Medicare is government-run health insurance for people 65 or older, certain people under 65 with disabilities, and people of any age with End-Stage Disease (ESRD).
Medicare is made up of different parts to help cover various medical services. These include:
Part A covers the care and treatment of patients in hospitals and other medical facilities. For example, hospice care and skilled nursing facility care.
Part B covers outpatient care and services. This includes bills for specialist consultations, vaccines, and durable medical equipment such as wheelchairs and walkers.
Part D covers the cost of prescription drugs and is run by private insurance companies, instead of the federal government.
For more information, be sure to read our 2022 guide to Medicare. It outlines how Medicare works, the benefits it covers, and the different types of options that you can choose from.
Deductible: This refers to the set amount you pay for health care services before your insurance begins to pay. For example, if you have a $2,500 deductible you have to pay $2,500 before your insurance kicks in.
Coinsurance: The percentage of costs you pay after your deductible has been met.
Copayment: A set rate you must pay for doctor’s office visits, hospital stays and prescriptions.
Out-of-pocket expenses: This term refers to costs that are not covered by Medicare and that you must pay for yourself. For example, a consultation fee for an appointment with the dentist.
To help cover the cost of medical expenses, many Americans take out Medicare Supplement Insurance.
Also known as Medigap, a Medicare Supplement Plan is a health insurance policy that you can buy from a private insurance company.
These plans help pay for the remaining costs that Medicare Parts A and B don’t cover. A few examples of these expenses include:
Eye tests and glasses
Each plan can be identified by a letter: A, B, C, D, F, G, K, L, M, and N. It’s important not to confuse plans with Medicare parts, which cover basic medical needs.
Depending on the plan you choose, it could pay for:
An insurance company cannot sell you a Medicare Supplement Plan if you already have Medicaid or a Medicare Advantage Plan.
To find out more about these policies and take an in-depth look at the different Medicare Supplement Plans, take a look at this article.
Plan N (also known as Medigap Plan N) is one of 10 Supplement Plans that are designed to help you pay for the out-of-pocket costs that Medicare Part A and B don’t cover.
The table below shows the specific benefits that Medicare Plan N will help you cover.
Where you see a percentage, Medicare Supplement Plan N will cover that percentage of the benefit and you must pay the rest.
|Medicare Part A: Hospital and coinsurance costs up to an additional 365 days after Medicare Benefits are used||100%|
|Medicare Part B: Coinsurance or copayment||100%|
|Blood (the first 3 pints)||100%|
|Part A Hospice Care: Coinsurance or copayment||100%|
|Skilled Nursing Facility Care||100%|
|Part A Deductible||100%|
|Part B Deductible|
|Part B Excess Charges|
|Foreign Travel Emergency (up to plan limits)||80%|
As you can see, Medicare Supplement Plan N covers most out of the Medicare benefits, except the Part B deductible and Part B excess charges. Let’s take a look at what this means for you.
Medicare Part B covers outpatient services like vaccines and specialist consultations.
This benefit also has a standard annual deductible of $233 and a minimum monthly premium of $170.10. This monthly premium varies depending on your income.
Due to the fact that Plan N does not cover the Part B Deductible, you would have to pay the $233 annual fee before Medicare pays for outpatient services.
An excess charge refers to a situation when you receive treatment from a medical provider who does not accept the Medicare-approved amount as full payment for the service.
Some medical providers can charge you up to 15% more than the Medicare-approved price.
This means that you would have to cover these expenses yourself. We’ll go into more detail on how to avoid excess charges later in this article.
To give you a better idea of what Medicare Plan N costs, here is a breakdown of what you could expect to pay:
$233 for the Part B annual deductible
$170.10 as a minimum monthly Part B premium (remember, this amount depends on your income)
The Medicare Plan N monthly premium is set by the insurance company you buy the plan from
Copayments, which are set rates you must pay for visits to the doctor, hospital costs, and prescriptions
Possible excess charges of up to 15%
The cost of Medicare Supplement Insurance Plans can vary significantly. This is because insurance companies can charge people different premiums for identical basic benefits.
There are three ways that insurance companies set premiums. These are:
Community-rated: This premium is not based on your age. This means that the same monthly premium is charged to everyone. However, the price will vary according to inflation.
Issue-age rated: This premium will be based on the age you are when you buy the policy. Therefore, the premium is lower for people who buy it at a younger age and won’t change as you get older.
Attained-age rated: This premium is based on your current age and will go up as you get older. Although these premiums might be the least expensive at first, they will eventually become the most expensive and are also affected by inflation.
In addition to the factors above, the price of your premium may also depend on where you live and what your lifestyle habits are.
This is why it’s important that you compare the premium of Plan N from a few different insurance companies. This will allow you to compare each price side by side and find the one that works best for your budget.
The good news is that Medicare Supplement Plan N generally has lower premiums because you agree to cover the copayments yourself.
These copayments will be up to $20 when you visit the doctor and $50 for emergency room visits, as long as you are not admitted to the hospital.
Medicare Plan N also doesn’t cover Part B excess charges. As we mentioned earlier, this is when you receive treatment from a medical provider who does not accept the Medicare-approved amount as full payment.
This rate can be up to 15% more than the Medicare-approved price.
You can avoid this by simply asking the medical provider upfront whether or not they accept Medicare assignment.
A medical provider who accepts assignment agrees to accept the Medicare-approved amount as full payment.
By making sure that Medicare assignment is accepted, you won’t have to worry about excess charges for the medical treatment you receive.
To enroll in a Medicare Supplement Plan, you must first have Medicare Parts A and B.
It’s recommended that you enroll in one of these plans during the Medicare Supplement Open Enrollment Period. This is for a few reasons:
You are likely to get better prices
There will be more options available to you
You won’t have to answer any health questions
If you enroll outside of the Open Enrollment Period, you will be at risk of paying higher premiums and you might be denied coverage based on preexisting health conditions.
This window only happens once in your life (unless you collect Social Security Disability Income) and will last for six months.
You must be 65 or older for the Open Enrollment Period to begin. The six-month window starts on the first day of the month that your Medicare Part B (Medical Insurance) is effective.
At PolicyScout, we know that finding a Medicare Supplement Plan that’s right for you can be confusing and difficult.
Our Medicare Hub is filled with information that’s designed to help you learn more about Medicare and the different plans that you can choose from.
PolicyScout’s expert advisors are always ready to assist you or if you need guidance on navigating the Medicare maze.