What Is Medicare Supplement Plan N?

What Is Medicare Supplement Plan N?

Medicare Supplement Plan N is a private insurance plan to cover the out-of-pocket costs of Original Medicare. Plan N charges lower monthly premiums than most other Medicare Supplement plans. While Plan N has copayments, they are fixed and not based on the cost of your care. Plan N combines affordability with cost predictability.

Key Takeaways

• Plan N is the third most popular Medigap plan with beneficiaries and one of the least expensive plans.
• Plan N helps to cover your portion of Medicare out-of-pocket costs. 
• Plan N does charge copayments in some situations; it won’t pay 100% of your bills.
• The copayments are fixed between $20 and $50 and are not based on the cost of your care.

How Plan N Works 

Like other Medicare supplement plans, you buy a Plan N Medigap plan from a private insurer. Plan N was the third most popular Medicare supplement choice for Medicare recipients behind Plan G and Plan F, with more than 1.3 million enrollees in 2021 (excluding California), according to a 2023 report from the Congressional Research Service. 

Every month, you pay a monthly premium to the insurer to stay enrolled in the Medigap plan. Plan N has some of the lowest monthly premiums among all Medicare supplement plans other than High-Deductible Plan G, although pricing can differ by insurer. 

No matter which insurer you buy the plan from, Plan N has the same required, standardized basic benefits.

Medicare Part A: 

• Coinsurance or copayments (up to limits outlined below)
• Hospital costs up to an extra 365 days after using up Medicare benefits 
• Entire Part A deductible
• Copayments from day 21 to 100 for post-hospital skilled nursing facility care
• First three pints of blood every year as a hospital inpatient

Medicare Part B:

• Doctor’s office coinsurance or copayments (up to limits below)
• First three pints of blood every year as a hospital outpatient

In addition, Medicare Supplement Plan N covers 80% of foreign emergency care charges during your first 60 days outside the United States, with a lifetime maximum benefit of $50,000. You must first meet the $250 calendar year deductible. 

But Medigap doesn’t cover all the gaps. To get dental, vision, and hearing services and devices, you must sign up for a Medicare Advantage plan. 

Plan N Doctor’s Office Copayments: How They Work

Medicare Part A and B typically feature coinsurance requirements—for example, you’ll be asked to pay 20% of the cost of a doctor’s visit. Plan N steps in to pay most of this fee and only requires a smaller copay for office visits and emergency room visits. In both cases, you must meet the necessary deductibles (meaning you’ll pay bills in full out of pocket) before you’re only obliged to contribute your copayments.

With Plan N, you’ll pay $20 or less for each office visit. Office visits include covered healthcare provider and medical specialist visits. You’ll have a copay for each visit if you have multiple office visits in one day. 

“Office visits” include office consultations or evaluation and management visits. For example:  

• New patient visits
• Established patient office or outpatient visits 
• Ophthalmology visits
• Psychotherapy visits

The copay doesn’t apply to X-ray, laboratory, or durable medical equipment charges. 

Plan N Emergency Room Copayments: How They Work

You’ll pay $50 or less for each covered emergency room visit if you’re not admitted to the hospital. You don’t pay a separate physician copay, according to CMS guidance. An urgent care visit doesn’t count as an emergency room visit. 

If you are admitted to the hospital, and the emergency visit is wrapped into a Medicare Part A expense, you don’t pay the copay. Emergency room visits have a higher copayment to “discourage unnecessary emergency room visits,” according to CMS. 

Plan N vs. Plan G

Plan G and Plan N are similar in most ways. Both pay for foreign-based emergency care, skilled nursing facility care copayments, and the entire Part A deductible. Neither pay the Part B deductible. 

However, Plan N’s premiums tend to be lower than Plan G’s. Plan G also offers a high-deductible option that lowers the monthly premiums—premiums are typically under $100 a month—but you’ll first need to hit a $2,800 deductible before your High-Deductible Plan G plan covers costs. 

In addition, Plan G covers the Part B excess charges from medical providers above Medicare’s approved amount, while Plan N does not. Plan G covers all doctor’s office and emergency room visit costs after you meet the deductible. But with Plan N, you’ll pay $20 for doctor’s office visits and $50 for emergency room visits after meeting the deductible. 

Pros & Cons of Plan N

Plan N is one of the more affordable Medicare Supplement plans. While Plan N charges copayments, the costs are fixed. Other low-premium plans, like Plan K and Plan L, charge a percentage of your total medical bill, so your out-of-pocket cost could end up much higher than with Plan N. Plan N also helps pay for emergency travel costs and other gaps in your medical coverage.

On the other hand, Plan N still charges copayments. Other Medicare Supplement plans, like Plan C, Plan F, and Plan G, do not. Plan N doesn’t offer a high-deductible version. Plan N also doesn’t cover your vision, dental, and hearing expenses, even preventive ones—for those, you’ll likely need a Medicare Advantage plan. 

Requirements for Plan N

To qualify for Plan N, you usually must be:

• Turning 65 on or after Jan. 1, 2020
• Enrolled in Original Medicare (not Medicare Advantage) Parts A and B
• In the initial enrollment period for Medicare at age 65
• In 33 states, people who qualify for Medicare due to a disability can be eligible for Plan N or other Medicare supplement policies.

The best time to enroll is during the six-month initial enrollment period for new Medicare beneficiaries. During this period, insurers can’t turn you away for preexisting health conditions, refuse to sell you a Medigap policy, or charge more based on your health history. States also regulate Medigap plans. In some states, Medigap guaranteed enrollment is extended beyond this period.

Note

As long as you stay enrolled and pay the premium, the insurer can’t cancel your Medigap Plan N. 

If you qualify for Plan N, you’ll pay monthly premiums to buy the plan from the insurance company. Generally, you can expect an increase in the plan premium every year. 

Frequently Asked Questions (FAQs)

Does Medicare Plan N Cover Dental?

No, Medicare Plan N does not cover dental as a standard benefit. It is possible that the company you buy your Medicare plan from offers additional dental coverage in some form. However, most preventive senior dental coverage is provided through Medicare Advantage plans. 

What Are the Disadvantages of Plan N?

Plan N requires a copay with every office and emergency room visit after you’ve met your deductible. In addition, Plan N doesn’t cover Part B excess charges and doesn’t offer a high-deductible plan version, which can reduce monthly premiums. If you try to buy Plan N outside your initial Medicare enrollment period, the insurer could charge you a higher premium based on your health. 

The Bottom Line

Medicare Supplement Plan N is an affordable way to handle the Original Medicare coverage gaps. Insurers typically charge lower premiums for Plan N versus other Medicare Supplement plans. One drawback is that Plan N charges copayments, but these copayments are fixed and not based on the cost of your medical care. An insurance broker can help you estimate your total costs using Plan N versus your other Medicare insurance options.

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