Common Health Concerns for Seniors
Thanks to the advances in healthcare, people are living longer than ever. Life expectancy for the total
Thanks to the advances in healthcare, people are living longer than ever. Life expectancy for the total
When looking at the Medicare Supplement plan options available, it can be extremely overwhelming.
Medicare Supplement Plan N, also known as MediGap Plan N, is a plan designed to help fill in the gaps left by your Medicare Part A and Medicare Part B (Original Medicare). Original Medicare leaves Medicare enrollees with many out-of-pocket costs, including deductibles and coinsurances. Plan N is designed to limit many, but not all of these out-of-pocket costs.
When you turn 65, you can voluntarily enroll in Medicare. This is a federally-facilitated health insurance program that you have paid into for most of your working life. Original Medicare, also known as Medicare Part A and Medicare Part B, will only cover a portion of your healthcare, but you will be responsible for some of your remaining medical expenses. Your cost-share under Original Medicare includes, but isn’t limited to, deductibles, coinsurances/copayments, and excess charges. These cost-shares can be considered your “gaps in coverage.”
In our retirement years the last thing we want to do is worry about unexpected medical costs piling up. Luckily, there are plans available that can help to fill in these gaps and give Medicare enrollees peace of mind. Plans that are designed specifically to work with Original Medicare are called Medicare Supplement Plans, or MediGap Plans.
Fortunately for you, the government has standardized these Medigap plans. This will mean that the only difference between each lettered plan is going to be how much you monthly for the premium based on the insurance company you enroll with.
If you are currently covered under Medicare Part A and Medicare Part B, you’re eligible to purchase a Medicare Supplement plan. It is extremely beneficial to apply for a MediGap Plan to begin at the same time as your Medicare Part B, so you are not subjected to limitless out-of-pocket costs. We want all of our insurance coverage to be streamlined.
When it comes to your options for choosing a Medigap plan, there are going to be twelve to consider. They will be labeled as follows: A, B, C, D, F, high-deductible F, G, high-deductible G, K, L, M, and N. In case you were wondering what happened to plans E, H, I, and J, these plans won’t be available to purchase as a supplement to your Medicare. Also, if you turned 65 after January 1st, 2020, you are not eligible to enroll in Plan F, Plan C, or Plan F high-deductible.
As we mentioned previously, Medicare Supplement plans are designed to fill the gaps left behind by Original Medicare- Medicare Part A and Medicare Part B. Medicare Supplement Plan N helps to cover many of these aspects, with minimal out-of-pocket for your cost-share.
Benefits Covered | Plan N |
Part A Hospital Coinsurance and 365 Extra Hospital Days | 100% |
Part A Deductible | 100% |
Part B Coinsurance/ Copayments | 100% except certain copayments |
Part B Annual Deductible | Not Covered |
Part B Excess Charges | Not Covered |
First 3 Pints of Blood | 100% |
Cost of Foreign Travel Emergency | 80% |
Hospice Care Coinsurance | 100% |
Part B Preventative Care Coinsurance | 100% |
Skilled Nursing Facility Care Coinsurance | 100% |
Medicare Supplement Plan N covers many benefits 100%
Although Plan N covers many benefits at 100%, there are still some benefits that you as the enrollee may be responsible for a portion of-
Although Plan N does have a small amount of cost-share, it is still a full-coverage plan that will significantly limit your out-of-pocket spending on your Medicare costs.
To be honest, an excess charge sounds a little scary, doesn’t it? It is somewhat of a looming term when you hear about MediGap Plan N. Luckily, it really isn’t as scary- or common- as it sounds!
When physicians and other healthcare providers agree to accept Medicare as a form of insurance, they are given the option to be either a participating provider or a non-participating provider.
If your doctor is a non-participating provider and does not accept Medicare Assignment, it means that he/she does not accept Medicare’s payment as payment in full. This means that on-top of what Medicare is paying your doctor for a visit or service, you may be charged by your doctor’s office for up to 15% of the Medicare-approved cost. This 15% that you are being billed is referred to as an excess charge.
Although the majority of doctors and healthcare providers across the country accept Medicare Assignment, there is still the possibility of encountering an excess charge with Medicare Supplement Plan N. Luckily, Medicare.gov has a very easy to use provider tool where you can look up doctors by name or specialty in your zip code and determine whether they accept Medicare Assignment, or not. If your doctor appears with a little green checkmark by their name, you don’t have to worry about an excess charge!
There are even a few states the prohibit providers from billing an excess charge! If you live in one of these 8 states, you don’t ever have to worry about seeing an excess charge, unless you visit a provider across another state’s lines-
*In CT you must be a member of CONNMAP/QMB
With any of the Medicare Supplement Plans, there is no network of doctors or physicians that you have to adhere too. If a provider accepts Medicare as an insurance, they automatically accept your Medicare Supplement plan, as Original Medicare takes control of the billing.
Essentially, you can use your Medicare Supplement Plan N in all 50 states, as long as the doctor accepts Medicare! This is one the greatest benefits of Original Medicare with a supplement, as you have access to the best doctors and healthcare providers across the country without worrying about paying out-of-network charges.
Also, like other Medigap insurance plans, Plan N does have some benefits for traveling outside the US. It will include any ER care you receive within your first sixty days in another country. Your plan will cover 80% of your treatment up to plan limits- usually $50,000. Even so, it’s best to contact your insurance agent to discuss what your plan covers before traveling outside the US. It is better to be safe than sorry.
Keep in mind that when it comes to your Medigap Plan N or any other Medicare Supplement Plan, these are going to differ by your location and by your insurance company. Many private insurance companies will use a price ranking system to set the premiums they will charge you for.
Each insurance provider has their own premium set for Medicare Supplement Plan N. Keep in mind that when you are going to shop for a plan, it is essential to know what their price rating system is and how that may impact your rate increases throughout your enrollment in the plan. This will also help you understand the initial cost of the premium when you first begin your enrollment.
Another thing to consider when you’re researching a supplement policy for your Medicare insurance, make sure you’re comparing oranges to oranges and not apples to oranges. This means that if you were looking for a specific Plan N, you want to look at other Plan Ns across the board. You don’t want to look at two different types of plans to compare. A Plan C compared with a Plan B will show no exact comparison with differing plans like these two, especially when it comes to the benefits.
So, you’ve decided you like the coverage level of Plan N and the premium fits right into your budget. Now you’re left wondering, “how do I get a Plan N” and “when do I enroll in Plan N?”
When it comes to enrolling in a Medicare Supplement Plan, you want to line up your enrollment to begin the same month that your Medicare Part B begins.
If you want to enroll in this plan or another Medigap plan, you should consider at least five things before you go forward and make a purchase.
When it comes to deciding whether Medicare Supplement Plan N is the right fit for you, there are a few factors to consider. One large important factor is cost. Medicare Supplement Plan typically has an affordable premium, but you want to compare the premium to the next highest coverage level (Plan G) to see which plan would be most cost-efficient in the long-run.
With any Medicare plans, there are going to be benefits and drawbacks. Navigating through them can be a little challenging at times, but it helps to keep track of what you need for your current healthcare and have a bit of a plan for what you may need in the future. Speaking to an agent can prove very helpful in figuring out if this plan will be the correct one for you. In the end, you want to make sure that all of your healthcare will be covered as much as possible. Unfortunately, emergencies do happen, and you don’t want to be left with a huge medical bill or having to drain your retirement savings to pay for any medical expenses.
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