When comparing Medigap Plan G and Medigap Plan N, both offer substantial benefits to help cover gaps in Original Medicare (Parts A and B). However, the key difference lies in their cost-sharing structure. Plan G tends to offer more comprehensive coverage with higher premiums, while Plan N provides lower premiums but requires some out-of-pocket costs when you use healthcare services. Let’s dive into the details to help you decide which plan is right for you.
Plan G’s Comprehensive Coverage and Predictable Costs
Medigap Plan G is known for its comprehensive coverage, making it a top choice for those who want to minimize out-of-pocket healthcare costs. With Plan G, you only need to pay the Medicare Part B deductible, which is $240 in 2024, before the plan covers all approved services.
What Does Plan G Cover?
- Part A Deductible: Covers the entire Medicare Part A deductible, which is $1,632 in 2024.
- Part A Coinsurance and Hospital Costs: Pays for hospital costs beyond Medicare’s coverage, including an additional 365 days after Medicare benefits are exhausted.
- Part B Coinsurance and Copayments: Covers the remaining 20% of outpatient services that Medicare Part B does not cover.
- Skilled Nursing Facility Care Coinsurance: Pays for the coinsurance costs if you need care in a skilled nursing facility.
- Medicare Part A Hospice Care Coinsurance or Copayment: Covers hospice care copayments or coinsurance under Part A.
- First Three Pints of Blood: Covers the cost of the first three pints of blood needed for a medical procedure.
- Part B Excess Charges: Fully covers excess charges, which occur if a doctor charges more than the Medicare-approved amount, up to 15% over the limit.
For those seeking predictable costs and comprehensive coverage, Plan G offers peace of mind by minimizing any unexpected expenses beyond the Part B deductible.
Medigap Plan N: Cost Savings with Moderate Coverage
Medigap Plan N is a popular option for individuals who prefer lower monthly premiums and are comfortable with sharing some costs when they use healthcare services. Like Plan G, Plan N covers many of the gaps in Original Medicare, but it introduces some cost-sharing features to reduce the premium.
What Does Plan N Cover?
- Part A Deductible and Coinsurance: Like Plan G, Plan N covers the Medicare Part A deductible and all related coinsurance.
- Skilled Nursing Facility Care Coinsurance: Plan N pays for the skilled nursing facility care coinsurance, just like Plan G.
- Part A Hospice Care Coinsurance or Copayment: Covers hospice care under Part A.
- First Three Pints of Blood: Covers the cost of the first three pints of blood needed for a medical procedure.
- Part B Coinsurance: Plan N covers the Part B coinsurance, but unlike Plan G, there are copays for some doctor visits and emergency room visits.
What Does Plan N Not Cover?
- Part B Excess Charges: Unlike Plan G, Plan N does not cover Part B excess charges, meaning if your doctor charges more than the Medicare-approved amount, you may be responsible for up to 15% over the Medicare-approved cost.
- Copayments: For office visits, you may pay up to $20 per visit, and for emergency room visits, up to $50 unless you are admitted to the hospital. This makes Plan N a great option for those who are comfortable with occasional copayments in exchange for lower monthly premiums.
How to Choose Between Plan G and Plan N
When deciding between Plan G and Plan N, it’s important to evaluate your healthcare needs and financial preferences.
- Budget: If you prefer lower monthly premiums, Plan N could be the better option, but be prepared for some out-of-pocket costs for doctor and ER visits. Plan G, while more expensive upfront, offers predictability by covering nearly all your costs once you meet the Part B deductible.
- Part B Excess Charges: If you want complete protection against Part B excess charges, Plan G is the better choice. Plan N does not cover excess charges, so if you see a provider who bills more than the Medicare-approved amount, you may have to pay extra. However, if you live in a state that prohibits excess charges, Plan N may be a great fit.
- Healthcare Usage: Plan N is ideal for individuals who are relatively healthy and visit the doctor infrequently. If you anticipate needing regular healthcare services, Plan G may be more cost-effective in the long run due to the lack of copays and excess charges.
Which Plan is Better for You?
Ultimately, the right choice depends on your personal health needs and financial situation. If you value comprehensive coverage with minimal out-of-pocket costs, Plan G may be the better option. On the other hand, if you’re looking for a more budget-friendly plan and don’t mind sharing some costs through copays, Plan N could be a good fit.
Need help comparing Plan G vs Plan N? Our Medicare experts are here to guide you through your options. Call us today at (817) 249-8600 for a FREE consultation and let us help you find the best plan for your needs.