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:
Service | Who pays what? |
---|---|
First 60 days | Medicare pays: All cost but $1,632 Plan pays: $1,632 (Part A Deductible) Member pays: Nothing |
61st thru 90th day | Medicare 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 days | Medicare pays: Nothing Plan pays: 100% of Medicare-eligible expenses Member pays: Nothing |
Beyond the additional 365 days | Medicare pays: Nothing
Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First 20 days | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
21st thru 100th day | Medicare pays: All but $204/day Plan pays: Up to $204/day Member pays: Nothing |
101st day and after | Medicare pays: Nothing Plan pays: Nothing Member pays: All cost |
Service | Who pays what? |
---|---|
First three pints | Medicare pays: Nothing Plan pays: All cost Member pays: Nothing |
Additional amount | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
Hospice Care | Medicare pays: All but very limited
copayment/ coinsurance for outpatient drugs and inpatient respite care Plan pays: Medicare copayment and coinsurance Member pays: Nothing |
Service | Who pays what? |
---|---|
Part B Deductible | Medicare pays: Nothing Plan pays: Nothing Member pays: $240 (Part B Deductible) |
Part B Coinsurance | Medicare 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 |
Service | Who pays what? |
---|---|
Test for diagnostic lab services | Medicare pays: All cost Plan pays: Nothing Member pays: Nothing |
Service | Who pays what? |
---|---|
First three pints | Medicare 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 amounts | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who 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 day | Medicare pays: 80% Plan pays: 20% (Part B Coinsurance) Member pays: Nothing |
Service | Who pays what? |
---|---|
First $250 each calendar year/Remainder of charges | Medicare 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 |
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