by Russell Noga | Updated May 31st, 2024
Medigap Plans G & N are America’s two most sought-after Medigap policies.
The two plans have distinct differences, and we’ll unpack them for you in this article.
Understanding Federally Standardized Medigap Plans
Medigap policies are available from leading healthcare insurers in America. While private companies sell these plans, the Federal government regulates the coverage they provide to beneficiaries of these policies.
That means that all policy benefits are equal in all plans offered by all insurers.
However, some providers can choose to offer additional benefits above the standardized coverage regulated by the Federal government. For instance, some providers might provide household discounts, gym memberships, or other services not offered by other companies.
Our team of licensed agents can assist you with finding the best provider for Plan G & N in your state.
Medicare Plan G Explained
With Plan F being discontinued for new Medicare members, Plan G is the most suitable replacement, giving you the highest level of coverage for your outpatient and inpatient medical expenses. Plan G is available from medical insurers across the country, as is Plan N.
You’ll enroll in Plan G & N during the six months from your 65th birthday during the open enrollment window. As long as you register in this window, the insurer has to accept your application.
If you enroll outside the window, the insurer might require you to undergo medical underwriting.
Plan G – Inpatient Coverage
With Medigap Plan G, you won’t have to pay anything for extended stays in the hospital. Plan G covers you for inpatient care for up to 365 days after your Original Medicare benefits expire.
Plan G covers the Part A costs associated with inpatient coverage, and by adding Plan G, you get 100% coverage for inpatient hospital healthcare services.
Medigap Plan G – Outpatient Coverage
For outpatient services involving trips to her doctor’s office and the specialist, Medigap Plan G gives you complete coverage; all you pay is the Part B deductible of $226 for 2023.
The Part B deductible can change from year to year, and Plan N beneficiaries will also have to pay this deductible to activate Plan N and its inpatient coverage.
- With Plan G, you get total peace of mind knowing that your policy covers you for everything.
- You don’t have any copays for doctor visits and no coinsurance responsibilities.
- Plan G covers everything but your Original Medicare Part B deductible.
- The only annual out-of-pocket you incur is your Medicare Part B deductible.
Is Medigap Plan G the Best Option?
Medigap Plan G offers you similar care to Plan F. However, Plan F is no longer available to new Medicare members enrolling in the program after January 1, 2020.
Plan G brings you all the same benefits as Plan F, but you’ll have to pay the Part B deductible of $226 for 2023.
So, Plan G brings you the most comprehensive Medigap policy available. Once you meet the Part B deductible, Plan G activates and covers the rest of your medical expenses.
Both Plan G and Plan N don’t have any limits on the out-of-pocket medical costs covered, and you can see any doctor or specialist that accepts Medicare anywhere in the United States.
If you’re a senior or retiree that visits the doctor frequently or makes trips to the emergency room for treatment and care, Plan G offers you the best option for limiting your out-of-pocket costs. Plan G is also available in a high-deductible version.
That means you’ll have a more expensive Part A deductible of $2,700 in 2023. However, you offset this through lower monthly premiums than the standard Plan G option.
Understanding Medigap Supplement Plan N
Medigap Plan N is slightly different from Plan G in that it requires beneficiaries to make copayments (which we’ll discuss the specifics of in a minute). Plan N requires the beneficiary to pay excess charges on Part B Medicare services.
While these copayments and excess charges limit the coverage offered by Plan N, it also reduces the cost of your monthly premiums. So, if you’re a healthy senior that only makes a few trips to the doctor, Plan N can save you money on your monthly premiums.
However, if you need emergency care, Plan N covers you for the vast majority of your inpatient and outpatient medical expenses.
Medicare’s Guidance for Plan N Copays
With Plan G, you don’t have any copayment or coinsurance responsibilities associated with your healthcare expenses. However, with Plan N, you have to make a $20 copayment when visiting a doctor or if they treat you in the hospital.
Plan N beneficiaries also have to make a $50 copayment for trips to the emergency room that result in the doctor not admitting them.
These rules came into play in 2010 when Plan N was still a new option for people eligible for Medigap policies. Medicare issued this guidance on copayments to indicate that no copayment is required for urgent care visits or telehealth consultations.
Plan N Part B Excess Charges
Another major difference between Medigap Plan G & N is that Plan N requires beneficiaries to pay the Part B excess charges incurred from healthcare providers. Some medical providers, like doctors and specialists, charge above the Medicare-approved rate for their services.
As a result, you have to pay the balance that Medicare doesn’t cover.
With Plan G, you get cover for this additional excess charge from medical professionals that don’t work “on assignment.” However, with Plan N, you’re liable for the excess fees involved with doctors charging above the Medicare-approved rate.
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Frequently Asked Questions
What services does Medicare Supplement Plan N cover?
Medicare Supplement Plan N covers a variety of services, including hospital stays, skilled nursing facility care, and Part A and B coinsurance.
Does Medicare Supplement Plan N cover Part A deductible?
Yes, Medicare Supplement Plan N covers the Part A deductible, which is an expense associated with hospital stays.
What about Part B coinsurance? Is it covered?
Yes, Plan N covers Part B coinsurance or copayments, reducing your out-of-pocket expenses for doctor visits and outpatient care.
Are emergency room visits covered under Plan N?
Indeed, Medicare Supplement Plan N covers emergency room visits, even if they don’t result in an inpatient admission.
Does Plan N include coverage for skilled nursing facility coinsurance?
Absolutely, Medicare Supplement Plan N covers skilled nursing facility coinsurance, offering peace of mind for extended care needs.
Does Plan N cover Part B excess charges?
No, Medicare Supplement Plan N does not cover Part B excess charges, which are additional fees that some doctors may charge beyond the Medicare-approved amount.
What is the coverage for foreign travel with Medicare Supplement Plan N?
Plan N provides coverage for 80% of eligible emergency care costs during foreign travel, which can be valuable for those who frequently travel abroad.
Is there a yearly out-of-pocket limit with Plan N?
Yes, Medicare Supplement Plan N has an annual out-of-pocket limit, ensuring that your costs remain manageable even during high healthcare needs.
Can I freely choose my healthcare providers with Plan N?
Certainly, you have the freedom to choose any doctor or specialist who accepts Medicare patients, without referrals or restrictions.
Does Medicare Supplement Plan N cover prescription drugs?
No, Medicare Supplement Plan N does not include prescription drug coverage. You’d need to enroll in a separate Medicare Part D plan for prescription medications.
How Do I Choose Between Medigap Plan G & Plan N? – Let the Experts Guide Your Decision
Call our team if you need help understanding the differences between Plan F & G. We’re licensed, experienced brokers offering free advice on the right Medigap policy.
Call us at 1-888-891-0229 for a free consultation.
Alternatively, you can use the calculator tool on our site for an automated quote on Plan F. Or fill out the contact form, and a licensed Medigap professional will get back to you to discuss your needs.
Russell Noga is the CEO and Medicare editor of Medisupps.com. His 15 years of experience in the Medicare insurance market includes being a licensed Medicare insurance broker in all 50 states. He is frequently featured as a featured as a keynote Medicare event speaker, has authored hundreds of Medicare content pages, and hosts the very popular Medisupps.com Medicare Youtube channel. His expertise includes Medicare, Medigap insurance, Medicare Advantage plans, and Medicare Part D.