Medicare Plan G vs Plan N

Medicare Plan G and Plan N are both popular Medicare supplement insurance plans, also known as Medigap plans. These plans are designed to work alongside Original Medicare (Part A and Part B) to help cover out-of-pocket costs such as deductibles, coinsurance, and copayments. Here’s a comparison of Medicare Plan G and Plan N:

Medicare Plan G:

  1. Coverage: Plan G offers comprehensive coverage. It covers almost all of the gaps in Original Medicare except for the Part B deductible. This means it covers your Part A deductible, skilled nursing facility coinsurance, Part A and Part B coinsurance or copayments, and more.
  2. Part B Deductible: The only cost not covered by Plan G is the annual Part B deductible. Beneficiaries are responsible for paying this deductible themselves before the plan starts covering their Part B costs.
  3. Predictability: Plan G provides more predictable costs because once you’ve paid the Part B deductible, you typically won’t have many additional out-of-pocket costs for Medicare-approved services during that year.
  4. Premiums: Premiums for Plan G tend to be higher than some other plans, like Plan N, due to the comprehensive coverage it offers.

Medicare Plan N:

  1. Coverage: Plan N provides similar coverage to Plan G, but there are a few differences. Plan N covers your Part A coinsurance and hospital costs, Part B coinsurance or copayments (except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in an inpatient admission), and more.
  2. Cost Sharing: With Plan N, you may have some cost-sharing in the form of copayments for certain services. This can include up to a $20 copayment for office visits and up to a $50 copayment for emergency room visits (that don’t lead to an inpatient admission).
  3. Part B Excess Charges: Plan N doesn’t cover Part B excess charges, which are additional charges that some doctors and providers may charge beyond the Medicare-approved amount. Beneficiaries are responsible for paying these excess charges themselves.
  4. Premiums: Premiums for Plan N are generally lower than those for Plan G due to the cost-sharing elements and the fact that it doesn’t cover Part B excess charges.

When deciding between Medicare Plan G and Plan N, it’s important to consider your individual healthcare needs, budget, and preferences. If you’re willing to pay slightly higher premiums for more comprehensive coverage and a more predictable cost structure, Plan G might be a good choice. On the other hand, if you’re looking for lower premiums and are comfortable with some cost-sharing for office and ER visits, Plan N could be a suitable option. It’s recommended to compare the plans’ benefits, costs, and your own health situation before making a decision.

Medicare 101

I am not a financial advisor or insurance expert, but I can provide some general information on this topic.

When you become eligible for Medicare, you have an initial enrollment period to sign up for both Medicare Part A (hospital insurance) and Part B (medical insurance). This initial enrollment period begins three months before the month you turn 65, includes your birthday month, and ends three months after your birthday month.

Medigap, also known as Medicare Supplement Insurance, is private insurance that helps cover some out-of-pocket costs not covered by Original Medicare (Part A and Part B). There is a one-time Medigap Open Enrollment Period (OEP) that starts when you are both 65 or older and enrolled in Medicare Part B. The OEP lasts for six months.

During the Medigap OEP, insurance companies are required to sell you a Medigap policy regardless of your health status, and they cannot charge you a higher premium based on any pre-existing conditions. After this six-month period, you can still apply for Medigap, but insurance companies can use medical underwriting to determine your eligibility and premium rates.

It’s generally a good idea to start researching Medigap plans and considering your options before your Medigap OEP begins. This will give you time to compare different plans, providers, and costs, and ensure that you make an informed decision. You can sign up for a Medigap policy during your OEP, and in many cases, coverage will begin immediately after your Medicare Part B coverage starts.

However, before making any decisions, it’s important to consult with a licensed insurance agent or financial advisor, as they can provide personalized guidance based on your specific needs and circumstances.