Medigap Plan G vs. Plan N Differences

Medigap or Medicare Supplement insurance plans are provided by private insurance companies and are designed to close the gaps in payments left after Medicare paid its share. Supplemental coverage helps you pay your medical expenses. If you choose to enroll in a Medigap plan, you will have ten standard plan types, named alphabetically from Plan A to Plan N, each offering a different level of coverage. Among these ten choices, two stand out as the most popular plans among current Medicare beneficiaries: Plan G and Plan N.

The Old Debate: Plan F vs. Plan G

The debate between Plan G and Plan N is actually new. Until January 2020, the two most popular plans were Medicare Supplement Plan F and Plan G. The only difference between these two plans is that Plan F paid the policyholder’s Medicare Part B deductible (and reasonably came with a higher premium). And both of them have a high-deductible plan version.

So, what happened to cause the change?

MACRA happened. MACRA, the Medicare Access and CHIP Reauthorization Act came out with new regulations that prohibit any Medicare Supplement plan from paying the Part B deductible. Since Plan F did just that, it is no longer offered to newly eligible beneficiaries. However, those enrolled in Plan F before January 1, 2020, are allowed to keep their benefits, but no new beneficiaries are allowed.

Those who already had Plan F can continue their same coverage. Anyone who delayed enrollment past the age of 65 but did turn 65 prior to January 1, 2020, is also eligible to enroll in Plan F. Those who turn 65 on or after that date are not and will not be eligible for Plan F.

The New Debate: Plan G vs. Plan N

Medigap Plan G is now considered the most comprehensive coverage for anyone ineligible for Plan F. However, it also comes with a higher monthly premium than the rest of the Medigap plans.

Medigap Plan N comes in second place regarding overall coverage and benefits. Let’s look at the differences between these two popular Medigap plans.

Plan G Coverage Details

  • Part A (inpatient care) coinsurance and hospital costs
    • It also offers an additional 365 days after Medicare benefits are exhausted
  • Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Hospice care coinsurance or copayment
  • Part A deductible
  • Part B excess charges
  • foreign travel emergency care

Plan N Coverage Details

  • Part A coinsurance and hospital costs
    • It also offers an additional 365 days after Medicare benefits are exhausted
  • Part B coinsurance or copayment
  • Blood (first 3 pints)
  • Hospice care coinsurance or copayment
  • Part A deductible
  • Foreign travel emergency coverage

A Breakdown of Differences

As we mentioned earlier, neither of these plans pays for the Part B deductible. In 2023, the Part B deductible will be $226.

Plan G does not have copayments for office or emergency room visits. Medicare Supplement Plan N requires a $20 copayment for doctor visits and a $50 maximum copayment for emergency room visits. However, if you are admitted as an inpatient after visiting an emergency room, the $50 copayment is waived.

Plan G offers coverage for Part B excess charges. Excess charges are additional fees charged by a provider who does not accept Medicare Assignment. These excess charges may be up to an additional 15% of the covered services. Plan N does not pay for Part B excess charges.

However, if you live in a MOM state, you will not pay Part B excess charges. MOM stands for Medicare Overage Measure. Some states have enacted this measure to prevent providers from over-charging for services provided to Medicare beneficiaries. Currently, there are eight MOM states: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont.

If you live in a MOM state, having the benefit of your Part B excess charges taken care of is a plan benefit that you should consider.

The Best Plan

Like in other plans offered to Medicare beneficiaries, the best plan is the one that fits both your needs and budget.

Yes, Plan G does offer more coverage and will save you the most in out-of-pocket expenses, but it does have a higher monthly premium to consider. However, Plan N has almost the same coverage, especially if you live in a MOM state. Plan N has great value for a cheaper monthly premium.

To make your decision, you will need to weigh the benefits and the cost. Remember, your premium will increase as you get older, so it is important not to pick a plan that is already requiring you to stretch your budget.

You don’t have to make this decision alone! Give the agents at Temmen Insurance a call. We can compare plans as well as insurance companies to make sure you get the best value.

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