Medicare Supplement Plan N


Medigap Plan N is a Medicare supplement insurance plan designed to provide coverage for certain medical expenses not covered by Original Medicare. It offers a balanced combination of benefits and cost-sharing.

With Medigap Plan N, you can expect coverage for Medicare Part A coinsurance and hospital costs, as well as Medicare Part B coinsurance or copayment. The plan covers your Part A deductible and provides coverage for skilled nursing facility care coinsurance. Additionally, it covers emergency care received during foreign travel.

However, it's important to note that Medigap Plan N does have some cost-sharing features. You will be responsible for paying the Medicare Part B deductible, as well as copayments for certain medical services such as visits to the doctor's office or emergency room. These copayments are generally a set amount or percentage of the cost, depending on the specific service.

Medigap Plan N can be a suitable choice if you're looking for a plan that offers comprehensive coverage for hospital stays and other major medical expenses, while also providing some cost-sharing to help keep premiums lower. It's important to evaluate your healthcare needs and budget to determine if this plan meets your specific requirements.

Below is a comprehensive list of the covered services provided by Medicare Supplement Plan N, which include benefits under Medicare Part A, Medicare Part B, and other areas:

MEDICARE PART A - HOSPITAL SERVICES - PER BENEFIT PERIOD


HOSPITALIZATION
Semi-private room & board, general nursing and miscellaneous services and supplies

ServiceWho pays what?
First 60 daysMedicare pays: All cost but $1,632
Plan pays: $1,632 (Part A Deductible)
Member pays: Nothing
61st thru 90th dayMedicare pays: All cost but $408/day
Plan pays: $408/day
Member pays: Nothing
91st day and after (While using 60 lifetime reserve days)Medicare pays: All cost but $816/day
Plan pays: $816/day
Member pays: Nothing
Once lifetime reserve days are used; additional 365 daysMedicare pays: Nothing
Plan pays: 100% of Medicare-eligible expenses
Member pays: Nothing
Beyond the additional 365 daysMedicare pays: Nothing
Plan pays: Nothing
Member pays: All cost


SKILLED NURSING FACILITY CARE
You must meet Medicare’s requirements, including having been in a hospital for at least three days, and enter a Medicare approved facility within 30 days after leaving the hospital.

ServiceWho pays what?
First 20 daysMedicare pays: All cost
Plan pays: Nothing
Member pays: Nothing
21st thru 100th dayMedicare pays: All but $204/day
Plan pays: Up to $204/day
Member pays: Nothing
101st day and afterMedicare pays: Nothing
Plan pays: Nothing
Member pays: All cost


BLOOD

ServiceWho pays what?
First three pintsMedicare pays: Nothing
Plan pays: All cost
Member pays: Nothing
Additional amountMedicare pays: All cost
Plan pays: Nothing
Member pays: Nothing


HOSPICE CARE
You must meet Medicare's requirements, including a doctor's certification of terminal illness.

ServiceWho pays what?
Hospice CareMedicare pays: All but very limited
copayment/ coinsurance for outpatient
drugs and inpatient respite care
Plan pays: Medicare copayment and
coinsurance
Member pays: Nothing

MEDICARE PART B - MEDICAL SERVICES - PER CALENDAR YEAR


MEDICAL EXPENSES
In or out of the hospital and outpatient hospital treatment, such as physician's services, inpatient and outpatient medical services and surgical services, physical and speech therapy, diagnostic tests, durable medical equipment.

ServiceWho pays what?
Part B DeductibleMedicare pays: Nothing
Plan pays: Nothing
Member pays: $240 (Part B Deductible)
Part B CoinsuranceMedicare pays: 80%
Plan pays: 20% (Part B Coinsurance) less $20 for office visits and $50 less for emergency visit if not resulting in hospitalization
Member pays: $20 for Office visit and $50 for emergency visit if not resulting in hospitalization
Part B Excess Charges
(above Medicare approved
amounts)
Medicare pays: Nothing
Plan pays: Nothing
Member pays: All cost


CLINICAL LABORATORY SERVICES

ServiceWho pays what?
Test for diagnostic lab services  Medicare pays: All cost
Plan pays: Nothing
Member pays: Nothing


BLOOD

ServiceWho pays what?
First three pintsMedicare pays: All cost
Plan pays: Nothing
Member pays: Nothing
Additional amount (First $226 of
Medicare approved amounts)
Medicare pays: Nothing
Plan pays: Nothing
Member pays: $240 (Part B deductible)
Remainder of Medicare approved amountsMedicare pays: 80%
Plan pays: 20% (Part B Coinsurance)
Member pays: Nothing

MEDICARE PARTS A & B - MEDICAL SERVICES - PER CALENDAR YEAR


HOME HEALTH CARE
Medicare approved services

ServiceWho pays what?
Medically necessary skilled care
services and medical supplies/
Durable medical equipment
(First $226 of Medicare approved amounts)
Medicare pays: Nothing
Plan pays: Nothing
Member pays: $240 (Part B deductible)
61st thru 90th dayMedicare pays: 80%
Plan pays: 20% (Part B Coinsurance)
Member pays: Nothing

OTHER BENEFITS


FOREIGN TRAVEL
Medically necessary emergency care services beginning during the first 60 days of each trip outside the United States

ServiceWho pays what?
First $250 each calendar year/Remainder of chargesMedicare pays: Nothing (exccept under limited circumstances)
Plan pays: $0/80% to a lifetime maximum of $50,000
Member pays: $250/20% and amounts over the $50,000 lifetime maximum

Other Medicare Supplement Plans

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