 2019.)
Plan G is a more popular plan than Plan N for two reasons — its coverage is more comprehensive and, most importantly, it does not impose copays for physician and ER visits that don’t result in hospitalization.
Also, Plan G’s expenses are more transparent than Plan N costs, mostly paid up front through deductibles, making it easier to budget for health care expenses. With Plan N, beneficiaries are required to pay copays for physician and ER visits, costs that can quickly add up during the course of a year. These costs are not always predictable or apparent because a beneficiary may not know how many times he or she will have to visit the physician or ER.
Is Plan N the best supplement plan for you?
Medigap Plan N is a popular plan that is a good choice for many people. However, there are multiple factors to consider when choosing the best plan for you.
- Coverage versus cost: Beneficiaries should first determine what they want in a Medigap policy— what the plan needs to cover and whether it is affordable. These are the two primary factors when deciding which plan is right for you.
- Pricing differences between providers: The costs of Medicare supplemental policies often vary among insurance carriers. For example, one company may provide cheaper monthly premiums for Plan N than another carrier. Another insurance company may provide discounts for non-smokers or for being married, discounts not offered by a competing insurance provider.
- Out of pocket expenses: Also consider whether the plan has its own deductible, how much of Medicare's coinsurance it covers and if it imposes copays that could significantly add costs during the course of a year.
- Plan restrictions or perks: In some instances, an insurance company may require you to see certain providers in exchange for a lower premium. Some companies may also provide extra benefits like free gym memberships, for example, or help with vision and dental services.
Medicare Supplement Plan N reviews
Plan N is available from our three top Medicare Supplement companies for 2022: Aetna, Cigna and AARP/United Healthcare. Among these providers, you'll save an average of $31 per month by choosing Plan N over Plan G.
Monthly cost for a 65-year old female non smoker
Your actual costs for Medicare Supplement plans can vary by age, location and other factors. Request a personalized quote to find out how much you'll pay.
Remember that coverage for Plan N is standardized so you'll get the same medical benefits with all providers. However, providers have different rates, customer service and add-on benefits.
Aetna Medicare Supplement
The cost for Aetna's Medigap plans is consistently cheaper than its main competitors, and the combination of low costs and overall customer service for policyholders makes Aetna Medicare Supplement one of our top recommendations.
Aetna falls short based on the customer complaint index from the National Association of Insurance Commissioners, (NAIC), scoring a 1.57 for its Medicare supplement product, meaning its complaint performance was significantly worse than the average of 1.00 across the country.
Cigna Medicare Supplement
Cigna Medicare Supplement is available in 48 states, but the company only offers four Medigap policies – A,F, G and N – in 46 states. These are the most popular Medigap plans, making it highly likely that beneficiaries will find a plan they like in these states.
Cigna's rates are generally higher compared to other competing companies. But the company offers a rewards program as part of its supplemental plan coverage, providing discounts on health and wellness programs and services, adding to the overall value of what you're getting if you sign up for Plan N.
Some Cigna members and providers complain about customer service, citing long hold times and other service delays as well as difficulty getting claims approved or paid.
AARP/UnitedHealthcare Medicare Supplement
AARP Medicare Supplement plans are a popular way to reduce medical expenses. Enrollees get discounts for vision, dental and hearing programs, as well as a 24/7 nurse line and free gym memberships where available. However, AARP/UHC Medigap policyholders must also be AARP members, adding a nominal membership fee of $16 a year.
With an AARP/UHC policy, a 65-year-old may pay slightly more for a supplemental policy, but yearly increases are generally lower with these plans, meaning a beneficiary could end up paying less for a plan when they are in their 70s or 80s.
Most complaints about UnitedHealthcare result from the company’s handling of claims. Other complaints cite too much junk mail generated by the company, overly aggressive marketing and poor customer service.
Frequently asked questions
Is Medicare Plan N a good plan?
Medigap Plan N combines fairly extensive coverage with relatively modest premiums, making Plan N a good policy. It is important to remember that Plan N imposes copays for physician visits and trips to ERs that do not result in hospitalization. These costs can quickly add up for high-end users of health care services. As a result, Plan N is probably best suited for beneficiaries who do not require a lot of physician and ER visits during the course of the year.
How popular is Medicare Plan N?
Amount 10% of all Medigap enrollees have Plan N, making it the third most popular plan overall, and the second most popular plan for new enrollees.
Does Plan N have a deductible?
Most Plan N policies do not have a deductible. However, beneficiaries enrolled in Plan N are required to meet the Medicare Part B deductible, $233 in 2022.
Does Plan N have a maximum out-of-pocket limit?
Plan N does not have an out-of-pocket limit. Only two supplement plans have an out-of-pocket limit: Plans K and L.
Can I have Medigap Plan N while enrolled in a Medicare Advantage plan?
No. Medigap policies are only available to people enrolled in the Original Medicare program. They cannot be used by beneficiaries in Medicare Advantage, also called Medicare Part C. Medigap policies are true supplement plans, augmenting, not replacing Medicare Part A and Part B coverage.
Methodology and sources
Sources for the above comparisons include Medicare.gov, insurance providers, the Better Business Bureau, J.D. Power and the National Association of Insurance Commissioners. Comparisons are based on plan details, coverage levels and cost data.