People newly eligible for Medicare often get confused by the number of options they have regarding plan benefits. Many people wrongly believe that federal Medicare coverage pays 100% for all their trips to healthcare providers or emergency room visits.
For these people, the out-of-pocket costs of their first few doctor’s office visits can be quite a surprise. That’s where Medicare supplement plans, called Medigap policies, come in. Coupled with Medicare Part A, they provide an alternative to purchasing Medicare Advantage Plans (called Medicare Part C).
Private insurance companies (not the government) offer supplemental Medicare policies in ten different plans, labeled Plans A through N. You can learn more about all the Medicare supplement plans from us at The Modern Medicare Agency, but two of the most popular Medigap plans are Plan N and Plan G.
If you visit the doctor frequently, travel a lot, or have chronic health problems that require treatment regularly, getting a Medigap supplemental policy can help you save money overall, even though you may pay a higher monthly premium.
In this post, we’ll explore the differences between Medigap Plans N and G. First, let’s look at how private Medigap Supplement Plans function.
How Do Medicare Supplement Insurance Plans Work?
Medigap policies are supplemental policies that, in principle, cover the 20% that Medicare’s 80% doesn’t pay. The differences between Plans G and N are mostly about whether you choose to pay copays (coinsurance) out of pocket (Plan N) or to have copays fully covered by your policy (Plan G).
In every state except Massachusetts, Minnesota, and Wisconsin, Medicare standardizes Medigap policies. This means that purchasing a Medicare Plan G supplement from an agency in Colorado will provide the same coverage and benefits as an agency in California or New York.
What Is the Difference Between Medicare Plan N and Plan G?
Medigap policies come from private insurance companies. You should anticipate your medical needs in choosing coverage. In short, Plan N offers lower costs, while Plan G provides you with a higher level of protection overall. Both plans offer more comprehensive coverage than basic Medicare Part A, but their exact benefits differ.
Comparing the Benefits of Medicare Supplement Plans N and G
Medigap Plan G and Plan N are similar in offering the following set of benefits:
- Part A hospital stays and coinsurance, up to 365 days after Medicare benefits are used up
- Part A deductibles
- Hospice care coinsurance and copayment through Medicare Part A
- Up to three pints of transfused blood
- Coinsurance for skilled nursing facility care
- 80% of coverage for a foreign travel emergency, subject to your deductible
There are two significant differences between Plan N and Plan G. First, Plan G covers 100% of your Part B coinsurance, while Plan N requires you to pay a copay of $20 per office visit and $50 for ER visits that result in inpatient care. If you have chronic health conditions requiring many office visits, these copays can add up quickly.
The second major difference between Plan G and Plan N is that Plan G covers the Medicare Part B excess charge. If you know that you will need a procedure that may be subject to an excess charge, Plan G may be the better choice for you.
Can You Switch from Medicare Supplement Plan G to Plan N?
You can switch from one Medicare supplement plan to another, but when you do so, it’s worth it to have an expert broker on your side. The regulations about your situation will vary. You may live in a state with a birthday rule, or you may qualify for a “guaranteed issue” policy. Having a licensed broker to guide you through this process is advisable.
In general, to switch between Plans G and N, you should:
- Contact your current insurance company to alert them of your intentions
- Purchase a new Medicare supplement policy from an insurer
- Once your new policy takes effect, finalize canceling your old policy
Depending on your personal circumstances, you may be subject to underwriting or other barriers as you switch plans. A broker cannot answer medical questions but can help you weigh the pros and cons of your Medicare benefits and decide whether choosing a new supplement is a good idea.
Medicare Supplement Plan G vs. Plan N Costs
When comparing the costs of Medigap Plan G and Plan N, you should look at the big picture. Don’t just add up the monthly premiums. Instead, consider the copays and the overall cost of your medical care.
Medicare Plan G tends to have higher premiums than Plan N. However, depending on your location and your current health condition, the difference in premiums between Plan G vs. Plan N may be as low as $20 per month.
If your current health dictates that you visit your primary care provider frequently, this extra premium cost may pay for itself in a few visits per month. If you are in good general health, each Medigap policy provides the same level of coverage for an emergency room visit and for outpatient services.
What Happens When Doctors Don’t Accept Medicare Assignment? Medicare Excess Charges, Explained
“Accepting Medicare assignment” means a provider willing to accept Medicare’s rates as full payment. Medicare members commonly encounter an “excess charge.” This represents the difference between the Medicare-approved amount of payment for a service and what the doctor customarily charges for that same service.
One of the primary selling points of Medigap Plan G is the fact that it covers these Medicare Part B excess charges. Medigap Plan N, on the other hand, does not. In each of these cases, your healthcare provider cannot charge more than 15% more than the Medicare assignment.
Learn More About Medigap Plans with Our Team at The Modern Medicare Agency
Finding the right Medicare plan is tricky, especially for new Medicare beneficiaries. If you are interested in contrasting Medicare Plan N and Plan G, check out our comparison chart of Medicare supplement plans. To get a free Medicare supplement plan quote, contact us at The Modern Medicare Agency today.