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Comparing Medigap Plan G and Plan N: Which is Right for You?

Comparing Medigap Plan G and Plan N: Which is Right for You?

Approximately 14.6 million Americans are enrolled in a Medigap Plan (or Medicare Supplement Insurance Plan). However, there are ten different Medigap plans to choose from.  

Two of the most popular plans are Medigap Plan G and Plan N. Between 2018 and 2021, enrollments for Medigap Plan G nearly doubled. It is a top-rated plan across the country, but does that mean it’s better for you? 

In this article, we’ll compare Medigap Plans G and N, break down their key differences, and help you make an informed decision.

Medicare Supplement Plan G vs. Plan N: A Comprehensive Comparison

Both Plan G and Plan N are designed to fill the gaps in Original Medicare, providing you with added financial security and peace of mind. Let’s delve into the specifics of each plan to help you determine which one aligns better with your healthcare needs.

Medigap Plan G: Comprehensive Coverage with a Small Deductible

Many Medicare beneficiaries choose Medigap Plan G because of its comprehensive coverage. It’s similar to the now-unavailable but previously popular Plan F. It covers almost all Medicare gaps except for the Part B deductible. Here’s a closer look at what Medigap Plan G offers:

1. Hospital Expenses: Plan G covers your hospital costs, including the Part A deductible and copays for extended hospital stays.

2. Skilled Nursing Facility Care: If you require skilled nursing facility care, Plan G has you covered.

3. Doctor Visits: It pays the 20% coinsurance that Medicare Part B doesn’t cover. Plus, you can see any doctor that accepts Original Medicare.

4. Outpatient Medical Services: Plan G covers many outpatient services, such as lab work, surgeries, x-rays, ambulance services, and more.

5. Foreign Travel Emergency Benefits: Plan G offers up to $50,000 in emergency coverage if you travel abroad.

6. Part B Deductible: You are responsible for the annual Part B deductible ($226 in 2023). Once paid, Plan G covers the remaining 20% of your outpatient costs.

Plan G provides excellent coverage for individuals who want peace of mind without breaking the bank on premiums. It’s particularly attractive for those who expect more than a few doctor visits and are willing to pay the Part B deductible.

Medigap Plan N: Affordable Coverage with Copays

Medigap Plan N covers many of the same areas as Plan G, with a few out-of-pocket expenses. Here’s what you need to know:

1. Doctor Visit Copay: With Plan N, you’ll pay up to a $20 copay for each doctor’s office visit, whether a specialist or a primary care physician. This copay is relatively small for those who only visit the doctor occasionally.

2. Emergency Room Copay: If you end up in the emergency room and are not admitted to the hospital, Plan N requires up to a $50 copay.

3. Part B Deductible: Similar to Plan G, you must pay 100% of the annual Medicare Part B deductible.

While Plan N does introduce copays, it often results in lower monthly premiums compared to Plan G. It’s an attractive choice for individuals who consider themselves generally healthy and visit the doctor infrequently.

Should I worry about excess charges under Plan N?

Compare Medigap Plan G and Plan N - Worried senior couple feeling stressed while have to pay their bills over Internet

One area where Plan G and Plan N differ is that Plan N typically comes with out-of-pocket costs, namely Medicare Part B excess charges. These are additional fees that doctors can legally charge above what Medicare approves.

Excess charges can be a potential concern when you’re on Plan N, especially if you seek medical care from a healthcare provider who does not accept Medicare assignments. 

However, let’s look at the facts. Over 85% of doctors across the country accept Medicare assignments, which means they agree to the approved Medicare rates for covered services. In most cases, this significantly reduces the chances of encountering excess charges.

While the concept of excess charges can sound intimidating, the actual amounts charged by doctors who don’t accept Medicare assignments can vary. In our experience, many clients on Plan N have rarely paid more than $200 in out-of-pocket excess charges. 

We recommend looking at Plan N if you live in one of the states that specifically prohibits excess charges. Those states are: 

  • Connecticut
  • Massachusetts
  • Minnesota
  • New York
  • Ohio
  • Pennsylvania
  • Rhode Island
  • Vermont

Rate Increases Under Plan G and Plan N 

When we compare how the costs change over time for Plan G and Plan N, we can see some interesting trends. 

Plan N tends to have more stable and gradual increases in premiums from year to year. On the other hand, Plan G, which is very popular, often sees more significant annual increases in the amount you have to pay. 

This increase is primarily because of the people enrolled in each plan. Plan G tends to attract more people, including those with health issues. More health issues mean more claims and higher costs for the insurance companies, leading to more significant premium hikes. Plan N, on the other hand, tends to have healthier beneficiaries who don’t need to see the doctor as often, resulting in fewer claims and smaller premium increases. 

Choosing Between Plan G and Plan N

Cheerful mature ladies caring of their health

The choice between Plan G and Plan N depends on your healthcare needs, budget, and eligibility. Here are some key considerations:

Plan G: Opt for Plan G if you want comprehensive coverage, are willing to pay the Part B deductible, and can manage the slightly higher premiums.

Plan N: Consider Plan N if you prefer lower monthly premiums, don’t mind copays for doctor and emergency room visits, and are generally healthy with infrequent doctor visits.

When making this decision, you must assess your health status, anticipated medical expenses, and budget. Both plans offer valuable Medicare supplement coverage, and your best choice is the one that aligns with your specific circumstances.

Can I switch from Plan N to Plan G (or vice versa)? 

Yes, you can switch plans at any time. However, you may need to answer some health questions if you are outside your 6-month Open Enrollment period. Your approval would not be guaranteed. 

Looking to The Medicare Family for Your Medicare Needs

Navigating Medicare can be challenging, but you are not alone. The Medicare Family, a family-owned business with over 40 years of experience, is here to help seniors make strategic Medicare choices. The Medicare Family is here to give you personalized help and understand what Medicare is all about. We know Medicare inside and out and are here to help you make the best decision for your healthcare needs and budget. Schedule an appointment with us today to get started!

Sylvia Gordon, aka Medicare Mama®, is an expert on all things Medicare and Social Security. She is the 2nd Generation here at The Medicare Family and has served on the advisory boards of major insurance companies like UnitedHealthcare®, Cigna, and Anthem. In her free time, she can be found taking care of her animals (dogs, goats, peacocks, chickens), and reading a good book. Learn More.
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