The subject of today’s blog is Medigap Plan G vs Plan N: Truth You Should Know. What’s the difference between plans G and N? Senior citizens should know about these two important Medigap options. So, they can make an informed decision on which plan is best for them. Let’s take a closer look at what sets these two plans apart from one another.
Plan G covers two areas that Plan N does not. Plan N doesn’t cover excess charges and copayments. The Part B deductible is not covered by either Plan G or Plan N. Premiums for each policy vary depending on the carrier that sells it.
Have you been wondering what the difference is between Medicare Plan G and Plan N? Both of these popular plans offer great benefits, but there are some key differences that you should know about before you make your decision. We’ll break down those differences for you so that you can make the best choice for your needs. Keep reading to learn more!
Why Representing multiple companies Helps with Medigap Plan G vs Plan N
By representing multiple companies I’m able to objectively compare all of the benefits from the plans like Medigap Plan G vs Plan N. Also the costs to make sure you are getting the exact right program at the best cost for your needs. All of my services are free to you. Medicare dictates the costs and benefits must be the exact same whether you use my free service or you go directly to the company. Give me a call and I can help you get the exact product for your needs at the best price.
What is a Medicare Supplement Plan?
What is a (Medigap) Plan? I get this right from Medicare’s publication titled Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare. It states on page 9, “A Medigap policy is an insurance policy that helps supplement Original Medicare and is sold by private companies. A Medigap policy can help pay some of the remaining health care costs that Original Medicare doesn’t pay for covered services and supplies, like copayments, coinsurance, and deductibles. Original Medicare pays for much, but not all, of the cost for covered health care services and supplies. These are “gaps” in Medicare coverage. It also states, “All Medigap policies must follow federal and state laws designed to protect you, and policies must be clearly identified as “Medicare Supplement Insurance.” Each standardized Medigap policy must offer the same basic benefits, no matter which insurance company sells it.
Cost Is The Only Difference? Want To Know Why?
This next sentence is very important. Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies. What this means is that all companies offering a Medicare Supplement must have the same basic benefits. For example, if you’re looking at a Plan G you know the Plan G with every company is going to pay the same exact amount.
If you have a Part A deductible claim and you have a Plan G, you know that every company will pay the full Part A deductible. Not one company’s Plan G will pay 90% of it. Or one company will pay %110 percent of it they will all pay the same. When you’ve made your decision on what Medicare plan you want, don’t worry if one company’s Plan G or N pays more or less.
How to Pick the Best Medicare Supplement Plan?
Let’s get back to the sentence that says, “Cost is usually the only difference between Medigap policies with the same letter sold by different insurance companies.” This is accurate, but not 100%. Many untrained agents like to say, the Medicare Supplement plan you choose has the same benefits as every company. You might as well pick the cheapest. It’s true the monthly premium between the companies can be a lot. Over $100 a month difference sometimes, but picking a company, just because they’re the cheapest can be dangerous. While we know the benefits are the same, not all companies are the same. When looking for the right company you should take into account rate increase history.
How long a company has been in the Medicare Supplement market? At the time I’ve made this blog, several Medicare Supplement companies have left the market and that can cause you to rate problems down the road. Click on the video below to view.
- Some companies can offer additional benefits beyond the basic benefits.
- There are companies that offer free gym benefits
- Some offer vision and hearing insurance for example.
I’m able to shop all the plans, from all the companies in just seconds and all my services are free to use.
What are Medigap Policies? REMOVE More on Medigap Plan G vs Plan N
We know a Medicare Supplement is something we purchase from a private insurance company to pay for the gaps in Medicare. And also know it’s easy to compare plans because the benefits are standardized. I want to get a little terminology straight before we move on. Medicare Supplements are sometimes called Medigap policies. They’re the exact same thing they just can be referred to with two different names. Next, I’ll talk about the costs that Medicare beneficiaries incur because as we know Medicare doesn’t pay 100% of the bill. I’ll show our most popular Medicare Supplement can pay every deductible, copay, and coinsurance Medicare doesn’t pay for except for a small $203 once per calendar year deductible.
I like to give this ridiculous scenario because it illustrates how good this coverage is. Imagine in January you’re diagnosed with cancer, then in February you have a stroke, then in March you have a heart attack, and then in April, you’re hit by a bus. Besides the monthly premium you pay for the plan, your out-of-pocket cost with this plan would just be a small deductible of $203 in 2021. Now that’s some good coverage. I’ll show you a plan that has a lower monthly premium. It has a few more out-of-pocket costs for the Medicare beneficiary. These are our two most popular plans. The first one I described is called Medicare Supplement Plan G and the other is called Medicare Supplement Plan N.
What does a Medicare Supplement Cover?
Here’s a chart of all the Medicare Supplement Plans available. I also get this from the guide for Choosing a Medigap policy. Medicare Supplements are lettered A through N with a few letters missing. When you look at the chart it can be a little overwhelming, but there are only a few options that are truly worth purchasing. The two most popular plans are Plan G, and Plan N. You may hear about Plan F, but it’s no longer available for purchase for Medicare beneficiaries that have a Medicare effective date of January 1, 2020, or later. I want you to look at the column labeled benefits on the left. These are all the deductibles, copayments, and coinsurance you’d be responsible to pay if you only had Original Medicare Parts A and B and didn’t purchase any Medicare Supplement.
Medicare Supplement Plans Costs
I’m going to explain this a little out of order than the chart shows. All dollar amounts I give are for 2021. If you’re reading this in 2022 or beyond the costs will probably be a little higher. I’ll start with the Part A deductible. The Part A deductible is $1,484. This covers you for the first 60 days in the hospital. This 60 day is called a benefit period. This box here is for hospital stays lasting 61 to 90 days. You’re responsible to pay $371 per day during this period. Also included in this box is hospital stays lasting more than 90 days. For hospital stays lasting over 90 days you’re responsible to pay $792/day until you exhaust your lifetime reserve days. You get a total of 60 lifetime reserve days more on lifetime reserve days in a moment.
So by looking at this chart, you can see that Plan G and N and others, but we are focusing on G and N in this blog, pay 100% of the Part A deductible of $1,484 and also 100% of the Part A coinsurance and hospital costs. Those costs are the $371 per day hospital stays lasting between 61 and 90 days and the $792 per day for stays lasting over 90 days. Plan N and G will also give you an additional 365 days of inpatient hospital coverage if you use your 60 lifetime reserve days.
What is Deductible for Medicare Part B?
You can see under Plan G and N the Part B deductible boxes are blank. That means the Medicare beneficiary is responsible to pay the deductible. This isn’t a big deal because in 2021 the deductible is only $203. This deductible is only once per calendar year. I get asked if this deductible is on each service and the answer is “no”. You only pay the first $203 of all of your Part B claims.
Next is Medicare Part B coinsurance. This is the 20% we hear about. After the first $203 of Part B claims, Medicare will pay 80% of the Part B claim. And you the beneficiary are responsible to pay the remaining 20% of the Medicare negotiated amounts. But if you have a Plan G you can see it will pay 100% of the 20% Part B coinsurance Medicare doesn’t pay.
What is Medicare Plan N Coverage?
Let’s look under Plan N. Plan N will also pay 100% but it has a few asterisks. Plan N has a lower monthly premium in general as compared to Plan G. One of the reasons is when you go to a doctor’s office visit and you’ve already paid the Part B deductible, you’re responsible to pay up to, notice I said up to, a $20 copayment. This is the maximum copay, sometimes it can be less than $20 but $20 is the max. When you go to the emergency room you’re subject to up to a $50 copayment and that copayment is waived if you’re admitted to the hospital as an inpatient. Having these small copayments built-in helps lower the monthly premium of Plan N.
Does Medicare Cover the First 3 Pints of Blood?
Blood’s first 3 pints. If you need blood Medicare doesn’t pay for the first 3 pints. Don’t ask me why, I just know they don’t pay. But if you look under Plan G and N these Medicare Supplements will pay for the first 3 pints. You may be asking well what happens after the first 3 pints. Medicare will pay for additional pints, but with an 80/20 split, with the Medicare beneficiary being responsible for the 20%. So Plan G and N will pay 100% for the first 3 pints. And then Plans G and N will also pay 100% of the 20% coinsurance. You’d be responsible for under the Part B 20% coinsurance.
If you have Plan N, because the blood isn’t a doctor or emergency room visit it isn’t subject to any copays. Now we have skilled nursing facility care coinsurance. The coinsurance for the first 20 days is $0. But for days 21 through 100 the coinsurance you’re responsible for is $185.50 per day. With Plan G and N they will pay the entire coinsurance for up to 100 days. If you max out the 100 days this is a benefit of $14,840.
Which Medigap plans Provide Foreign Travel Emergency Care When a Member Travels Outside the United States?
Original Medicare doesn’t cover service out of the United States. But if you have Plan G or N you have emergency coverage if you are traveling outside the United States. This coverage will pay a lifetime maximum of $50,000. A $250 deductible and the Medicare Supplement will pay 80% of the bill and you’re responsible for 20% of the bill.
What is Medicare Assignment?
Medicare Assignment is when a provider doesn’t accept Medicare as full payment. When a provider doesn’t accept Medicare as full payment or doesn’t accept Medicare Assignment which is unusual, over 90% of all providers accept Medicare Assignment, but if a provider doesn’t accept Medicare Assignment, the provider has the option to charge you an extra 15% above what Medicare pays them.
What is the Medicare Excess Charge?
The last area I’ll cover is excess charges. They can be a little confusing. I’ve made a separate blog explaining them more in-depth and how to look to see which providers charge excess charges. If Medicare pays them $1,000 for a service and the provider has decided not to take Medicare Assignment, they may charge the Medicare beneficiary an additional 15% or $150 in this example. You can see under Plan G that it will pay 100% of these excess charges. However, with Plan N you the Medicare beneficiary is responsible to pay the excess charges. This is another reason why Plan N generally has a less expensive premium than Plan G. Please read my blog on excess charges. It outlines more about excess charges and Medicare Assignment along with also how to use Medicare’s website to look up all providers that accept medicare and those that accept Medicare Assignment.
When is the Best Time to Buy a Medicare Supplement Policy?
I get this directly from Medicare’s website; it states, “buy a policy when you are first eligible” The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. You generally will get better prices and more choices among policies. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you’re 65 and enrolled in Medicare Part B (Medical Insurance), and it can’t be changed or repeated. After this enrollment period, you may not be able to buy a Medigap policy. If you’re able to buy one, it may cost more due to past or present health problems.
Does Medigap Require Medical Underwriting?
Medigap insurance companies are generally allowed to use medical underwriting. This is to decide whether to accept your application and how much to charge you for the Medigap policy. However, even if you have health problems, during your Medigap open enrollment period you can buy any policy the company sells for the same price as people with good health.
Next, I would like to read the section for being outside of your open enrollment. It states, “If you apply for Medigap coverage after your open enrollment period, there’s no guarantee that an insurance company will sell you a Medigap policy if you don’t meet the medical underwriting requirements unless you’re eligible due to one of the situations below.”
What Does Open Enrollment Mean for Medicare Supplements?
Before I end this blog I want you to understand a very common misconception about open enrollments and Medicare Supplements. I get many calls during the Medicare Annual Enrollment Period that lasts from October 15 to December 7. It’s critical to understand that this time has absolutely nothing to do with Medicare Supplements. Many people have the impression, and I understand why because the ads that run during this time are misleading, especially ads with celebrities in my opinion.
But the impression during this time is that you can buy for the first time a Medicare Supplement and be guaranteed to be accepted. At the best possible price. They also believe that during this time that they can switch to a new company without having to answer medical underwriting questions. The only time you can get a Medicare Supplement for the first time without answering any medical underwriting questions is during the first 6 months your Part B is effective. This time from October 15th to December 7 only applies to Part C Medicare Advantage and Part D Prescription Drug coverage.
A Medigap is offered by private insurance companies for a monthly premium and helps pay the gaps Original Medicare doesn’t pay for. Medicare Supplements and Medigap Policies are the same. Plan G generally has a higher premium than Plan N. The two most popular plans we provide are Plan G and N. Plan G will pay every deductible, copay, and coinsurance Medicare doesn’t pay except for the small Part B deductible. Plan N generally has a lower monthly premium but has more out-of-pocket costs you are responsible for. Where Plan N differs from Plan G is when you go for a doctor visit there’s a maximum $20 copay. And when you go to the emergency room there’s a maximum $50 copay and Plan N doesn’t cover excess charges.
The best time to buy a Medicare Supplement is during your 6 months open enrollment that starts during your birth month. By the way, you can actually purchase your Medicare Supplement up to six months prior to your 65th birthday month. It doesn’t go effective until your Part B start date, but for those who like to get this done early, you can get it out of the way up to 6 months before you turn 65.