Deciding on the right Medicare Supplement Plan is a crucial part of your retirement planning. With a dozen different Medigap policies to choose from, selecting the ideal plan for your needs can seem overwhelming. Two of the most popular options are Medigap Plan G and Medigap Plan N. While these two plans share some common benefits, their key differences in coverage and cost can have significant implications. This comprehensive guide examines Plan G vs. Plan N to provide clarity, helping you determine which supplemental plan is the best fit.

An Introduction to Medicare Supplement Insurance

Before diving into the specifics of Plan G and Plan N, let's step back and understand what Medigap is and why it's valuable. Medicare Supplement Insurance, commonly called Medigap or Medigap Plans, refers to private health insurance policies that help fill coverage gaps in Original Medicare. While Parts A and B of Medicare cover a significant portion of healthcare costs, you’re still responsible for deductibles, copayments, and coinsurance. This is where Medigap comes in – it acts as a safety net to minimize your out-of-pocket expenses associated with Medicare.

Medigap Plans are standardized by the government and labeled with letters A through N. Each plan offers a different combination of basic and extra benefits to complement Original Medicare. These policies provide peace of mind by limiting unexpected medical costs, making them ideal for retirees living on fixed incomes. When shopping for Medigap coverage, Plan G and Plan N emerge as two of the most popular and comprehensive options.

Shared Benefits in Plan G and Plan N

As standardized supplements, Medigap Plan G and Plan N include several identical core benefits beyond what Medicare covers. Understanding these shared benefits can give you a foundation before examining their differences.

Part A Cost Sharing

Both plans provide coverage for Medicare Part A coinsurance and hospital costs up to an additional 365 days once your Medicare benefits have been exhausted. They also cover the Part A deductible for inpatient hospital stays.

Part B Cost Sharing

Plan G and Plan N cover the coinsurance or copayments for Medicare Part B services. The extent of coverage for Part B coinsurance differs between the two plans and will be explained in detail in the next section.

Skilled Nursing Facility Care

If you require skilled nursing care, these plans provide coverage for coinsurance associated with days 21 through 100 of your stay.

Hospice Care

Regardless of which plan you choose, you'll have coverage for coinsurance or copayments for hospice care from Medicare.

Blood Transfusions

Plan G and Plan N both cover the first three pints of blood you may need.

Emergency Care Abroad

When traveling outside of the United States, both plans provide coverage for medically necessary emergency care during the first 60 days of your trip. Certain limitations apply.

Now that we’ve reviewed the standard benefits included in Medigap Plan G and Plan N, let’s examine some of the key differences that distinguish these two options.

The Major Differences Between Plan G and Plan N

While Plan G and Plan N share the core benefits outlined above, they diverge when it comes to coverage for Medicare Part B coinsurance and excess charges. These differences can significantly impact your healthcare spending. Carefully considering them can steer you towards the right Medigap Plan based on your expected medical needs and budget.

Part B Excess Charges

One major distinction lies in coverage for Part B excess charges. Medigap policies fill gaps in Original Medicare, but they cannot control how much physicians and healthcare facilities charge for services. Medicare establishes an approved amount for procedures and services under Part B. However, providers who don’t accept Medicare assignment can legally charge up to 15% more than Medicare’s approved amount. This is known as excess charges.

Plan G offers protection by covering these Part B excess charges, so you won’t face extra costs. Plan N does not include coverage for excess charges, leaving you exposed to potentially significant medical bills if you seek care from providers that bill above Medicare’s approved amount.

Part B Coinsurance

Both Plan G and Plan N provide coverage for the 20% coinsurance under Medicare Part B. However, Plan N requires copayments for some services.

With Medigap Plan G, you’ll have full coverage for all Medicare Part B coinsurance. This means once you meet the Part B deductible, you’ll have no additional out-of-pocket costs for:

• Doctor’s office visits

• Outpatient hospital services

• Preventive screenings

• Durable medical equipment

• Mental health services

• Lab tests

• X-rays

• Emergency room visits

• Ambulance transportation

Plan N also covers the Part B coinsurance in full after you meet the deductible. But it adds copayment requirements for specific types of visits:

• $20 copayment for physician office visits

• $50 copayment for emergency room visits unless admitted to the hospital

After paying these copayments under Plan N, coverage for coinsurance kicks in. The copays apply each time you receive the applicable services. Some experts recommend Plan N if you only visit a doctor a few times per year. For those with frequent medical appointments, the copays can quickly add up, making Plan G more economical.

Monthly Premium Comparison

Now that we’ve explored the coverage differences, how do the monthly premium costs stack up?

Medigap Plan G is known for its extensive coverage but also carries higher premiums. Plan N’s structure with copayments allows for lower premiums compared to Plan G. However, don’t assume Plan N is automatically the most affordable option. Actual premium amounts vary significantly based on your location, age, gender, tobacco use, and the insurance company.

Let’s look at sample monthly premiums for Medigap Plan G and Plan N for a 65-year-old female non-smoker in New York:

• Plan G: $183

• Plan N: $160

Based on this example, the monthly savings from Plan N would amount to $23. Is this potential savings worth the tradeoff in coverage? The answer depends on your unique situation.

For infrequent users of medical services, the lower premiums of Plan N can make financial sense. But if you see doctors regularly for chronic conditions and take several prescriptions, the comprehensive benefits of Plan G are likely worth the extra monthly cost.

When pricing different policies, be sure to get quotes from multiple insurance carriers. Two companies may offer the same Medigap Plan at very different rates. Shopping around can help you find the most competitive premium for the coverage you want.

Should You Choose Medigap Plan G or Plan N?

When deciding between Medigap Plan G and Plan N, start by looking at your budget and healthcare needs. Consider factors like:

• How often do you visit the doctor or emergency room? The copays required by Plan N add up quickly if you have frequent medical appointments. In this case, Plan G offers more value despite the higher monthly premium.

• Do you travel internationally? Plan G covers emergency medical care abroad after Medicare runs out, while Plan N does not. If you travel extensively, G may be the safer choice.

• What is your prescription drug usage? Prescription costs also impact your healthcare spending. Review the gaps in Medicare Part D to determine if you need comprehensive Medigap coverage.

• Which doctors do you see? If your providers accept Medicare assignment, they won’t charge excess fees above Medicare’s approved amounts. Lacking excess charge coverage under Plan N may not be an issue.

• How important is budget predictability? The defined copays and full coinsurance coverage of Plan G allows you to accurately forecast your costs. Plan N involves some variability.

• What is your age and health outlook? Plan N offers an attractive premium now, but costs will rise as you age. If you anticipate more frequent medical care in the future, Plan G provides lasting value.

• Do you have retiree benefits? Retiree health plans may cover some costs that Medigap would cover. Review your existing coverage before choosing a Medicare supplement.

Medigap policies from different insurance companies must offer the same benefits if they have the same plan letter. But premiums often vary dramatically between carriers. Comparing rates from multiple insurers can help you maximize savings on the plan that’s best for you.

Choosing the Right Medicare Supplement Insurance Company

In addition to selecting the right Medigap Plan, you also want to choose an insurance company that provides strong customer service and reliable coverage. Here are some tips for evaluating carriers:

• Compare pricing. Get quotes from as many companies as possible to find competitive premiums.

• Consider policy stability. Look for insurers that have a track record of minimal rate increases. Avoid companies with frequent hikes.

• Check ratings. Verify the financial strength and customer satisfaction ratings from agencies like A.M. Best.

• Review complaints. Check with your state insurance department for complaints lodged against the insurer.

• Confirm licenses. Make sure the company is licensed in your state.

• Evaluate changes. Find out the requirements and costs if you want to change policies later.

• Ask about discounts. Some carriers offer discounts for paying annually or bundled policies.

The insurance company you select for your Medigap Plan can significantly impact your customer experience. Conducting thorough research helps you find an insurer that is financially sound and offers strong service.

The Bottom Line

Choosing between Medigap Plan G and Plan N involves carefully weighing your expected healthcare utilization against the premium costs. For those in good health with minimal doctor visits, Plan N provides an affordable option to cover catastrophic costs. If you see providers often or want robust coverage, Plan G may offer better long-term value despite slightly higher premiums.

Whichever route you take, purchasing Medicare Supplement Insurance provides invaluable protection against burdensome medical bills in retirement. Understanding the key differences between Plan G and Plan N allows you to select the right policy with confidence. With smart preparation, you can look forward to your golden years with greater financial peace of mind.

We’re Here to Help

You do not have to spend hours reading articles on the internet to get answers to your Medicare questions. Give the licensed insurance agents at Golden Years Design Benefits a Call at 1-732-526-7659. You will get the answers you seek in a matter of minutes, with no pressure and no sales pitch. We are truly here to help.

FAQS

What is the difference between Medicare supplement Medigap Plan G and Plan N?

 Medicare supplement, or Medigap, Plans are designed to fill the gaps in coverage left by Original Medicare and medicare advantage plan. Plan G and Plan N are two popular options among Medicare beneficiaries. The main difference between Plan G and Plan N is that Plan G offers more comprehensive coverage and may have a higher monthly premium compared to Plan N. Plan G covers the Medicare Part B deductible, whereas medicare supplement Plan N requires you to pay a copayment for each doctor’s office visit and a copayment for each emergency room visit. Plan G also covers Part B excess charges, while Plan N insurance plan does not.

How do Medicare supplement plans work?

Medicare supplement plans, also known as Medigap plans, are health insurance policies that help cover certain out-of-pocket costs not covered by Original Medicare. These plans are sold by private insurance companies and are designed to work alongside Original Medicare. Medicare pays its share of the Medicare-approved amount for covered healthcare services, and then the Medigap plan pays its share to cover the remaining costs.

What is Medicare Plan F?

 Medicare Plan F is a type of Medicare supplement, or Medigap, plan that offers the most comprehensive coverage. With Plan F, you generally have little to no out-of-pocket costs for Medicare-approved services. However, Medicare Plan F is no longer available to newly eligible Medicare beneficiaries as of January 1, 2020. If you were eligible for Medicare before January 1, 2020, you may still be able to purchase Plan F.

How does Medicare Supplement Plan N compare to  Medicare Supplement Plan G?

Medicare Plan N and Plan G are both popular Medigap plans. While medicare supplement Plan G offers more comprehensive coverage, Plan N can be a lower-cost alternative for those who are willing to pay some out-of-pocket expenses. With Plan N, you will be responsible for paying copayments for doctor’s office visits and emergency room visits, and you may also have to pay Part B excess charges. However, Plan N may have a lower monthly premium compared to Plan G.

What does Medicare Plan N cover?

 Medicare Plan N covers a variety of services, including hospital inpatient care coinsurance and costs up to an additional 365 days after Medicare benefits are exhausted, the Part A deductible, Part A coinsurance, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, the Part B coinsurance or copayment (except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits), and the Part B excess charges.

How much does Medicare Plan N cost?

 The cost of Medicare Plan N can vary depending on factors such as your location and the insurance company you choose. In addition to the monthly premium, you may also be responsible for copayments and coinsurance when you receive healthcare services. It’s important to compare the costs and coverage of different Medicare supplement plans before making a decision.

What is the coverage difference between Plan G and Plan N?

 The main coverage difference between Plan G and Plan N is that Plan G covers the Medicare Part B excess charges  deductible, while Plan N does not. Additionally, with Plan G, you do not have to pay copayments for doctor’s office visits or emergency room visits, and the plan covers Part B excess charges. With every Plan N, you are responsible for copayments for these services and medicare part a deductible Part B excess charges are not covered.

How do I compare Medigap Plan F and Plan G?

 When comparing Medigap Plan F and Plan G, it’s important to consider the coverage and costs associated with each plan. Plan F offers the most comprehensive coverage, while Plan G is also a comprehensive option but with a lower monthly premium. Since Plan F is no longer available to newly eligible Medicare insurance beneficiaries, like Plan G may be a popular alternative.

Can I switch from Plan F to Plan G?

 If you currently have Plan F and want to switch to Plan G, you may be able to do so. However, it’s important to note that once you switch from Plan F to Plan G, you may not be able to switch back to Plan F in the future. Before making any changes to your Medicare supplement plan, it’s recommended to compare the coverage and costs of different plans and consult with a licensed insurance agent.

Which Medicare supplement plan is right for me?

 The right Medicare supplement insurance plan for you will depend on your individual healthcare needs and budget. It’s important to consider factors such as the coverage, costs, and availability of different plans in your area. You may find it helpful to compare Medicare supplement plans and consult with a licensed insurance agent who can provide personalized guidance based on your specific situation.