Medigap Plan N | https://www.remedigap.com | 888-411-1329
Medicare Supplement Plan N can be a great value. It’s premiums are often 30% less than Plan F and 20% less than Plan G.
That means some people can get Plan N for under $100 a month.
So what’s the catch?
Well, there’s no trickery or super fine print, but there are a couple benefits Plan N doesn’t cover..
Stick with me and I’ll tell you what they are:
So, when we talk about Medicare Supplement insurance (which is also known as Medigap), Plan F is usually the first one to come to mind. After all, it’s the one most people have heard of…but when when we’re talking about value we immediately think of Medigap Plan G… but you should not overlook Plan N.
It’s low premiums make it a great plan to consider…you just need to be aware of some benefits Medicare Supplement Plan N doesn’t have when compared to Plan G and Plan F.
Taking a looking at Plan F, G and N side by side, Plan F, of course covers every benefit on the chart. Plan G and Plan N don’t cover the Part B deductible (that’s what these two plans have in common).
Now let’s focus on what else Plan N does not cover, because this is where it separates itself from Plan G.
Plan N Copays
Medigap Plan N has provider and emergency room copays.
This is how it works…Medigap providers can charge you a copay up to $20 per office visit. Now, the key here is the wording “up to $20”. So, it could be a $0 copay, a $20 copay or anything in between…but never more than $20.
And, if you visit the emergency room, the copay is $50 per visit. However, that copay is waived if you’re admitted into the hospital and the emergency room visit is covered as a Medicare Part A expense.
Okay, that was the easy part. Now, we’re going to focus on the Part B excess charges. This is a covered benefit with Plan F and Plan G, but not with Plan N.
The good news is that you are only responsible for excess charges if the provider does not accept Medicare assignment.
A doctor can provide care to Medicare patients and not accept Medicare Assignment. That probably bears repeating…a doctor can provide care to Medicare patients and not accept Medicare Assignment.
When a Medicare provider doesn’t accept assignment they’re telling Medicare they don’t accept Medicare’s approved amount for payment.
When the doctor sends your claim to Medicare, they provide the billed amount for the service. Let’s say the doctor billed $250. But Medicare has a set amount of money they pay for certain services. So, if the doctor billed $250 for your visit and Medicare’s approved amount is $100… the doctor can bill you 15% of Medicare’s approved amount (the $100) but only IF the doctor doesn’t accept Medicare assignment.
Basically, the doctor is telling Medicare that they’ll see Medicare patients, but they don’t agree on Medicare’s approved amount. So they elect to not accept Medicare Assignment and therefore can send you a bill for 15% above Medicare’s approved amount for your claim.
They can’t charge you more than 15% of the Medicare-approved amount…this is the limiting charge.
So…Is this a deal breaker when considering Plan N? Well, it shouldn’t be. But you do need to be prudent in knowing if any of your providers don’t accept assignment. And, that includes specialists and any doctors who might treat you at the hospital.
There’s an easy way to see if a provider accepts assignment.
Now, you can always call a doctor’s office and ask…but, you never know who is on the other end of the phone and whether or not they understand what Medicare assignment means. That’s why I like to use Medicare.gov physician finder tool.
As a side note, there are some states that do not allow excess charges (Medicare Overcharge Measure law): Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont.
Do you have a better understanding of Medigap Plan N? I’d love to know in the comment section below. And, remember, if you like this video, click the like button, share with your friends and if you want to learn more about Medicare and Medigap sign up for your FREE eCourse at www.remedigap.com