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Understanding Medigap Plan N

Understanding Medigap Plan N

If you have a good understanding of Medigap Plan N, then you may be able to save a considerable amount on your annual health care expenses if you are enrolled in Medicare Part A and Part B.

For those who are enrolled in Original Medicare (Medicare Part A and B), this program can cover a lot of your health care costs. However, it also requires that you spend a considerable amount in out-of-pocket expenses – primarily in the form of copayments, coinsurance, and deductibles.

To helps with reducing – or even in eliminating – these hefty charges, many Medicare enrollees obtain Medicare Supplement insurance. Having this type of coverage can result in thousands of dollars of savings each year.  If you already have a plan such as a Plan J and have questions, we can help you find answers.

What is Covered Under Medicare Supplement Plan N?

While Medigap Plan A may be a good fit for some, there are others who may have alternate requirements, such as in the premium that they pay and / or in the benefits that they want to receive.

With Medicare Supplement Plan N, the plan enrollee will still be responsible for sharing his or her health care expenses in some situations. For example, you may be required to pay a copayment of up to $50 for emergency room visits (if you are not admitted to the hospital as an inpatient), as well as a copayment of up to $20 for doctor visits.

The benefits that are included in Medigap Plan N (in 2016) are the following:

  • Medicare Part A hospitalization co-insurance and other expenses – up to an additional 365 days after Original Medicare’s benefits have been used up;
  • Medicare Part A hospice care copayment or co-insurance;
  • Medicare Part A deductible;
  • Medicare Part B copayment or co-insurance (other than for a co-payment of up to $20 for some doctors’ visits and / or a co-payment of up to $50 for emergency room visits that do not result in a hospital inpatient admission);
  • First 3 pints of blood per year that are used in a medical procedure;
  • Medicare Part A skilled nursing facility care co-insurance;
  • Foreign travel emergency care – up to the plan’s limits (covered at 80%).

Why Should Someone Consider Medigap Plan N Versus Other Medigap Plans?

There are many different Medicare Supplement insurance plans to choose from, so it can be difficult to decide which may be the best for you. When considering a Medigap Plan N, there are several criteria to keep in mind.

First, this plan will provide all of the basic “core” benefits that are provided in Medigap Plan A – along with some additional coverages. One of those added benefits is the Part A Skilled Nursing Home facility co-insurance.

This benefit alone can save you up nearly $13,000 if 100 days or more of qualifying skilled nursing home confinement is required. This is because (in 2016) the Medicare daily co-payment is $161 for days 21 through 100. If that amount had to be paid out-of-pocket, it would cost a Medicare enrollee $12,880 ($161 daily co-payment X 80 days = $12,880).

There are, however, some trade-offs to keep in mind concerning Medicare Supplement Plan N. For example, if considering Medigap Plan N, it is important to note that this policy does not cover the Part B deductible for Medicare, nor the Part B excess charges. Because of that, you would still be responsible for paying these costs out-of-pocket if you had a Plan N Medicare Supplement insurance policy.

However, with Medigap Plan N, 100 percent of Medicare Part B’s co-insurance expenses would be covered – other than just up to a $20 co-payment for office visits, and up to a $50 co-payment for emergency room visits.

How Does the Medicare Program Work and How Much Can It Cost?

When it initially came about, the Medicare program consisted of just two parts – A and B. Now, however, Medicare has four distinct components. These are:

  • Medicare Part A – Hospitalization: Medicare Part A covers inpatient hospital care. This part of Medicare can also include care that you may receive at home from a home health care agency after you return home from an inpatient hospital stay, as well as some limited skilled nursing facility care, and some hospice care coverage.
  • Medicare Part B – Medical / Doctors’ Services: Medicare Part B provides coverage for medical and doctors’ services, such as outpatient hospital care and visits to your primary care physician. Part B also provides coverage for medical equipment that is ordered by your doctor such as walkers and wheelchairs, as well as for various preventive care services. Medicare Part A and Part B are often referred to as Original Medicare.
  • Medicare Part C – Medicare Advantage: Medicare Advantage is another name for Medicare Part C. This is an alternate way for people to receive their Medicare Part A and Part B coverage – and the plans are provided by private insurance carriers as versus through Medicare itself. Medicare Advantage plans must provide all of the same coverages that are offered in Medicare Parts A and B. But, these plans will typically provide even more, too, such as vision, dental, and / or wellness benefits. In many cases, prescription drug benefits are also included in Medicare Advantage plans. Coverage in Medicare Advantage plans is often provided in a managed care fashion, meaning that enrollees will be required to choose their doctors, hospitals, and other healthcare providers from a list or “network.” If care is received outside of the network, coverage will either not be reimbursed, or the cost will be higher to the participant.
  • Medicare Part D – Prescription Drug Coverage: Part D of Medicare is prescription drug coverage. Similar to with Medicare Advantage plans, prescription drug plans are also offered by private insurance carriers – so, the plans and the premiums can differ from one to another. Those who are enrolled in Original Medicare (Part A and Part B) can purchase a Medicare Part D plan if they want to have prescription drug coverage. If you are enrolled in a Medicare Advantage plan, however, you cannot purchase Medicare Part D, as it is likely already covered in your Medicare Part C plan.

Medicare Part A and B enrollees are likely well aware of the out-of-pocket expenses that are associated with Medicare’s coverage. This is especially the case if you have visited your doctor regularly and / or required hospital services. In 2016, the Medicare Part A and B deductibles, copayments, and co-insurance costs are as follows:

Medicare Part A hospital inpatient deductible and coinsurance:

  • $1,288 deductible for each benefit period
  • Days 1 – 60: $0 coinsurance for each benefit period
  • Days 61 – 90: $322 coinsurance per day of each benefit period
  • Days 91 and beyond: $644 coinsurance per each “lifetime reserve day” after day 90 for each benefit period (up to 60 days over your lifetime)
  • Beyond lifetime reserve days: all costs

Medicare Part B deductible and coinsurance:

  • Deductible of $166
  • After the deductible is met, you typically pay 20% of the Medicare-approved amount for most doctor’s services (including most doctor’s services while you are a hospital inpatient), outpatient therapy, and durable medical equipment.

What is Medicare Supplement (Medigap) Insurance?

Although the out-of-pocket costs that are required for Original Medicare enrollees can certainly add up, there is good news in that you could help to curb these expenses by obtaining a Medicare Supplement insurance policy.

This type of coverage is designed to help pay for some or all of the deductibles, co-payments, and / or co-insurance that is required by Medicare Part A and / or B. In addition, some of these Medicare Supplement insurance plans may also offer additional coverage as well. Because these plans essentially fill in many of Medicare’s coverage “gaps,” they are often referred to as “Medigap” insurance.

How Does Medigap Insurance Work?

Today, there are ten different Medicare Supplement insurance policies that you can choose from. Each of these is named after a different letter of the alphabet, beginning with Plan A – which offers the most basic set of “core” benefits.

The benefits that are offered in Medicare Supplement Plan A (in 2016) include:

  • Medicare Part A coinsurance and hospital expenses – up to an additional 365 days after Medicare benefits have been exhausted;
  • Medicare Part B coinsurance or copayment;
  • First 3 pints of blood per year;
  • Medicare Part A deductible.

All of the insurance carriers that offer Medicare Supplement insurance coverage are required to provide the same set of identical benefits in each of the plans of the same corresponding letter. This means that all of the Medigap Plan N’s will be the same regarding coverage, regardless of which insurer you purchase it from.

The amount of the premium that can be charged, however, can differ – in some cases, significantly. Therefore, it is important that you shop and compare before making your final decision on coverage.

What to Consider When Choosing a Plan

Before enrolling in Medigap Plan N – or in any Medicare Supplement insurance policy – it is important to consider several items. These will help you to ensure that you are getting the very best plan for your health care needs.

For example, you should factor in what your specific health care requirements typically are throughout the year, as well as which of those needs are the most important to you. If you are married, you should also do this for your spouse.

You should also take into consideration the amount of money that you will be comfortable paying in premium for a Medicare Supplement insurance plan premium – especially about how much you may be able to save in out-of-pocket deductible, co-insurance, and / or copayment costs over that same period.

Who is Eligible for Medicare Supplement Insurance Coverage?

Whether or not you are even eligible to purchase a Medigap insurance plan will also certainly factor into the overall equation. Those who are enrolled in a Medicare Advantage plan are not able to purchase Medicare Supplement coverage. Only those who are age 65 and over, and who are also enrolled in Original Medicare (Medicare Part A and B) can purchase this type of coverage.

When is the Best Time to Buy a Plan?

The best time to buy Medicare Supplement insurance is during your open enrollment period. This is the period when you have turned age 65, and you have also enrolled in Medicare Part B.

This is because, during this six-month period, you cannot be turned down for a Medicare Supplement insurance policy – or even charged more for your Medigap coverage – even if you have an adverse health condition.

Where Can You Find the Best Premium Rates for Medicare Supplement Insurance Plan N?

When shopping for the very best rates on a Medigap Plan N, you should ideally work with a company or agency that has access to multiple insurance carriers. That way, you will be able to more directly compare policies and premium rates. If you are ready to move forward with a quick and easy comparison of Medigap Plan N, we can help. We work with many of the best Medicare Supplement insurance carriers, and we can get you the details that you need instantly. To move forward, just simply fill out the form on this page.

If you should have any additional questions regarding Medigap Plan N, or even if you just simply have a question about Medicare Supplement in general, please feel free to contact us directly. We can be reached toll-free by dialing 1-800-376-0824.

We understand that purchasing a Medicare Supplement insurance plan may seem a bit overwhelming. There are a lot of details to go over, and you want to ensure that you’re getting the best plan for your needs. We are experts in this area, and can walk you through the process. So, contact us today – we’re here to help.

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