Medicare Plan N vs Plan G: A Comprehensive Comparison
When it comes to supplementing Original Medicare (Parts A and B), Medigap plans offer a way to reduce the out-of-pocket costs that Medicare doesn’t cover. Two of the most popular options are Medicare Plan G and Medicare Plan N. While both provide extensive coverage, understanding the key differences between these two plans can help you choose the one that best fits your healthcare needs and budget.
What is Medigap Plan G?
Medigap Plan G is one of the most comprehensive supplemental insurance options available for individuals with Original Medicare. This plan is designed to cover most out-of-pocket costs that Medicare does not, including:
- Part A coinsurance and deductible: Plan G covers the coinsurance and deductible costs associated with hospital stays under Medicare Part A.
- Part B coinsurance: The plan covers the 20% coinsurance for outpatient services that Medicare typically does not cover.
- Excess charges: Plan G covers any excess charges if a healthcare provider charges more than the Medicare-approved amount for services.
- Skilled nursing facility care: It covers the daily coinsurance costs for stays in skilled nursing facilities.
- Hospice care: Medigap Plan G also covers coinsurance for hospice care under Part A.
- Emergency care abroad: If you’re traveling outside the U.S., Plan G pays 80% of emergency medical costs, up to the plan’s limits.
Plan G is available in all states except for Massachusetts, Minnesota, and Wisconsin, where different standards apply.
Plan G Coverage Details
While Plan G covers nearly all costs, it does not cover the Medicare Part B deductible, which is $240 in 2024. Additionally, Plan G has no out-of-pocket limit, meaning once the deductible is met, the plan covers nearly all costs associated with Medicare.
What is Medigap Plan N?
Medigap Plan N offers coverage that is similar to Plan G but with some notable differences. It covers most of the same out-of-pocket costs as Plan G, including:
- Part A coinsurance and hospital costs: Like Plan G, Plan N covers Part A costs for up to 365 days after Medicare benefits are exhausted.
- Part B coinsurance: Plan N pays the Part B coinsurance, but with exceptions for some office visits and emergency room visits.
- Hospice care: It covers hospice care coinsurance or copayments under Part A.
- Skilled nursing facility care: Plan N covers the coinsurance for skilled nursing facility care, just like Plan G.
- Foreign travel emergencies: Plan N provides coverage for 80% of emergency medical care abroad.
Plan N Coverage Details
Plan N differs from Plan G primarily in its handling of doctor’s office visits and emergency room visits. Plan N requires copayments of up to $20 for some doctor’s visits and $50 for emergency room visits if you’re not admitted as an inpatient. Unlike Plan G, Plan N does not cover Part B excess charges, meaning if a doctor charges more than the Medicare-approved amount, you would be responsible for paying the difference.
Plan N also does not have a high-deductible option like Plan G, which may be an advantage for those looking for a more budget-friendly plan with slightly less coverage.
Plan G vs Plan N: Key Differences
The following are the key differences between Medicare Plan G and Plan N:
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A coinsurance and hospital costs | 100% | 100% |
| Part B coinsurance or copayment | 100% | 100%, except for some doctor’s office and emergency room visits |
| Part B excess charges | 100% | Not covered |
| Skilled nursing facility coinsurance | 100% | 100% |
| Part A deductible | 100% | 100% |
| Part B deductible | No | No |
| Emergency care outside the U.S. | 80% | 80% |
| Out-of-pocket limit | None | None |
Cost Comparison of Plan G vs Plan N
Generally, Plan G comes with a higher monthly premium than Plan N due to the more extensive coverage it provides. For example, in 2024:
- Los Angeles, CA: Plan G costs $148 to $1,189, while Plan N ranges from $114 to $912.
- Brooklyn, NY: Plan G ranges from $302 to $776, and Plan N ranges from $220 to $483.
- Chicago, IL: Plan G costs between $114 and $830, while Plan N costs $88 to $590.
Premiums vary by location, so it’s crucial to compare plans available in your area.
Choosing Between Medicare Plan G and Plan N
When deciding between Plan G and Plan N, consider your healthcare needs and budget. Plan G is ideal if you’re looking for more comprehensive coverage, especially if you want protection against Part B excess charges. It is particularly beneficial for those who require frequent medical care, as it covers most out-of-pocket costs without exceptions.
On the other hand, Plan N might be a better option if you’re looking for a lower monthly premium and don’t mind paying small copayments for office visits and emergency room visits. It is a solid choice for those who are generally healthy and want to save on premiums.
Factors to Consider
- Healthcare needs: If you have ongoing health conditions or expect to need frequent medical care, Plan G’s more comprehensive coverage might be the better choice.
- Budget: If keeping monthly premiums low is a priority, Plan N could be a more affordable option.
- Premium cost variations: It’s important to shop around and compare premiums from different insurers to get the best deal in your area.
Enrolling in Medigap Plan G or Plan N
The best time to enroll in a Medigap plan is during the Medigap Open Enrollment Period, which begins when you turn 65 and are enrolled in Medicare Part B. During this time, you cannot be denied coverage or charged higher premiums due to pre-existing health conditions. If you enroll later, insurance companies may impose medical underwriting, which could result in higher premiums.
Both Plan G and Plan N are excellent options, but choosing the right one depends on your healthcare needs and financial situation. By understanding the differences between these plans and considering factors like coverage, costs, and copayments, you can make an informed decision that best fits your Medicare coverage needs.