Plan N Medicare Supplement Insurance
Get a Quote »If you are shopping Medigap plans, you may be considering Plan N for your Medicare supplement insurance. Plan N is not a perfect fit for every senior, but it does provide an attractive balance between monthly premiums and out-of-pocket exposure.
Like all insurance plans, it is important to understand the gaps in any policy you might choose. The gaps in Plan N are reasonable for most and usually do no expose the insured to significant expenses.
There are three distinct gaps with a Plan N supplement and we will explain the costs associated with each below. Contact us for quotes by clicking on the button above.
Plan N Doctor’s Office Copay Amounts
Plan N is unique in that it is the only Medicare supplement that has a doctor’s office copay associated with it. This simply means that doctors can charge you a fixed copay for a visit. In this way, it is very much like most traditional health plans for consumers under age 65.
The maximum Plan N copay is $20 for a doctor’s office visit. This fixed amount has not increased or decreased since the advent of Plan N in the summer of 2010. Medicare officials could always choose to change this number if they wished. If they do, it will affect all N plans – both new and old.
It is interesting to note, that not all doctors will collect the $20 from their patients. And in other cases, the copay can be less than $20 depending on certain formulas and coding practices by your doctor’s office. If you are someone who visits one or more doctors on a regular basis, Plan N may not offer significant savings if you often encounter the $20 copay.
The Medicare Part B Deductible
Like Plans G and D, Medicare supplement Plan N does not cover the Part B deductible. Of the two Medicare deductibles this is the smaller one – Part A is the larger one. Part B applies to doctors visits and out-patient procedures whereas Part A occurrences are for hospital and in-patient procedures.
For 2013, the Part B deductible is only $147. In 2012, it was $140 and for years 2011 and 2010 it was $162 and $155 respectively. As you can see, it is not a very large number as far as insurance deductibles go.
The risk with Plan N (albeit a slight one) is that Medicare officials would increase the Part B deductible significantly in the future. As this would affect all N plans both past and present, any major change could negate the lower monthly premiums associated with Plan N.
Entitlement programs like Medicare may have to undergo future changes to account for the government expenditures and the rising national debt, but it is unlikely the Part B deductible will change drastically for those already enrolled in Medicare. The Part B percentage increase year over year has always been modest.
Plan N appears to be a safe bet when accounting for the Part B deductible.
Plan N Does Not Cover Part B Excess Charges
Part B excess charges only apply to doctors who do not accept Medicare assignment - which is the customary amount Medicare bills for health care services. The maximum Part B excess amount is 15% above what Medicare deems to be customary.
Plan N does not cover Part B excess charges, but these fees are not widely encountered. In some states, like Ohio for instance, Part B excess charges are unallowable. If you are considering Plan N in a state like Ohio, then you need not worry about excess charges.
Should you ask, your doctor will tell you if s/he does not accept Medicare approved amount. You would then have a choice of finding a doctor that does accept Medicare assignment. In most cases, the excess amounts are reasonable unless you encounter a significant doctor’s fee.
Contact Us To Learn More About Medicare Supplements
Hyers and Associates is an independent insurance agent specializing in Medicare supplements, Advantage plans, and prescription Part D coverage. We license direct with all of our carriers.
If you are considering Plan N or any other supplemental plan, contact us today and we can help you compare rates while helping to make sure that your are purchasing the coverage the best suits your needs and budget.