Navigating Medicare Plan N & Medigap Supplement Insurance

• Original Medicare beneficiaries can enroll in a Medicare supplement insurance plan known as Medigap or MedSupp to ​“fill in the gaps” of their health plan’s coverage. Medicare Advantage beneficiaries cannot enroll in a Medigap policy, however. 

• Medigap helps cover Medicare-approved expenses. It will not cover dental and other such costs that are not included in Original Medicare plans. 

• Medigap Plan N is one of the most popular Medicare supplemental insurance policies due to its lower premiums.

Medicare is a government health insurance program created by the federal government in 1965. Medicare plans provide health insurance for those age 65 and older, younger Americans with disabilities, and those with end-stage renal disease (ESRD).

There are two main ways someone can enroll in Medicare: Original Medicare or Medicare Advantage.

While Original Medicare covers many healthcare services, it does not cover everything. That said, those who decide on an Original Medicare plan have the option to add on a Medicare supplemental insurance policy to their coverage. These plans are known as Medigap (or MedSupp). 

There are various types of Medigap policies to choose from. The most popular among beneficiaries are Medigap plans F, G, and N. This article will explain everything that Medicare beneficiaries need to understand about Medicare, Plan N, and Medigap policies in general.

The Federal Medicare program is made up of government-run health insurance plans for Americans age 65 and up, as well as younger Americans with disabilities and those with end-stage renal disease (ESRD). There are two main ways to sign up for Medicare coverage. Enrollees can either enroll in an Original Medicare plan or a Medicare Advantage plan.

Original Medicare is the first iteration of Medicare. Original Medicare benefits are divided into two Medicare Parts: Medicare Part A and Medicare Part B. Each of these portions covers specific types of healthcare services.

What is Medicare Part A?

Medicare Part A (hospital insurance) encompasses inpatient healthcare services received during hospital stays. Some of these services include:

• Inpatient hospital care

• Skilled nursing facility care

• Nursing home care (non-custodial or long-term care)

• Hospice care

• Home healthcare

What is Medicare Part B?

Medicare Part B (medical insurance) covers outpatient healthcare services. Some of these services include:
 

• Medically necessary doctors visits
• Certain vaccines
• Durable medical equipment (DME)
• Clinical research

• Emergency room visit

Medicare supplement insurance plans supplement Original Medicare in order to provide beneficiaries with more comprehensive health coverage. Most Medicare supplement plans have contracts with local insurance agencies and providers, allowing them to regulate pricing on certain services or items, known as the Medicare approved amount. There are three main types of supplement plans:

• Medicare Advantage: Medicare Advantage (also known as Medicare Part C or MA plans) consists of Medicare Part A and Medicare Part B. Many Medicare Advantage plans also include Medicare Part D, as well as other additional benefits such as hearing, dental, vision, and more. MA plans are sold by private insurance companies.

• Medicare-Medicaid (Dual Eligibles): Medicaid is a state-government-run health insurance program created for low-income adults, children, pregnant women, elderly adults, and people with disabilities. Some Medicare beneficiaries qualify for both Medicare benefits and Medicaid benefits, a program known as Dual Eligibles. 

• Medigap (MedSupp): Medigap plans (also known as MedSupp) are policies that are sold by private insurance companies. Many Medigap policies help pay out-of-pocket costs such as deductibles, coinsurance, and copays. Medigap benefits will vary based on the supplemental policy chosen. 

Medigap policies ​“fill in the gaps” of Original Medicare. While Original Medicare pays for many health-related services, it will not cover all the costs. This is where Medigap comes in. Medigap can help pay for the remaining medical expenses and hospital costs such as: 
 

• Copayments
• Coinsurance
• Deductibles

Medigap will not pay for healthcare services that are not part of Original Medicare benefits, meaning a Medigap policy will only cover Medicare-eligible expenses. Examples of what is not covered by a Medigap policy include:
 

• Long-term care
• Vision care
• Dental care
• Hearing aids
• Eyeglasses
• Private-duty nursing
• Prescription drug coverage (you can purchase a Part D plan for this coverage)

Are There Different Types of Medigap Plans?

Yes, there are different types of Medigap plans. These Medigap policies are lettered ​“A” through ​“N.” Each Medigap plan pays for core policy benefits. What is covered (i.e. deductibles, copays, and coinsurance) will vary based on the specific Medigap plan chosen.

Medicare Plan N is one of the most popular plans chosen by Medicare beneficiaries in 2021.

Medicare Supplement Plan N is best for beneficiaries who want a lower monthly premium without that lower cost affecting coverage. The reason Medicare Supplement Plan N is able to price premiums at a lower cost is that there are still copays involved, although these are small. Medicare Supplement Plan N enrolees are also responsible for paying Medicare Part B’s deductible. 
 

How Much Does Medicare Supplement Plan N Cost?

Medigap requires monthly premium payments. Your combined Medicare and Medigap policy will also most likely have a Part B deductible to pay before Part B coinsurance and copayments are covered. Once the deductible is covered, the beneficiary is responsible only to pay up to a $20 copay for office visits or $50 for emergency room visits. However, most costs of Medicare Supplement Plan N will vary based on the beneficiary’s location as well as the insurance company they buy the Plan N policy from.

Beneficiaries can get an estimate for Plan N’s costs by using Medicare’s plan finder tool. All they need to do is plug in their zip code to get estimates for their area. This tool also gives interested parties the option to compare Medicare supplemental insurance plans.

For more information on Medigap Plan N costs, visit this source.

Medigap plan benefits differ slightly, depending on which plan letter you choose, as does the average monthly premium. Plan N’s covered services include:

• Part A hospital and coinsurance costs
• Part B Copays and coinsurance costs
• Part A hospice or skilled nursing facility care copays and coinsurances
• First 3 pints of blood
• Part A deductible
• Part B deductible
• Part B excess charges

One benefit of Plan N that isn’t featured in some other Medigap plans is that this plan covers foreign travel emergencies (up to 80%). That means hospital benefits on this plan extend to international settings, though outpatient care must be provided in the US by providers who accept Medicare plans.

Does Medicare Plan N help cover emergency care?

If someone requires an emergency visit, Plan N pays for some billed charges not covered by Parts A and B. This includes many costs associated with ER visits, the first three pints of blood when blood transfusions are medically necessary, and other services.

However, it’s important to note some copays for emergency room visits and outpatient visits at doctor’s offices or other facilities may not be covered. This can vary depending on when a benefit period begins, where you receive services, and whether the amount a doctor or other health care provider is legally permitted to charge is more than the Medicare approved amount. 

Given there are many Medigap plans to pick between, it is understandable that someone may feel overwhelmed by their choices. Below are some best practices for picking the best plan for someone given their situation, medically and financially:

• Call State Health Insurance Assistance Program (SHIP). SHIP can provide free guidance in choosing a policy. Do note, not all states participate in SHIP. Learn more at this resource.

• Research online: Visit the official website of the Centers for Medicare & Medicaid Services for complete details on everything there is to know about the particulars of Medicare coverage. 

• Discuss options with a licensed insurance agent: Licensed insurance agents can help enrollees navigate their Medigap choices and help them make the best decision. 

• Contact Medicare: Get the contact information for Medicare at this resource.

• Review medical records: For those who have infrequent doctor visits, Plan N may be a good option because of its lower monthly premiums. 

• Compare Medigap policies: This page found on the official Medicare website lays out everything beneficiaries need to know about the various coverage levels available when it comes to Medigap.