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In this video, I am going to review Medicare Supplement Plan N and compare the benefits and cost to Medicare Supplement Plan G and Plan D.
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Medicare supplement Plan N can be a better value than Medicare supplement Plan G. This is especially true in states that have specific laws reducing the value of Plan G. In addition, some insurance companies are preparing for Medicare Supplement Plan D to be one of the top selling plans in Medicare. To be clear, I am referring to the Medicare Supplement Plan D and NOT Medicare Part D prescription drugs. Medicare supplement Plan D is a direct competitor to Medicare supplement Plan N.
Is Medicare Supplement Plan N the right plan for you? Let’s take a look.
When comparing Medigap Plan N vs. Plan G, people that prefer the Plan G to the Plan N tend to be people who would rather pay a little extra each month and avoid having to do the extra work to avoid excess charges.
This table illustrates the benefits of each of the ten different Medicare supplement plans. The plans are identified by letter across the top row. The category of Medicare services are in the left hand column. In the column below the Plan letter you can see the percentage of insurance coverage offered by that plan.
You can find this table on our website and in various Medicare publications.
With Medigap Plan N we see that it covers 100% “Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used up.). Notice that all the supplements have this coverage. Also, notice down here that Medicare Supplement Plan N pays the Medicare Part A deductible.
In 2017 that deductible is $1,380 per event. It will change every year, but with a Medigap Plan N that doesn’t matter. Your supplement will pay it.
Without a supplement you pay the deductible up front, then have 60-days of hospital coverage before you start paying a copay. With Medicare supplement Plan N you can be an inpatient in the hospital for more than 365 days with 100% coverage. You will have no out of pocket costs for Part A.
The asterisks indicate that you have the Medicare supplement Plan N copay. You will be required to pay up to a $20 co-pay for every doctor visit and a $50 copay for every emergency room visit unless you end up an inpatient in the hospital. Then the $50 copay is waived. The important qualifying words here are “up to”…$20. Here is what you can expect.
So notice that with Medicare supplement Plan N you have 100% coverage until you get down to this line item referring to the Medicare Part B deductible and Medicare Part B excess charges. Here Medigap Plan N has no coverage at all. You are expected to pay those fees out of pocket. That’s important.
Later in this video I am going to go over a real life example using a common joint replacement that will clear up some of the most common questions and misunderstandings about Medigap Plan N.
In order to evaluate if Medicare supplement Plan N is right for you, you need to know what the Medicare Part B deductible is and what it is expected to be in the future. It’s also critical that you understand Medicare Part B excess charges. So let’s focus on these and then go over a real life example to show you how Medicare supplement Plan N works with office visits, hospital stays and physical therapy.
If a doctor or hospital does not accept Medicare assigned rates, they are paid 5% less from Medicare, but allowed to charge you 15% more. The amount the doctor or hospital charges you that is more than what Medicare pays the doctor for that service is called an excess charge.
Excess charges are only allowed on Medicare Part B services. Those are outpatient and physician services.
There are also some states that either forbid or severely restrict Medicare Part B excess charges. These state laws are called Medicare Override Measure or MOM laws.
If you live in either Connecticut, Massachusetts, Minnesota, New York, Pennsylvania, Ohio, Rhode Island or Vermont your state either forbids or limits Medicare Part B excess charges.