Medicare is a huge asset to the aging population, especially when healthcare costs are getting higher, and critical illnesses are on the rise. If you are one of the millions of seniors who rely on Medicare, it helps to know how different plans affect you.
Medicare Plan G and Plan N are popular among many seniors. However, there is just one question—what’s the difference between the two? According to experts, Medicare Plan G is the “second most popular Medigap plan in the” country.
Plan G functions much like Plan F, but premiums with Plan G are typically lower than the premium for plan F. Moreover, plan F is no longer available to new Medicare enrollees with an Original Medicare effective date after January 1st, 2020. Because of this, many experts recommend selecting Plan G.
Medicare Plan G does not cover the Part B deductible. Plan G is the preferable choice among seniors, primarily because it covers several expenses, including copays, coinsurance, and deductibles not covered under Medicare Part A and Part B. Part A & B are referred to as “Original Medicare.”
While Medicare Plan G is widely popular, it is one of the more expensive Medicare options. According to Nerd Wallet, Medicare Plan G is one of the most expensive options for seniors. However, Medicare Plan G is desirable, because it is the most comprehensive in covering costs that Medicare does not cover on its own.
Medicare Plan G covers more out-of-pocket costs than most other Medicare plans. Any outstanding balance that remains after Medicare pays its share is covered by Plan G—a huge benefit for seniors on a budget. Plan G offers more benefits than any other Medicare plan, excepting the retired Plan F.
Ten types of Medicare are offered in the United States, except for Wisconsin, Minnesota, and Massachusetts. These states have their own individual standards when it comes to Medicare plans.
Of course, it’s important to note that Medigap coverage is only available to beneficiaries who are enrolled in Medicare Part A and Part B. But what exactly does Medicare Plan G cover? Medicare Plan G covers Part A coinsurance and any hospital care or hospital stay exceeding 365 days after Medicare benefits are exhausted.
Additionally, Medicare Plan G covers the Medicare Part A deductible and coinsurance or copayment for Part A hospice care. Plan G also covers the Part B copayment or coinsurance. If a medical provider charges more than Medicare’s allowed amount, Plan G covers Part B excess charges.
In addition to this, Medicare Plan G covers the first three pints of a blood transfusion. It also covers skilled nursing facility care. Those who travel abroad can enjoy emergency healthcare services for their first 60 days of travel. However, there are limitations on this.
While those considering Plan G should know what is covered, it also helps to understand what Plan G does not cover. Medigap Plan G and all other Medigap plans do not cover the Medigap Part B deductible. Plans that cover these are not available for purchase (Plan F and Plan C).
Medicare Plan G does not cover prescription drugs, long-term care, such as a nursing home, or dental care. Plan G does not cover vision care, either. Any costs for vision or dental care is going to come out of your own pocket. Additionally, Plan G does not cover private-duty nursing.
While Plan G is good, it is quite expensive, touting an average monthly premium of $145 in 2023. It varies by age, zip code, gender and tobacco use. As of January 1, 2023, the annual deductible for Plan G is $226/year and is offered in a high deductible version with a $2,700 deductible, as well. Because of this, beneficiaries with Plan G must pay $226 before Medicare covers the rest.
But what about Medicare Plan N? How is it different? According to experts, Medicare Plan N is a supplemental insurance plan that reduces the amount of money Medicare recipients must pay out-of-pocket. Plan N covers the entire cost of the coinsurance when you are admitted into the hospital.
As one of the 10 Medigap policies, Plan N provides better coverage than many other supplemental plans. Plan N covers most medical expenses for an average monthly cost of $132. It fills in for any costs that Medicare does not pay. This makes it easier for Medicare beneficiaries to have all their medical costs paid.
Only 80 percent of medical costs are covered by Medicare Part A and Part B, so this added coverage through Plan N makes it easier for seniors to afford care on a fixed income. Supplemental insurance policies, like Plan N, cover the remaining 20 percent of one’s medical costs.
Medicare Part N has a host of other benefits, including cost coverage for Medicare Part A, Medicare Part B, skilled nursing facility and hospice care coverage. One of the key features of Plan N is its requirement of copays. Often at a lower premium than Plan G, it’s essentially the same coverage; however, it requires copays in certain circumstances. You simply pay $20 for a standard doctor visit and $50 for emergency room visits that don’t lead to admission into the hospital.
This supplemental insurance company typically has its own copay for services, such as these. With Plan N policies, there is typically no fee for visits to urgent care facilities. Beneficiaries typically buy supplemental policies from private insurance companies, like Aetna, United Healthcare, and Cigna.
However, Plan N policies purchased through these companies are the same with all other insurance providers. Although Plan N is very good, it does not cover the Medicare Part B deductible. Plan N’s copays cannot be put toward a Part B deductible.
The biggest disparity between Medicare Plan G and Plan N is the fact that Plan N requires copays for certain medical office and emergency visits, while Plan G does not. If you do not need to pay these copays frequently, Plan N may be a cheaper option.
However, keep in mind that the plan that is best for you will ultimately depend upon your individual needs.
Although Medigap Plan G and Plan N have the same core benefits, there are a few key differences. Medicare Plan G covers excess charges incurred by Medicare Part B. Plan N, on the other hand, does not.
If a provider charges more than what is covered by Medicare, the balance remaining after Medicare’s payment will be the patient’s responsibility. However, these charges are rare. Anything above what Medicare pays is considered an excess charge. Medigap Plan G, as a whole, covers more than many other Medigap plans.
Premiums for Plan G are generally higher, because of its comprehensive coverage. Plan N’s premiums are typically lower, because it has copay requirements. Of course, it helps to do comparisons.
In one state, the lowest premium is $96 under Plan G. Under Plan N, the lowest cost is $72. Many people may wonder if they should choose Plan G or Plan N. If you want a lower monthly premium, you may want to consider a few things. If you don’t go to the doctor often, Medicare Plan N may be the best bet for you.
If you want comprehensive coverage with small out-of-pocket expenses, Plan G might be right for you. There are benefits and drawbacks to both plans, depending on your situation. Plan N boasts a number of benefits, including hospital visits for serious medical emergencies and needs. Plan N also allows you to see any doctor in the country who accepts Medicare.
Although a Plan N premium is lower, you also have additional copays to deal with. While Plan G is often dubbed the superior plan, it typically has higher premiums and is privy to higher increases in price.
Both Medicare Plan G and Plan N both cover Medicare Part A coinsurance and hospital expenses. Both also cover Medicare Part B coinsurance or copayment. In addition, both cover the first three pints of blood in a blood transfusion. However, there are some key differences. Medicare Plan G covers Part B excess charges, while Plan N does not.
Neither Plan G nor Plan N covers a Part B deductible. Ideally, it may help to consider your finances and determine what is the best option for you. The plan you choose may depend on your financial situation.
If you are looking for the most extensive coverage, Plan G may be the best option for you. However, for those who don’t mind paying extra costs, Plan N may be the way to go. One of the biggest cons of Plan N is the fact that you pay for additional visits and procedures.
Bear in mind that Plan G premiums are high because of its expansive coverage. In 2023, the monthly premium for Medicare Plan G was $137 per month. However, premiums can also change, depending on your age, zip code, gender and tobacco use.
5 Sources
MedigapCoverage has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.
https://www.nerdwallet.com/article/insurance/medicare/medigap-plan-g
https://www.valuepenguin.com/best-medicare-supplement-plans
https://www.cms.gov/medicare/health-plans/medigap/fandj
https://www.humana.com/medicare/medicare-supplement-plans/plan-n
https://www.nerdwallet.com/article/insurance/medicare/medigap-plan-g-vs-n