Choosing the right Medicare Supplement Insurance (Medigap) plan can significantly impact your health care coverage and out-of-pocket costs. Plan G and Plan N are two of the most popular Medigap plans available, offering different levels of coverage and cost-sharing. This article provides an in-depth comparison between Medicare Plan G and Plan N to help you decide which plan might better suit your healthcare needs.
Understanding Medicare Supplement Plans
Medicare Supplement Insurance, or Medigap, is designed to fill the gaps in coverage that are not covered by Original Medicare, such as copayments, coinsurance, and deductibles. These plans are standardized and must follow federal and state laws designed to protect you, making each plan type consistent across every insurance company that offers it.
Medicare Plan G: Comprehensive Coverage
Plan G is one of the most comprehensive Medigap plans available, second only to Plan F (which is no longer available to new Medicare enrollees as of January 1, 2020). Here’s what you need to know about Plan G:
Coverage Details
- Part B Excess Charges: Plan G covers 100% of Part B excess charges. This is important if you see doctors who do not accept Medicare assignment and choose to charge up to 15% over the Medicare-approved amount.
- Foreign Travel Emergency: Covers 80% of the costs for emergency medical care when traveling outside the U.S., up to plan limits.
- Medicare Part A Deductible and Coinsurance: Plan G covers the Part A deductible and coinsurance, including an additional 365 days of hospital costs after Medicare benefits are exhausted.
- Medicare Part B Coinsurance or Copayment: After you pay the annual Medicare Part B deductible, Plan G covers the remaining hospital and medical costs typically split with Medicare.
Out-of-Pocket Costs
- Premiums: Plan G usually has higher monthly premiums than Plan N due to its extensive coverage.
- Deductibles: You are responsible for paying the Medicare Part B deductible annually.
Medicare Plan N: Lower Premium with Cost-Sharing
Plan N is another popular choice, offering lower premiums than Plan G but requiring more out-of-pocket spending when you use medical services.
Coverage Details
- No Part B Excess Charges: Plan N does not cover Part B excess charges, which means you could be responsible for additional costs if a provider charges more than the Medicare-approved amount.
- Foreign Travel Emergency: Similar to Plan G, it covers 80% of the costs for emergency medical care abroad, up to the plan limits.
- Medicare Part A Deductible and Coinsurance: Like Plan G, Plan N covers these costs.
- Medicare Part B Coinsurance or Copayment: Plan N covers 100% of the Part B coinsurance, except for a copayment of up to $20 for some office visits and up to $50 for emergency room visits that don’t result in inpatient admission.
Out-of-Pocket Costs
- Premiums: Generally lower than those for Plan G.
- Copayments and Deductibles: Besides the Part B deductible, expect copayments for doctor visits and ER visits.
Which Plan Should You Choose?
The choice between Plan G and Plan N often comes down to how you balance monthly premiums against potential out-of-pocket costs:
- Choose Plan G if:
- You want more predictable health care costs.
- You often visit doctors who charge Part B excess charges.
- You prefer having the Part B deductible as your only major annual out-of-pocket medical expense.
- You want more predictable health care costs.
- Choose Plan N if:
- You are comfortable with a small copayment for doctor visits and ER visits.
- You prefer lower monthly premiums.
- You do not often need medical care and can handle occasional out-of-pocket costs.
- You are comfortable with a small copayment for doctor visits and ER visits.
Both Plan G and Plan N offer solid coverage under the Medigap policies, with Plan G providing more comprehensive coverage at a higher monthly cost, and Plan N offering a balance of lower premiums with some cost-sharing. Your choice will depend on your financial comfort and healthcare needs. As with any insurance decision, it’s advisable to review your medical spending patterns and talk to a professional to help guide your choice based on your individual circumstances.