Medigap Plan N vs Plan F 

Medigap Plan F vs Plan N

Medigap Plan F and Plan N  are both supplemental insurance plans that help cover Medicare out-of-pocket costs, but while Plan F provides comprehensive coverage, Plan N offers slightly lower premiums with some cost-sharing responsibilities.

Medigap Plan N vs Plan F in Texas

In Texas, Medigap Plan N and Medigap Plan F are popular choices for beneficiaries seeking additional coverage alongside their original Medicare, but while Plan F offers comprehensive coverage without any cost-sharing, Plan N provides slightly lower premiums with some cost-sharing responsibilities such as copayments for certain services and a Part B deductible. 

Medigap Overview

Medigap, also known as Medicare Supplement Insurance, is a type of private health insurance designed to supplement Original Medicare. It helps cover the “gaps” in Medicare coverage, such as deductibles, coinsurance, and copayments, providing beneficiaries with more comprehensive and predictable healthcare costs. Medigap plans are standardized and regulated by the federal government, offering various lettered plans (A, B, C, D, F, G, K, L, M, and N) with each plan providing a different level of coverage. Beneficiaries can choose the plan that best suits their needs and budget, and the coverage is accepted by any healthcare provider that accepts Medicare. Medigap plans to provide beneficiaries with the flexibility to access healthcare services without network restrictions, ensuring peace of mind and financial protection against unexpected medical expenses.

Medigap Plan F 

Medicare Plan F is a comprehensive Medicare Supplement plan that fills the coverage gaps in Medicare Part A and Part B. It was highly popular due to its extensive benefits, including coverage for the Medicare Part B annual deductible. Plan F covers various expenses such as coinsurance, deductibles, excess charges, skilled nursing facility care, blood transfusions, and foreign travel emergencies.

However, there are certain medical costs that Plan F does not cover, such as prescription drugs, hearing health, dental care, vision care, and cosmetic surgeries. To obtain coverage for these benefits, additional insurance is necessary.

The cost of Medicare Plan F varies based on factors like location, gender, age, tobacco use, and the insurance provider. Premiums can range from $150 to $400 per month, with an average of around $230. High-deductible Plan F options have an annual deductible of $2,490.

Medicare Plan F is still available for those who were eligible for Medicare on or before January 1, 2020. They can sign up for Plan F or keep their existing coverage. 

For individuals who are newly eligible for Medicare and cannot enroll in Plan F, there are alternatives to consider. Medicare Supplement Plan G is often recommended as the best alternative to Plan F. Plan G offers similar benefits, except it does not cover the Part B deductible. It is considered a modern-day version of Plan F. The premium for Medicare Plan G varies depending on the insurance company, and there are options with or without a deductible.

Medicare Plan G covers various expenses, including Medicare Part A deductible, coinsurance, hospital costs, hospice coinsurance or copay, skilled nursing coinsurance, the first three pints of blood, and 80% of foreign travel emergencies. By enrolling in Plan G, individuals can have peace of mind knowing that unexpected medical bills are less likely to occur, even though they may need to pay a slightly higher premium.

Medigap Plan N 

Medicare Supplement Plan N offers comprehensive benefits that complement Original Medicare coverage. By enrolling in Plan N, individuals are responsible for only their Medicare Part B deductible, small copays at the doctor’s office, and applicable excess charges. This plan significantly reduces out-of-pocket costs compared to Original Medicare.

While Plan N is not the most comprehensive option, it is ideal for those who want additional coverage while being comfortable with copayments and small costs. It suits individuals who receive care a few times a year during preventative appointments and desire emergency coverage. Similar to Plan G, Medigap Plan N provides significant cost-sharing benefits.

The benefits of Medicare Supplement Plan N include Medicare Part A coinsurance, Part A deductible, foreign travel emergency care, and 20% coinsurance for Part B (with a $20 copayment for doctor visits and $50 copayments for non-admitted emergency room visits). It’s important to note that Medicare Supplement Plan N does not cover Medicare Part B excess charges, which may apply depending on the state and healthcare provider. However, most doctors accept Medicare assignment, making excess charges rare.

Enrolling in Plan N requires paying the Medicare Part B deductible, currently $226 for 2023, and additional charges for Medicare Part B excess charges in applicable states. Plan N covers the same services as Original Medicare, so additional plans like dental, vision, hearing, and Medicare Part D can provide coverage for those needs.

The average monthly cost of Medicare Supplement Plan N in 2023 ranges from $120 to $180, although premiums vary based on various factors.

Differences between Plan F and Plan N 

Medicare Supplement Plan F offers comprehensive coverage with zero out-of-pocket costs beyond the monthly premium. It is a first-dollar coverage plan, meaning it covers expenses from the first dollar after Original Medicare pays its portion. There are no deductibles, coinsurance, or copays to worry about. However, due to its extensive coverage, Medicare Supplement Plan F has the highest monthly premium compared to other plans. Typical premiums for Plan F range from $180 to $300 per month.

Medicare Supplement Plan N is suitable for individuals who are willing to pay small copays when visiting doctors or hospitals. These copays help keep the monthly premium lower. If you frequently visit the doctor’s office, Medigap Plan G might be worth considering.

Under Medicare Supplement Plan N, you may be responsible for Medicare Part B excess charges if they apply in your state. However, not all states allow these charges, so they are not standard.

In terms of premiums, Medicare Supplement Plan N has the lowest average cost among the three plans. The nationwide average monthly premium for Plan N is around $110 to $200.

Final thoughts 

  •  Medigap Plan F offers comprehensive coverage with no out-of-pocket costs beyond the monthly premium.
  •  Medigap Plan N has lower premiums and requires some cost-sharing responsibilities, such as copayments and deductibles.
  • Both plans are popular in Texas, with Plan F providing comprehensive coverage and Plan N offering reduced premiums.
  • Medigap plans to fill the gaps in Medicare coverage and provide additional financial protection for beneficiaries.
  •  Consider personal healthcare needs and budget when choosing between Plan F and Plan N, as they offer different levels of coverage and cost-sharing.
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