Also see our General Information about Medigaps page.
Plan N is chosen by 40% of new policyholders
In 2023, Plan N accounted for about 40% of new Medigap enrollment among the three most common plans in the United States. (Plans G, N, and high-deductible G [G(HD)] are the most common.)
Compared with Plan G, Plan N may reduce monthly premiums by about $50 for a 65-year-old and $80 for an 80-year-old.
Here are some differences between Plan G and N
After the annual Part B deductible is met, Plan G covers all Part B coinsurance and copayments. It also covers all Part A hospital costs, including the Part A deductible.
Plan N provides similar Part A and Part B benefits but requires certain copayments after the Part B deductible is met. You pay $20 for face-to-face office or telehealth visits with a doctor or nurse practitioner. Medicare billing codes determine which visits are subject to this copayment.
Part B physician services received while you are hospitalized are not included, nor are services such as: CT scans; surgery; infusions; or pathology reports when there is no qualifying face-to-face visit.
Plan N also charges $50 for an emergency room visit if you are not admitted to the hospital.
Finally, Plan N does not cover Part B 15% excess charges from providers who do not accept Medicare Assignment. Nationally, only about 2% of providers fall into this category.
Plan N copayments are billed after the plan pays
The provider bills Medicare for the visit. Medicare then determines whether you have met the annual Part B deductible. If you have, Medicare generally pays the provider 80% of the Medicare-approved amount for most services. Medicare also sends the claim information to your Medigap plan, including the remaining balance. After the deductible is met by your payments, the plan pays the provider the covered balance minus the $20 or $50 copayment. The provider then bills you for the remaining amount. Unlike many Medicare Advantage plans, this copayment is not collected at the time of service.