What Is Medigap Plan N? What You Need to Know
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Medigap Plan N is the third most popular Medicare Supplement Insurance plan type.
Compared to Plan G, Plan N offers almost the same coverage, but often has lower premiums.
The trade-offs for Plan N’s lower premiums are copays for certain office and/or emergency visits.
Medigap Plan N offers nearly the same benefits as higher-coverage plans, such as Plan G, but often at lower monthly premiums. A potential downside is that you pay copays of up to $20 for medical office visits and up to $50 for non-admitted emergency visits.
Medicare Supplement Insurance, or Medigap, is sold by private insurance companies to cover certain copays, coinsurance and deductibles left over from Original Medicare. If you expect to have relatively infrequent medical appointments, Medigap Plan N may be a more cost-effective option compared with other Medigap plan types.
Medicare Supplement Insurance Plan N is often called Medigap Plan N. You might also see it referred to as "Medicare Plan N" or even "Medicare Part N," even though those labels aren't quite accurate.
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What is Medicare Supplement Plan N?
Once Medicare pays its approved amount for health care costs and services, Medicare Supplement Plan N pays for certain out-of-pocket costs, such as your Medicare Part A deductible or Part B coinsurance. However, there are copays for certain doctor’s office visits and emergency room visits:
Office visits: Up to $20 for some office visits.
Emergency room visits: Up to $50 if you're not admitted to hospital inpatient care.
After that, Plan N covers anything of your Part B copay or coinsurance that's left.
Medicare Supplement Insurance Plan N is the third most popular plan type, covering about 10% of all Medigap members as of 2022. Plan F and Plan G have more members (and of the two, only Plan G is available to new Medicare members).
Medigap plans are only available if you have Original Medicare — they can’t be used with Medicare Advantage plans.
There are 10 standardized Medigap plans available in most states (except Massachusetts, Minnesota and Wisconsin, which use different standards). The plans differ in terms of coverage for services, out-of-pocket limits and premium costs.
Medicare Supplement Plan N pros and cons
Medigap Plan N has advantages and disadvantages:
Coverage: Plan N covers nearly all Medigap benefits.
Premiums: Plan N has lower premiums than other popular options like Plan G and Plan F.
Availability: Plan N is available from nearly every Medigap company.
Copays: Unlike most plan types, Plan N has copays for certain medical visits.
Excess charges: Plan N doesn’t cover Medicare Part B excess charges. These are rare, but could be costly if you see a health care provider who charges more than Medicare’s approved amount.
» MORE: Medigap Plan G vs. Plan N
What Medigap Plan N covers
Here’s what Plan N covers, according to Medicare.gov:
Part A coinsurance and hospital stays up to an additional 365 days after Medicare benefits are used up.
Part A deductible.
Part A hospice care coinsurance or copayment.
Part B coinsurance (copayments are up to $20 per office visit and up to $50 per emergency room visit; waived if admitted).
Skilled nursing facility care coinsurance.
Blood transfusion (first three pints).
Medically necessary emergency health care service for the first 60 days when traveling outside the U.S. Deductible and limitations apply.
What Medigap Plan N doesn’t cover
Medigap Plan N is one of the more comprehensive Medicare Supplement Insurance plans. However, there's one benefit included in some other plans that Plan N doesn’t cover — Medicare Part B excess charges (if a provider is permitted to charge more than Medicare’s approved amount and does so).
Additionally, all Medigap plans, including Plan N, sold to new Medicare members don’t cover the following:
Part B deductible. (Since 2020, new Medicare members can’t buy any plan that covers the Part B deductible, although existing members may own older plans that do.)
Long-term care (like non-skilled care you get in a nursing home).
Private-duty nursing.
Shopping for Medigap plans? We have you covered.
MEDICARE SUPPLEMENT, or Medigap, is private health insurance that covers “gaps” in traditional Medicare coverage. Compare options from our Medigap roundup. | |
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How much does Medicare Supplement Insurance Plan N cost per month?
Private companies sell Medigap policies, and they each set their own prices. Medigap Plan N premiums for a 65-year-old nonsmoker range from $90 to $232 per month in Atlanta, which has average costs among major U.S. metro areas for the most popular plan types.
The cost of a Medigap Plan N policy can vary based on factors including age, location and tobacco use.
Should you buy Medigap Plan N?
Buy Medigap Plan N during Medigap open enrollment
The best time to buy a Medicare Supplement Insurance policy is during your Medigap open enrollment period.
This period happens only once. It starts once you’re 65 and enrolled in Medicare Part B, and lasts for six months. (If you're still working after 65 and covered by a group employer plan that is deemed creditable coverage, your six-month period starts after you’ve ended active employment or no longer have that insurance.)
Medigap policies are cheapest and easiest to get during this open enrollment period because insurance companies aren’t allowed to factor your health or medical history into your price. After the period ends, the prices may go up or you may be denied coverage due to your health status or medical history.
In some states, insurance companies sell Medigap plans to those under 65 who are living with a disability and are eligible for Medicare. You can find more information through your State Health Insurance Assistance Program, or SHIP.
When shopping for a Medigap plan, review your medical records. If you don’t frequently visit the doctor, then Plan N may be the better option for you.
Compare alternative plans
Get details on Medicare Supplement Insurance options | |
Coverage | Medigap Plan |
Basic benefits | |
Basics plus some extras | |
Highest coverage | |
Lower premiums, but higher copays | |
Lowest premiums — partial coverage | |
No longer for sale to new Medicare members | |
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