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Medigap - Plan N
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Important Points
Medigap Plan N is one of the more popular Medigap plans.
Plan N offers lower premiums compared to Plan G, but has slightly more out-of-pocket costs.
Plan N covers all gaps in Medicare except the Part B deductible, Part B excess charges, and small copays for doctor and ER visits.
Mohring Insurance Services LLC | Talk to a Medicare Expert at (866) 440-1885
Overview
Plan N is a Medigap policy that usually has lower premiums. In return for lower premiums, you pay the Part B deductible, excess charges, and some copays for doctor and emergency visits. Plan N was introduced in 2010 and has been popular ever since. This option was created for beneficiaries who enjoy paying a lower premium in exchange for taking on a small annual deductible and some copays.
All Medigap Plan N policies are the same regardless of which insurance company you choose to purchase it from. Due to it's popularity, Plan N is available in many states from many well-known insurance companies. With Plan F fading out, Plan N has become the second most popular plan just behind Plan G.
Medigap Benefits - Plan N
Medicare Part A Coinsurance & Hospital Costs
(Up to an additional 365 days after Medicare benefits are used)
Medicare Part B Coinsurance or Copayment
Blood (First 3 Pints)
Part A Hospice Care Coinsurance or Copayment
Skilled Nursing Facility Coinsurance
Medicare Part A Deductible
Medicare Part B Deductible
Medicare Part B Excess Charges
Foreign Travel Emergency (up to plan limits)
Plan N - Coverage
What Does Medigap Plan N Cover?
Medigap Plan N covers the 20% that Medicare Part B doesn't. Additionally, it pays for your hospital deductible and all of your hospital costs. You will only be responsible for Part B excess charges, the Part B deductible, and some small copays for doctor and emergency room visits.
You can request a Medigap Plan N Outline of Coverage from one of our agents before you enroll, which will give you more details.
What Does Medigap Plan N Cover at the Doctor's Office?
It is important to know that your standard preventive care is covered 100% by Medicare itself, so you will pay nothing for these services. Plan N also covers other preventive services like screenings for diabetes, cancer, and cardiovascular conditions. Preventive services can also include annual physicals, vaccines, colonoscopies, mammograms, and various other tests.
Your Medigap Plan N covers will also include visits to your doctor for injury and illness, ambulance, surgeries, lab work, home health, durable medical equipment, diabetes tests, imaging tests, and many more services. The key is that if Medicare Part A or Part B covers it, your Medigap Plan N will also cover it. Medicare itself pays 80% and then sends the bill to your Medigap plan.
If, by chance, your doctor does not accept Medicare assignment, you will pay a 15% excess charge. You can avoid these by asking your doctor upfront if he or she accepts Medicare assignment.
What Does Plan N Cover in the Hospital?
Your Medicare Part A hospital benefits give you coverage for inpatient hospital services, including inpatient admission, home health, hospice care, skilled nursing facility care, and blood transfusions. Typically you would owe a deductible for your hospital stay, but your Medigap Plan N will pay that for you. It is also important to understand that the Part A deductible is per benefit period. If you are admitted to the hospital several times within the year, your Medigap Plan N will cover all Part A deductibles that you experience.
Here's a quick list of what Medigap Plan N covers in the hospital:
Your Part A Hospital deductible (in 2025, this is $1,632) and your coinsurance (20%)
An extra 365 days of hospital benefits after Medicare's coverage runs out
Hospice care coinsurance at any certified hospice center
Coverage for the first 3 pints of blood
Foreign travel emergency benefits up to the plan's limit
Medigap Plan N Costs
Medigap Plan N offers identical basic benefits similar to the more popular Plan G, but you agree to pay a share of a few things that you wouldn't pay with a Plan G. First, you agree to pay the small annual Part B deductible ($240 in 2025). Second, you will pay copays of up to $20 for doctors appointments and $50 for emergency room visits.
Finally, people with Plan N also pay excess charges to some medical providers. Providers can charge 15% more than what Medicare allows. This is what is referred to as an excess charge. Plan N does not cover this for you like Plan G would. This may result in some small bills from time to time.
You can avoid excess charges by asking your providers upfront if they accept Medicare assignment. If they do, there is no need to worry about excess charges. Another option you have is to look at Plan G as an alternative to Plan N, since Plan G is only slightly more expensive. The major difference is that Plan G covers the litte copays and excess charges, so there are fewer bills you have to pay.
Cost Example - Medigap Plan N
Let's look at a hypothetical example:
Casey tells her agent that she only visits the doctor once a year. She feels like full coverage from Plan G isn't really worth it due to her low usage. Her agent explains to her that Plan N premiums are typically about 20% less than Medigap Plan G if she would be willing to take on copays for a few minor things.
For her inpatient care, Plan N fully covers her hospital deductible when she is admitted. For her outpatient care, Casey will pay the Part B deductible ($240 in 2025) during her first doctor visit of the year. She then must pay a copay of up to $20 when she sees her doctor during the rest of the year. She might have to pay an excess charge if her doctor is not a participating Medicare doctor. Let's see how these expenses on Plan N might affect her.
Let's say Casey visits her GI doctor in the middle of the year after she has already met her deductible. Medicare's assigned rate for this visit to the GI specialist is $100. If the doctor does not accept assigned rates, he can balance bill Casey for up to 15% beyond the approved rate for the visit, or a maximum of $15 in this case.
Casey owes her $20 copay, and her Medigap Plan N policy will pay the remainder of the approved charges.
If you find that Plan N is difficult to understand because of the excess charges and copays, then you may want to check out Plan G. With a Plan G, excess charges are covered by your Medigap plan and your cost-sharing is limited to the Part B deductible only.
Medigap Plan N - Eligibility
As long as you have Medicare Part A and Part B, you are eligible to enroll in Medigap Plan N. You must also live in the plan's service area. The best time to enroll in Medigap Plan N is during your Medigap Open Enrollment Period. This is a six-month window that starts on your Medicare Part B effective date. It is your one chance to enroll in any Medigap plan (not just Plan N) without answering health questions and being subject to underwriting. During this window, no insurance company can turn down your application due to health conditions.
If you have missed your Medigap Open Enrollment window, you can still apply for Medigap Plan N. We can explore the health questions on different company's applications to see if you are able to pass underwriting.
What is the Best Medigap Plan for You?
For a long time, Plan F dominated the market as the most popular plan for Medicare beneficiaries. However, with Plan F not being available for anyone who became eligible after January 1, 2020, Plan G and Plan N have been gaining popularity. There are many beneficiaries who would rather have lower premiums and pay the Part b deductible, and doctor copays IF they need to use those services.
One of our agents would be happy to give you a side-by-side comparison of plans that may be the best fit for you.
Plan N Insurance Companies
Each insurance company can choose whether or not to sell Plan N, or any Medigap plan for that matter. Fortunately, Plan N is quite popular so it is fairly easy to find since many insurance companies offer it.
Mohring Insurance Services LLC sells Medigap Plan N policies for several health insurance companies, like Blue Cross Blue Shield, Aetna, Humana, United Healthcare, and many more.
Plan N - FAQs
What is the monthly cost for Plan N?
Like all Medigap plans, Plan N does not have a set premium, but premiums can typically range from $85 to $200 per month. The premium depends on several factors such as gender, zip code, tobacco usage, and more. One of our licensed agents specializing in Medicare products can help compare which insurance company will be the most cost-effective for you.
What is the Plan N deductible?
In 2025, the deductible is $240 which is the Part B deductible that you are responsible for with Plan N. The Part B deductible is one gap that Plan N does not cover for you.
What is the difference between Plan N and Plan G?
Plan N has slightly more out-of-pocket expenses than Plan G, but the premium for Plan N is usually lower. You must pay up to $20 copays to see the doctor and up to $50 copays for emergency room visits when you enroll in Plan N. The more cost-effective choice for you is entirely dependent on your needs and lifestyle.
Do people prefer Plan N over Plan G?
Plan is can be very appealing since it tends to have lower premiums than Plan G. For people who don't often visit the doctor, this plan might be a good fit. Keep in mind, you will have slightly more out-of-pocket costs with copays and Part B excess charges. The right plan for you will entirely depend on your needs and your budget.
Can I switch from Plan N to Plan G?
Technically you can switch from Plan N to Plan G at any time during the year, but if you are outside of your six-month Open Enrollment window, you may have to answer health questions to switch and your approval is not guaranteed.
Plan N - Reviews
The Medicare program itself is the entity that decides which claims get paid. When Medicare approves a claim, your Medigap Plan N reviews the claim and MUST pay for its share.
As an agency with many clients, we get a lot of feedback from our policyholders. Many people give us a good review of Medigap Plan N. Some clients, though, worry about the uncertainty of excess charges. If this is a concern for you, ask our team to compare Medigap Plan N and Plan G for you. Getting a quote for both plans may help in your decisions as to which plan is right for you.
Key Points
Plan N might be more cost-effective for you than Plan G if you don't go to the doctor very often.
All companies that offer Plan N must provide the same coverage, but the premiums can be different with each company.
You can have up to a $20 copay for doctor visits and up to a $50 copay for ER visits once you have met the Part B deductible.
At Mohring Insurance Services LLC, we are happy to offer assistance with Medicare when you choose to enroll. Give us a call at (866) 440-1885, or to schedule a free consultation, click the link below:
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