Medigap Coverage Guide
What Is Medicare Supplement Plan N?
Plan N covers most major gaps in Original Medicare while leaving the Part B deductible, certain office and emergency-room copays, and excess charges.
Quick answer: Plan N covers most major gaps in Original Medicare, including the Part A hospital deductible. You still pay the annual Part B deductible, up to a $20 copay for certain office visits, up to a $50 copay for certain ER visits without inpatient admission, and any Part B excess charges.
Plan N Supplements Original Medicare
Plan N is standardized private insurance that works with Medicare Part A and Part B. Medicare generally processes an approved claim first; Plan N then pays its standardized share.
One company’s standard Plan N has the same medical benefits as another company’s Plan N. Premiums, discounts, rating methods, customer service and future rate changes can differ.
What Does Plan N Cover?
Hospital and Part A
- Part A hospital coinsurance and additional hospital days
- Part A inpatient deductible
- Skilled nursing facility coinsurance
- Part A hospice coinsurance or copayments
Medical and other benefits
- Part B coinsurance except permitted Plan N copays
- The first three pints of blood
- 80% of qualifying foreign-travel emergencies within plan limits
Plan N generally helps with your share of Medicare-covered services. It does not convert routine dental, vision, hearing or long-term custodial care into Medicare-covered services.
What Does Plan N Leave You to Pay?
- The annual Medicare Part B deductible
- Up to a $20 copay for certain office visits
- Up to a $50 copay for certain emergency-room visits that do not result in inpatient admission
- Part B excess charges, when applicable
- Your Part B, Plan N and separate Part D premiums
Plan N copays are permitted maximums for qualifying visits, not automatic charges for every encounter. Claim coding and processing determine whether they apply.
If you prefer a Medigap option that covers Part B excess charges and does not use Plan N’s permitted office and ER copays, review Medicare Supplement Plan G.
What Are Part B Excess Charges?
A provider who accepts Medicare but does not accept Medicare assignment may be allowed to charge more than the Medicare-approved amount for certain Part B services. Plan N does not cover that additional excess charge.
Before non-emergency care, ask the provider whether they accept Medicare assignment or use Medicare Care Compare. Do not assume every clinician within one system bills the same way.
Does Plan N Have a Network?
A standard Plan N generally works with any U.S. provider who accepts Medicare and is willing to treat you. Original Medicare generally does not require plan referrals to see specialists.
Medicare SELECT versions may require certain hospitals or providers for full supplemental benefits. Verify whether the proposed policy is standard Plan N or Medicare SELECT.
Who May Want to Consider Plan N?
Plan N may fit if you:
- Want strong protection against major Original Medicare gaps
- Are comfortable with limited office and ER copays
- Will verify Medicare assignment
- Find its premium meaningfully lower than alternatives
Another option may fit if you:
- Want fewer small bills after the Part B deductible
- Want coverage for Part B excess charges
- See providers frequently
- Find the premium savings too small for the tradeoff
Modern Medigap does not include outpatient prescription coverage. Someone using Plan N generally compares a separate Part D plan.
When Can You Buy Plan N?
Your strongest federal opportunity is the one-time six-month Medigap Open Enrollment Period that begins when you are at least 65 and enrolled in Part B. Outside that period, underwriting may apply unless guaranteed issue or state law protects the application.
If you already have coverage, do not cancel it until Plan N is approved and the new effective date is confirmed.
Plan N Questions
Does Plan N cover the Part B deductible?
No. The policyholder pays the annual Part B deductible.
Do I pay $20 at every doctor visit?
No. Plan N permits up to $20 for certain office visits. It depends on how the service is billed and processed.
Will I always owe $50 at the ER?
No. The permitted copay applies to certain ER visits that do not result in inpatient admission.
Does Plan N cover prescriptions?
No. A separate Part D plan is generally used for outpatient prescriptions.
Can Plan N be canceled if I become sick?
Standard Medigap policies are generally guaranteed renewable if premiums are paid and the application was truthful.
Independent Medicare guidance
Compare Medicare Supplement Options
Thompson Medicare Brokerage can help you compare plan benefits, premiums, enrollment rights and carrier options in Missouri and Illinois. Consultations are no-cost and no-obligation.
Thompson Medicare Brokerage is a non-government insurance agency. This page provides general educational information. Policy availability, premiums, underwriting, eligibility and enrollment rights vary by applicant, carrier, state and effective date.