Medigap Plan N – No Long Guaranteed Issue, But Still a Good Value

Medigap Plan N is rapidly gaining market share among Medicare Supplement policyholders as a viable, low premium alternative to restrictive Medicare Advantage plans. Plan N is, generally speaking, one of the least expensive Medigap plans that a company offers. Many of the companies are now offering Plan N in their plan offerings. Through early 2011, at least one company was offering Plan N on a “guaranteed issue” basis (i.e. no health questions) – this is no longer the case. Although Plan F has the largest market share (approx. 40%), Plan N, which has only existed since 2010, is up to around 12-15% by most estimates. And most importantly, it may be right for you.

What Does Plan N Cover
First and foremost, you must understand what Plan N covers. The advantage of this plan is that the coverage at the hospital is, basically, equivalent to the hospital (Part A) coverage under Plan F and other more comprehensive plans. Plan N covers everything that Medicare Part A does not cover at the hospital – it covers the Part A deductible and the 20% coinsurance.

Where Plan N differs from the more comprehensive plans is at the doctor’s office. Plan N does not cover the Medicare Part B deductible, which for 2012, is $140/year. Also, after the deductible, there is a $20 doctor’s office co-pay and a $50 emergency room co-pay. Lastly, Plan N does not cover the Part B Excess charges. These are charges that can be up to 15% above the Medicare-approved amount. This does not occur often – in 1% or less of the instances nationwide. However, it is a benefit that is not included on the Plan N.

How Does It Work
So, how does Plan N work? First of all, it works like all of the other Medigap plans. You can use it any doctor or hospital nationwide that takes Medicare. There are no networks and your coverage is portable anywhere in the United States. When you go to the doctor or hospital, you simply take your Medicare card and your supplemental Plan N card. The billing is all done automatically through the Medicare “Crossover” system.

Typically, the provider will not collect the $20 co-pay from you at the time or service (although some who are more familiar with your coverage or that plan in general MAY collect it). In most cases, however, they will bill you after the fact – after Medicare and the company have paid their share.

I do recommend Plan N as a viable option, especially for people in good health. It is particularly important to think about it this time of year, as many people are losing or leaving their Advantage plan coverage. This makes Plan N a viable opportunity – you are already used to some co-pays for doctor visits. But with Plan N, you can limit your total out of pocket exposure greatly and avoid the restrictions, networks, portability issues that are a part of Advantage plans.

If you have any questions about this plan or any of the plans in general, please contact me at 877.506.3378 or you can request a quote comparison on our website at Medicare-Supplement.US.

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