Medicare can offer you valuable health coverage, but often the different plan options and their benefits can be confusing. The following guide explains the different plans, in particular Medicare Supplement N, and their respective benefits.
Any American 65 or over qualifies for Medicare. In addition, individuals under the age of 65 with certain disabilities qualify for Medicare. Finally, any American with End-Stage Renal Disease can obtain Medicare.
Traditional or basic Medicare has two parts: Part A and Part B. Part A covers hospital costs as well as nursing home, hospice and home health care costs. Part B covers doctors’ costs as well as other outpatient costs. In addition, you can sign up for a third part, Part D, that will help cover prescription drug costs.
Parts A, B and D don’t cover all healthcare costs, however, and you still may face significant out-of-pocket expenses. A Medicare Supplement Plan, also known as a Medigap plan, may reduce these additional expenses.
The different Medigap plans, Medigap Plans A-N, have different benefits. A very popular plan is Medicare Supplement Plan N, which covers Part A hospital coinsurance, 365 hospital reserve days, the first 3 pints of blood, hospice coinsurance, skilled nursing home coinsurance, the Part A deductible, a foreign travel benefit and preventative care coinsurance. There is no out-of-pocket limit.
There are, however, significant expenses that Plan N does not cover. People on this plan will be responsible for Part B coinsurance co-pays, which will be up to a $20 for each doctor’s visit and $50 for each emergency room visit. They will also be responsible for a $147 Part B deductible.
In addition, those on Medigap Plan N will need to pay any Part B excess charges out-of-pocket. Part B excess occurs when a doctor charges the patient more money than Medicare Part D covers. For example, if Medicare pays $100 of a patient’s doctor visit, the patient will be responsible for any charge above $100. Doctors have the right under Medicare to charge 15 percent more than the Medicare-approved charge.
Medicare can significantly reduce your healthcare costs, but it is important to keep in mind that each plan, specifically the Medigap plans, all provide different levels of coverage. It is vital that beneficiaries take a close look at what out-of-pocket expenses they may incur under each plan before joining. That being said, people on Medicare Supplement Plan N will enjoy lower monthly premiums than Plan F or G, but will have some additional out-of-pocket expenses.