Medigap Coverage Guide
What Is Medicare Supplement Plan N?
Plan N covers most major gaps in Original Medicare while leaving several smaller costs for the policyholder to pay.
The short version: Plan N covers most major gaps in Original Medicare, but you still pay the annual Part B deductible, certain office and emergency-room copays, and any Medicare Part B excess charges.
🧩 How does Plan N work?
Plan N is one of the standardized Medicare Supplement—or Medigap—plans sold by private insurance companies. It supplements Original Medicare Part A and Part B; it does not replace Medicare.
When you receive a Medicare-covered service, Medicare generally processes the claim and pays its share first. Your Plan N policy then pays according to its standardized benefits, and you are responsible for any amount that Plan N does not cover.
The medical benefits of one standard Plan N policy are the same as another company’s Plan N policy. Premiums, pricing methods, household discounts, customer service and future rate changes can differ, so comparing the insurance company matters as well as comparing today’s price.
✅ What does Medicare Supplement Plan N cover?
Hospital and Part A costs
- Medicare Part A hospital coinsurance and additional hospital benefits
- The Medicare Part A inpatient hospital deductible
- Skilled nursing facility care coinsurance
- Part A hospice care coinsurance or copayments
Medical and other benefits
- Part B coinsurance, except for Plan N’s permitted copays
- The first three pints of blood Medicare requires for a medical procedure
- 80% of qualifying foreign-travel emergency costs, subject to the plan’s deductible and lifetime limit
Important: Plan N generally helps with your share of costs for services that Original Medicare covers. It does not turn a service that Medicare excludes into a covered service.
⚠️ What does Plan N leave you to pay?
Medical cost-sharing
- 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 an inpatient admission
- Medicare Part B excess charges, when applicable
Services outside Medigap
- Routine dental, vision and hearing care that Original Medicare does not cover
- Long-term custodial care
- Most outpatient prescription drugs
- Your Part B premium and your Plan N premium
Prescription reminder: Modern Medigap policies do not include outpatient drug coverage. If you choose Original Medicare with Plan N, you will usually want to consider a separate Medicare Part D plan.
🩺 What are Part B excess charges?
A provider who does not accept Medicare assignment may—in states where it is permitted—charge more than the Medicare-approved amount for certain Part B services. That additional amount is called an excess charge.
Plan N does not cover Part B excess charges. Before receiving non-emergency care, you can ask the provider whether they accept Medicare assignment or check the provider using Medicare’s Care Compare tool.
This does not mean that every provider who accepts Medicare automatically accepts assignment. It is worth checking the particular provider instead of assuming based only on location or health system.
⚖️ Plan N vs. Plan G
Plan N and Plan G cover many of the same major gaps. The key differences are Plan N’s office and emergency-room copays and its lack of coverage for Part B excess charges.
| Benefit or cost | Plan N | Plan G |
|---|---|---|
| Part A hospital deductible | Covered | Covered |
| Part B deductible | Not covered | Not covered |
| Certain office visits | Up to $20 copay | Covered after Part B deductible |
| Certain ER visits without inpatient admission | Up to $50 copay | Covered after Part B deductible |
| Part B excess charges | Not covered | Covered |
| Foreign-travel emergency benefit | 80%, within plan limits | 80%, within plan limits |
| Typical premium relationship | Often lower | Often higher |
Premiums vary by insurance company, age, location, pricing method, eligibility for discounts and other permitted rating factors. “Often lower” is not a guarantee for every applicant.
A practical comparison: Add the annual premium difference between Plan N and Plan G, then consider your expected copays and your comfort with possible excess charges. The lowest premium is not automatically the lowest total cost.
🎯 Is Plan N a good fit for you?
Plan N may be worth considering if you:
- Want broad protection against major Original Medicare cost-sharing
- Would prefer a potentially lower premium than Plan G
- Are comfortable paying occasional office or emergency-room copays
- Are willing to verify whether providers accept Medicare assignment
- Want the freedom to use any nationwide provider that accepts Original Medicare
Plan G or another option may fit better if you:
- Want fewer small bills when receiving Medicare-covered care
- See doctors frequently and dislike office-visit copays
- Want protection from Part B excess charges
- Prefer not to check whether individual providers accept assignment
- Find that Plan N’s premium savings are too small to justify its added cost-sharing
🌎 Does Plan N have a provider network?
A standard Plan N policy works with Original Medicare and generally does not use a conventional local provider network. You can receive covered care from doctors and hospitals nationwide that accept Medicare.
Plan N also generally does not require referrals to see Medicare-participating specialists. However, you should still confirm that the provider accepts Medicare and determine whether the provider accepts Medicare assignment.
Medicare SELECT versions of Medigap policies may have network requirements, so check the exact policy rather than relying only on the “Plan N” letter.
📅 When should you apply for Plan N?
Know your enrollment window
Your federal six-month Medigap Open Enrollment Period generally begins the first month you have Medicare Part B and are age 65 or older.
Compare more than premiums
Review current rates, household discounts, company history, pricing method and how increases could affect the policy over time.
Protect your existing coverage
If you already have Medigap, do not cancel it until your replacement policy has been approved and you understand its effective date.
Do not assume there is a yearly Medigap open enrollment period. Outside your initial Medigap Open Enrollment Period or a guaranteed-issue situation, an insurer may be allowed to ask health questions, charge more or deny an application. State-specific rights may also apply.
🔄 Plan N is not Medicare Advantage
Plan N supplements Original Medicare. A Medicare Advantage plan is a different way to receive your Medicare benefits.
You cannot use a Medigap policy to pay a Medicare Advantage plan’s deductibles, copayments or premiums. If you are considering leaving Medicare Advantage for Original Medicare and Medigap, check your Medigap eligibility before assuming that a Plan N company must accept you.
❓ Frequently asked questions
Does Plan N cover the Medicare Part B deductible?
No. You are responsible for the annual Part B deductible before Medicare and Plan N begin paying applicable Part B costs under their normal rules.
Do I pay $20 every time I see a doctor?
Not necessarily. Plan N permits a copayment of up to $20 for certain office visits. The amount depends on how the service is billed and processed, so it should not be described as an automatic $20 charge for every medical encounter.
Will I always owe $50 at the emergency room?
No. Plan N permits a copayment of up to $50 for certain emergency-room visits that do not result in an inpatient admission. The copay is waived when the visit results in an inpatient admission under the plan’s rules.
Does Plan N include prescription drug coverage?
No. If you want outpatient prescription coverage while using Original Medicare and Plan N, you generally need a separate Medicare Part D plan.
Can my Plan N policy be canceled if I become sick?
Standard Medigap policies are generally guaranteed renewable as long as you pay the premium and meet the policy requirements. An insurance company cannot ordinarily cancel the policy merely because your health changes.
Is every insurance company’s Plan N identical?
The standardized medical benefits are the same, but premiums, discounts, customer service, pricing methods and future rate increases can differ. Medicare SELECT policies may also impose provider restrictions.
Need help comparing Plan N?
The right choice depends on more than today’s premium. I can help you compare Plan N, Plan G and other Medicare options based on your budget, doctors and preference for predictable costs.
Thompson Medicare Brokerage is a non-government insurance agency. Plan availability, premiums, underwriting requirements and eligibility vary. For official standardized benefit information, review Medicare’s Medigap plan comparison.