MEDICARE PLAN “N” – Why It’s a Good Choice?

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Medicare Supplement Plan N can be a great value. Its rates are often 30% less than Plan F and 20% less than Plan G. That means some people can get Plan N for under $100 a month.

So, what’s the gotcha? Well, there’s fine print, but you will find there are a couple benefits Plan N doesn’t cover.

When you talk about Medicare Supplement’s, Plan F is usually the one to come to mind. Most of you have heard of Plan F. But these days, everybody is talking about value and we remember Plan G because it covers everything at 100%. Plan G does have a small deductible of $183.

Now, what does Plan N offer? Its reduced premiums make it a super plan to consider; however, you need to be aware of some benefits Plan N doesn’t cover when compared to Plan G and Plan F.

When you compare Plan F, G and N side by side what do you see? Plan F covers every benefit on the chart. The first noticeable item we see is that neither Plan G and Plan N cover the Part B deductible.

Now what else does Plan N not cover? This is where Plan N separates its self from Plan F and G. First thing is Plan N has doctor’s office and emergency room copays. When you visit your doctor’s office the receptionist is going to ask for “up to $20” per office visit copay.

Because the wording “up to $20”. So, it could be a $0 copay, up to a $20 copay. But you know already how much they are going to ask you for a copay, right. It’s going to be the $20.

When you visit the emergency room, the copay is $50 per visit. But that is waived if you’re admitted into the hospital and the emergency room visit is covered as a Medicare Part A expense.

The third difference is that Plan N has excess charges for Medicare Part B, again, think doctor’s office visits. Excess charges are covered with Plan F and Plan G, but not with Plan N. You are only responsible for excess charges if the provider does not accept Medicare assignment.

What’s this Medicare assignment business mean? It means the doctor will provide services to you as a Medicare patient but not accept Medicare approved payment amounts. When the doctor doesn’t accept assignment, the doctor is telling Medicare they don’t accept Medicare’s approved amount for payment.

When the doctor sends your claim to Medicare, they provide the billed amount for the service. Let’s say the doctor billed you for $500. But Medicare has a set amount of money they pay for certain services.

If the doctor billed $500 for your visit and Medicare’s approved amount is $200, Medicare pays 80% of $200 which is $160 and you pay $40.

The doctor can bill you an additional 15% of Medicare’s approved amount of $200 or $30.00 more. But only if the doctor doesn’t accept Medicare assignment. Your total payment in this example would be $70.00.

Now here’s my take on these “excess charges.” I have no idea how much these medical procedures cost. You probably don’t either. The insurance companies have established what is usual, reasonable and customary for these charges. After all, they are paying the bills.

If the bill is a $500 and the insurance company will only pay $200 – I would think that’s reasonable. The insurance company pays a $160 and then I pay the balance of $40. Now, the doctor wants to charge me an additional $30. My first thought is: “I don’t think so!” What do you think?

Fortunately, most doctors do accept assignment. There’s an easy way to see if a doctor does accept assignment. I suggest you use the Medicare.gov physician finder tool. When you pull the doctor’s information up, look for the “Accepts Assignment” in the middle of the profile box. Is it worth the extra five minutes to find out if a doctor takes assignment? Per the premium savings, it probably means yes.

What are the premium savings with Plan N? In general, you will save about 15 to 20% in premium compared to Plan G and about 30% compared to Plan F. This is a good plan, but please remember, the less you pay in premium the more out-of-pocket expenses you will have.

The best way to get your question answered or shop for a Medicare Plan N is to give us a call at either our Recorded Hotline at 1-800-958-8171 and record your question or request. The second and quickest way is to call my office direct at 1-800-825-2919. You’ll get an unbiased answer to point you in the right direction.

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