Navigating Medicare Plan N & Medigap Supplement Insurance
Article at a glance
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.
What Is The Federal Medicare Program?
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.
What Is Original Medicare?
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
What Are Medicare Supplement Plans?
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.
How Do Medigap Policies Work?
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 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
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.
How Does Medicare Supplement Plan N Work?
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 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 per office visit 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.
How to Choose The Best Medigap Plan
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.
Medigap FAQ
How are Medigap policies standardized?
Medigap policies are standardized, meaning these Medicare supplement policies must follow both state and federal laws. These laws are in place to protect beneficiaries. For example, insurance providers must clearly identify Medigap as "Medicare Supplement Insurance."
All Medigap policies offer the same basic benefits, meaning Medicare supplement plan g by a certain health insurance company is the same as medigap plan g offered by a different health insurance company. Not to mention, the Medicare approved amount on various health costs will be the same no matter which health insurance company is picked as well. The only difference between the same Medigap plans offered by different companies is the price of what you pay for them.
Do note, Medigap policies are standardized in a different way for those who live in Massachusetts, Minnesota, or Wisconsin.
Note: Learn more about Medigap at this resource.
When is the best time to purchase a Medigap policy?
The official Medicare website recommends Medicare enrollees buy a Medigap policy during the initial enrollment period (IEP).
Note: Learn more about purchasing Medigap at this resource.
Can Medigap be used with an MA plan?
No, Medigap and Medicare Advantage cannot be combined. In fact, it is illegal for an insurance provider to sell a Medicare beneficiary a Medigap policy unless they are switching back to an Original Medicare plan.
Note: Learn more about Medigap and Medicare Advantage at this resource.
When is the best time to change or drop a Medigap policy?
If a beneficiary is unhappy with their Medigap policy, they do have the option to drop or change their Medigap plan. Timing is crucial, however, in dropping or changing Medigap policies because there are instances a beneficiary may need to pay a late enrollment penalty as result.
Note: Learn more about dropping or changing Medigap coverage at this resource.
Sources
https://www.medicare.gov/what-medicare-covers/your-medicare-coverage-choices/whats-medicare
https://www.medicare.gov/supplements-other-insurance/how-to-compare-medigap-policies
https://www.medicare.gov/Pubs/pdf/11306-Medicare-Medicaid.pdf
https://www.medicare.gov/what-medicare-covers/what-part-a-covers
https://www.medicare.gov/what-medicare-covers/what-part-b-covers
https://www.medicare.gov/what-medicare-covers/whats-not-covered-by-part-a-part‑b
https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap
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