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An Introduction to Medicare Plan N

Updated on January 9, 2018
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Tamara Wilhite is a technical writer, an industrial engineer, a mother of two, and a published sci-fi and horror author.

What is Medicare Plan N?

Medigap plan N was rolled out in 2010. This Medigap plan helps cover the major gaps in Medicare coverage, which is why it is also called the plan N Medicare supplement. You must been enrolled in Medicare to be eligible for a Medigap plan.

The plan N Medicare supplement offers a lower premium than other Medigap policies. The lower premium is offset by the annual deductible and medical co-pays owed in a few cases.

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We think of retirement as a time for grandchildren and relaxation. Unfortunately, getting medical coverage in retirement can be a hassle. What are your options? | Source

What Does Medigap Plan N Cover?

Medicare plan N, also called Medigap plan N, pays all of the Medicare Part B coinsurance with a few exceptions. Part B coinsurance is typically 20% of the Medicare approved amount. The plan N medicare supplement does require up to a twenty dollar co-pay for some doctor's visits. If you have Medigap plan N, you will be charged a co-pay for emergency room visits unless you are admitted to the hospital. The hospital admission co-pay is capped at $50.
Plan N covers the first three pints of blood you receive. If you need more than three pints, you pay nothing for them.

Plan N covers the medicare Part A deductible. Medigap plan N covers the Medicare Part A hospice care co-pay. It has limited coverage for foreign travel emergencies. In these cases, you will pay the first $250 of medically necessary foreign medical care. Depending on the Medigap policy, you may have a lifetime maximum for foreign care; this lifetime maximum is generally $50,000. However, the foreign travel policy covers medical care during the first sixty days of travel outside of the United States. If you are relocating abroad, you should research other forms of medical insurance.

Medigap plan N pays the $20 a day Medicare does not pay for your first sixty days in the hospital and $296 per day for the 60th through 90th day. This means that those with Medigap plan N will pay nothing for the first three months in the hospital if you have a semiprivate room. Medigap plan N pays your semiprivate hospital room costs and nursing expenses until your lifetime reserve days are used. When the lifetime reserved days are used and the one year mark is reached, you are responsible for all costs.

If you are entering a Medicare approved skilled nursing facility after spending at least three days in the hospital, Medigap plan N covers the first 100 days of care. You must pay for care after the 101st day. In contrast, those with only Medicare have to start paying for all costs over $148 per day in expenses starting on the 21st day.

Medigap plan N will pay for all hospice care expenses if you have received a doctor's certification that you have a terminal illness and the facility meets Medicare's requirements.
Medicare pays for medically necessary medical supplies and durable medical equipment. Medigap plan N pays for the costs above the medicare approved amounts so that you only pay the first $147 for Medicare approved amounts.

Medigap plan N does not have an out of pocket limit like plans K and L. It has some coverage for the costs associated with medical emergencies that arise while you abroad, costs that Medicare will not cover.

What Doesn’t Plan N Cover?

The plan N Medicare supplement does not cover excess charges from Medicare part B, nor will it pay the part B deductible. Plan N coverage for one spouse does not extend to the other partner.

Medigap plan N coinsurance only starts after you have paid the Medicare deductible, unless the Medigap policy specifically states it pays that deductible. This depends on the Medigap plan, so read the policy carefully before signing up.

Medicare and Medicap plan N do not cover dental expenses such as the cost of new dentures or fillings. Plan N does not cover vision expenses, whether you need new reading glasses or glaucoma surgery. Neither Medicare nor Medigap supplement N pay for hearing tests or hearing aids. Plan N will not pay for your nursing home care after the one year mark.

Medigap and Obamacare

Obamacare, AKA the Affordable Care Act, does not affect Medicare or Medigap appreciably except for taking money away from Medicare to fund the insurance subsidies for the general population.

If you are enrolled in Medicare, whether or not you have a Medigap policy, you count as "insured" under the Obamcare mandate and will not face a penalty for not having health insurance.


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