Medicare Plan G vs Plan N: Which is Better?

Plans G and N are popular Medicare Supplements. Plan G covers all out-of-pocket costs except the Part B deductible. Plan N has a couple more uncovered costs.

What is the Difference Between Medicare Plan G and Plan N?

In this article, we’ll go over the coverage and benefits of both plans to help you understand the differences so you can make the right choice.

Overview of Medicare Plan N vs Plan G

Medicare Plans G and N are supplemental Medicare insurance that you can buy to cover the most costly out-of-pocket expenses in Original Medicare, including deductibles, coinsurance, and copayments. Without supplemental coverage, there is no out-of-pocket maximum on these expenses. For instance, if you have an operation that costs $100,000, without supplemental coverage you will pay about $20,000.

Here are the important facts about these two plans:

1. Medicare Plan N and Plan G are Medicare Supplement plans that cover some of the costs that Original Medicare does not cover.
2. Both plans cover 100% of the Part A deductible and coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used up.
3. Both plans cover the Part B coinsurance and/or copayment, the first three pints of blood, and Part A hospice care coinsurance or copayment. However, with Plan N you pay a copayment for doctor office visits (up to $20) and use of the emergency room (up to $50).
4. Medicare Plan G  also covers Part B excess charges, but Plan N does not.
5. Medicare Plan N and Plan G do not pay the annual Part B deductible ($240).
6. In about 98% of all areas, Medicare Plan G plus the annual Part B deductible costs less than Medicare Plan F.
7. In about 97% of all areas, Plan N rates are 20% to 30% less than Plan G.

Benefits of Plan N vs Plan G

The best way to understand Medicare Plan N vs Medicare Plan G, and to compare all Medicare Supplement plans, is to take a look at a chart:

Using this chart, you can quickly see that Plan G Medigap policies have more comprehensive coverage. Each out-of-pocket cost is a gap in coverage, and Plan N has a few.

Both Plan G and Plan N cover the major cost gaps. These include the Part A deductible ($1,632) , Part A coinsurance ($408 to $816 per day after 60 days), skilled nursing facility coinsurance ($204 per day after 60 days), first three pints of blood, hospice care coinsurance, and foreign travel emergencies.

Where these two plans differ is how they cover minor cost gaps. These include the Medicare Part B coinsurance and Part B excess charges.

Plan G covers both of these Part B out-of-pocket costs completely. Plan N doesn’t.

Cost Comparison of Plan N vs Plan G?

The big benefit of Medicare Plan N vs Plan G is the monthly premium. In most areas, you can get into a Plan N policy at age 65 for 20% to 30% less than Plan G.

In most areas, Plan N policies start at less than $100 per month. So, if you’re in an area where Plan G policies start at around $110 to $120 per month, you can get a Plan N policy for around $80 to $90 per month.

Even in high-cost states, like Florida, you can get a Medicare Supplement Plan N starting at around $130 per month (65-year-old, non-smoking female, living in Tampa, Florida on 1/1/2023). However, the cost reduction is not free.

Also See: Medicare Plan G Pros and Cons

Coverage Gaps of Medicare Plan G vs Plan N

The purpose of Medicare Supplement Insurance is coverage of the out-of-pocket expenses built into Original Medicare. For this reason, it’s worth highlighting the exact gaps covered in each of these plans. It also makes them easier to compare.

Plan G is easy to explain because it covers all gaps except one. It does not cover the annual Part B deductible. With a Plan G policy, you will pay all outpatient costs until the annual deductible is met. All other deductibles, copayments, and coinsurance costs are fully covered.

Plan N is a little more complex. Like Plan G, it covers all of the major gaps. But, there are two shared costs.

If you buy a Plan N policy, you pay a $20 copayment for most doctor visits. And, there’s a $50 copay for an emergency room visit. Other than that, Plan N covers all Medicare Part B coinsurance costs, up to the Medicare-approved amount, including medical supplies, tests, and durable medical equipment.

Plan N has a second gap that’s covered by Plan G. It does not cover any portion of Medicare Part B excess charges.

Exactly what are Part B excess charges? They are additional costs – up to 15% extra – that doctors and other healthcare providers can add to your bill if they do not accept Medicare assignment (Medicare’s standard rates). Plan G fully covers these costs.

Additional Benefits

Unlike Medicare Advantage plans, Medicare Supplements are not allowed to include additional benefits, such as coverage of prescription drugs. There is one exception, foreign travel emergencies.

Original Medicare covers you wherever you go in the United States and its territories. However, with rare exceptions, it does not you outside of the United States. However, Medicare Plans G and N both include foreign travel emergency coverage, as do Plans C, D, F, and M.

If you have Plan G or N and need medical care while traveling abroad, these plans cover up to 80% of your costs. This coverage is not available through a Medicare Advantage plan.

Enrollment Process

Unlike Medicare Advantage and Medicare Part D plans, Medicare Supplements do not have an annual enrollment period. In most states, you are free to enroll and disenroll at any time. However, there are certain benefits to enroll when first eligible.

Most of us are eligible to buy Medigap insurance at age 65 when we initially sign up for Medicare Part A and Part B. This Initial Enrollment Period automatically starts a six-month clock, which is known as your Medigap Open Enrollment Period. It begins the first month you have Medicare Part B.

During your Medigap Open Enrollment period you have certain Medigap protections. The most important protection is a guaranteed issue right, which allows you to buy the plan of your choice from your preferred insurance carrier. In other words, companies selling Medigap policies must accept an application from anyone who applies while they have their guaranteed issue right.

The application process, while you’re in your Medigap Open Enrollment Period, is very simple. But you do need to go through a licensed insurance agent to submit your application. You can do this once you sign up for both Medicare Part A and Part B, and have your Medicare number.

After your Medigap Open Enrollment Period expires, the application process is more complicated and an insurance company has the right to turn you down. It’s very important not to be late.

Also See: Why Can You be Denied a Medicare Supplement Plan?

Can You Change From Plan N to G?

Once you have a plan, you may or may not be able to make a change.

• If you are within your Medigap Open Enrollment Period, you can change plans.
• If you do not have a pre-existing condition, you might be able to change plans.

Generally speaking, the only time you are guaranteed the right to change plans is when you first sign up for Medicare. During the first six months after signing up, you have guaranteed issue rights. If you got a Plan N and then decide you want Plan G, you can switch.

After your guaranteed issue rights expire, insurance companies have no obligation to issue you a policy. This includes switching from one plan to another. They can deny you coverage.

Most insurance companies don’t like it when you want to switch to a plan with more coverage. It makes them wonder why you suddenly need more coverage.

Are They Better Than a Medicare Advantage Plan?

Medicare Advantage plans are the private health insurance alternative to traditional Medicare. These plans cover all of your Part A and Part B benefits, and most have additional benefits, such as prescription drug coverage.

What a Medicare Advantage plan doesn’t do is cover cost gaps from doctor office visits and hospitalization. With these plans, you may get extra benefits, but you still have deductibles, coinsurance, copayments, and other shared costs. These don’t go away.

As a result, a private Medicare plan could end up costing you more money than Original Medicare benefits without a Medicare Supplement plan. This is why people who can afford the monthly premiums buy a Plan G or Plan N policy.

The only way to decide which is better is to ask yourself these questions:

• Do you care more about additional benefits or out-of-pocket costs when you use healthcare services?
• Can you afford your healthcare out-of-pocket costs without additional insurance?

When you choose Medigap Plan G or Plan N, you can add a Medicare Part D plan to get prescription drug coverage and a separate dental plan for routine dental care.

Related: https://medicarewire.com/article/disadvantages-of-medigap-plans/

Who Should Get Plan N vs G?

Medigap Plan N is an excellent option for healthy people who want to save a little money. Think about it, if a Plan N policy saves you $30 per month, and you have the plan for 25 years, you save $9,000. It would take a lot of $20 copays and excess charges to make up that much money.

If you have one or more chronic health conditions that require regular doctor visits, particularly with a specialist, Plan N isn’t the best choice. In this case, Plan G is a better option.

It all boils down to your use of healthcare services. The less you use, the more you will save with Plan N. The more you use, the more you will benefit from Plan G.

What Else to Consider

Generally speaking, it’s better to buy more insurance (rather than less) when you first get your Medicare benefits. There’s less resistance to people who want to buy a policy with less coverage in the future.

Also, don’t forget that the federal Medicare program only guarantees you can get a policy when you first signup for Medicare. After that, a new application for Medigap coverage will go through medical underwriting.

When we retire, most of us are on a fixed income. If you didn’t plan ahead for the cost of healthcare in retirement, Medicare Supplement plans might appear to be an unaffordable expense.

So are the costs of skilled nursing facility care, emergency room visits, and outpatient services. Particularly if you see your doctor frequently. You need to carefully consider what your current health dictates and what might happen in the future.

As mentioned earlier, Medicare Supplements do not cover the cost of your prescription drugs. To get this coverage you need to add a stand-alone Medicare Part D Plan (PDP). You can research these plans on this page: https://MedicareWire.com/medicare-part-d/.

What Do You Do If You Want to Save More Money?

Plan N is a good way to save some money on monthly premiums. However, if you are healthy, and you can afford to take a little more risk, there are two more cost-saving plans.

Plan K is a cost-sharing plan. You pay 50% of most Part A and Part B costs until your annual out-of-pocket costs reach $7,060. These plans start at around $50 per month in most areas.

RELATED: How Does the Plan K Medicare Supplement Work?

The other cost-saving plan is High Deductible Medicare Supplement Plan G (HDG). This policy is exactly the same as the standard G plan once you’ve paid the annual deductible. This year the deductible is $2,800.

HDG plans are right around the same amount as Plan K. Sometimes a little less.

If you’re looking at Plan K’s $7,060 limit vs. HDG’s $2,800 deductible and wonder which might be the best Medicare Supplement for you, consider having this discussion with a licensed insurance agent who can walk you through the pros and cons of each.

Speak with Your Agent

It’s important to have a candid conversation with your insurance agent about your health and financial situation. Don’t make this important decision alone. Ask your agent if a Medigap policy is right for you. Be specific and ask about hospital stays, long-term care, and other important insurance topics. If you don’t have an agent, or you want a second opinion, Call 1-855-728-0510 (TTY 711) and speak with a licensed HealthCompare insurance agent. There’s no obligation, and they offer more plan options than any other national agency.

Frequently Asked Questions

Do you know the answer to these popular questions?

Citations & References:

cms.gov

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• Trump Administration Announces Historically Low Premiums and New Insulin Benefit as Medicare Open Enrollment Begins | CMS
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kff.org

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