Choosing the perfect Medicare supplement insurance can be a daunting task. Still, it only gets tougher when you’re trying to decide between two well-known options like Plan N and Plan F — both of which are designed to help cover some of the extra expenses left behind from Original Medicare.
There are some essential distinctions between these plans you should be aware of to make an informed decision, given your health and financial circumstances. Plan F offers the highest level of coverage, while Plan N provides excellent scope.
This guide will walk you through the details of both plans, enabling you to make an informed decision based on coverage specifics, costs, eligibility, and key considerations to keep in mind during the sign-up process.
What does Medigap Plan F cover?
Medicare Plan F is the most comprehensive coverage available, but it’s not available to new Medicare enrollees who are eligible for the program after January 1, 2020.
Plan F pays for nearly all of the remaining out-of-pocket costs that Original Medicare doesn’t cover, which makes it appealing for individuals who prefer predictable healthcare expenses. Here’s what Plan F covers for all its benefits:
- Medicare Part A deductible ($1,600 in 2024).
- Medicare Part B deductible ($240 in 2024).
- Medicare Part A coinsurance and hospital costs are covered for up to an additional 365 days after Medicare benefits are exhausted.
- Medicare Part B coinsurance or copayments (typically 20% of Medicare-approved amounts).
- Blood (first 3 pints).
- Part A: Hospice Care Coinsurance or Copayments.
- Skilled nursing facility care coinsurance.
- Medicare Part B excess charges (when doctors charge more than Medicare’s approved amount).
- Foreign travel emergency coverage (up to plan limits).
All this coverage results in Plan F recipients paying only the monthly premium and little to no surprise medical bills. Being able to take almost all other decisions out of the equation is highly appealing to individuals with ongoing health issues or frequent medical needs.
What is Medigap Plan N?
Unlike Plan F, Plan N provides coverage for most of the significant gaps in Original Medicare, and costs beneficiaries low, set amounts or sometimes no cost for some services.
Here’s what Medigap Plan N covers:
- Medicare Part A deductible.
- Medicare Part A coinsurance and hospital costs are covered for up to an additional 365 days after Medicare benefits are exhausted.
- Medicare Part B coinsurance or copayments (except for some specific costs).
- Blood (first 3 pints).
- Part A: Hospice Care Coinsurance or Copayments.
- Skilled nursing facility care coinsurance.
- Foreign travel emergency coverage (up to plan limits).
But Plan N, while still covering many costs, makes you pay certain out-of-pocket costs that Plan F would not. You will be responsible for the Medicare Part B annual deductible and copayments of up to $20 for some doctor office visits and up to $50 for emergency room visits that do not result in inpatient admission.
Medigap Plan N vs. Plan F
The following comparison highlights the key differences between these two popular supplement options:
| Coverage Feature | Plan F | Plan N |
|---|---|---|
| Part A Deductible | Covered | Covered |
| Part B Deductible | Covered | You Pay ($240/year) |
| Part A Coinsurance | Covered | Covered |
| Part B Coinsurance | Covered | Covered |
| Part B Excess Charges | Covered | You Pay |
| Doctor Office Copay | Covered | Up to $20 per visit |
| Emergency Room Copay | Covered | Up to $50 per visit |
| Foreign Travel Emergency | Covered | Covered |
| Monthly Premium | Higher | Lower |
| Predictable Costs | High | Moderate |
| Available to New Medicare Recipients | No (grandfathered only) | Yes |
The most notable practical differences play out in everyday healthcare usage. And with a Plan F, you hand over your Medicare and supplement cards, and you’re through paying. With Plan N, you may incur some out-of-pocket expenses, such as the Part B deductible each year, and occasionally a small copay. However, both are modest and somewhat predictable in most situations.
The $20 copayments in Plan N would add up for someone who sees the doctor a lot, making Plan F a better deal despite the higher premiums. On the other hand, if you’re pretty healthy and only see doctors occasionally, Plan N’s lower premiums often lead to overall savings when you consider the occasional copayment.
Medigap plan availability
Whether or not you can get a Medicare supplement plan at all will largely depend on when you first became eligible for Medicare and what your current enrollment status is.
Plan F Availability
Plan F is only available to individuals who became eligible for Medicare before January 1, 2020, or who first became eligible for Medicare due to disability at any time before that date. That means there is no such thing as “Medicare Plan F new enrollees” today because Plan F was closed off to new beneficiaries.
Availability of Plan N
Anyone on Medicare can still purchase Plan N, so if you can’t get Plan F, Plan N is a great option. It is sold by most of the big-name insurance companies that sell Medicare supplements, as well as some that have even better rates:
- AARP/UnitedHealthcare
- Mutual of Omaha
- Blue Cross Blue Shield
- Humana
- Cigna
When evaluating Plan N options, be sure to compare premiums and benefits from multiple insurance companies, as costs can vary significantly depending on the company’s pricing and location.
You have the best chance of being able to sign up for any Medigap plan — including Plan N — during your Medigap Open Enrollment Period, which starts the first month you’re age 65 or older and enrolled in Medicare Part B. During this period, insurance companies cannot refuse to cover you or charge you higher premiums because of your health status.
Can I change my Medigap policy?
Yes, you can switch Medigap policies, but the process may depend on the timing, whether you are in your Medigap open enrollment period. You have guaranteed issue rights in certain situations, which means that insurance companies must sell you a Medigap policy without medical underwriting. Those circumstances include losing employer coverage, moving out of your plan’s service area, or if your insurance company loses its license to sell Medicare policies in your state.
If you want to change plans outside of guaranteed issue situations, you can apply for a new Medigap policy at any time. Still, insurers may ask you to undergo medical underwriting. It entails an examination of your health history, and it can result in higher premiums, coverage exclusions, or the refusal of coverage for pre-existing conditions.
If you drop Plan F now, you may not be able to switch back later without the possibility of medical underwriting. Most beneficiaries find that taking the time to speak with a licensed insurance agent or Medicare counselor is beneficial in helping them understand how changing policies can affect their long-term best interest.
Conclusion
The decision of whether to get Medicare Plan N vs Plan F will ultimately depend on your personal healthcare needs, financial position, and tolerance for potential out-of-pocket costs.
Plan F offers a combination of comprehensive coverage with predictable expenses, making it an excellent option for individuals who prefer minimal cost surprises and are willing to accept higher premiums. However, it’s only available to individuals who were eligible for Medicare before 2020.
Plan N represents one of the best values when you compare its high level of coverage with its lower premiums, which require only small copayments for a few services. For many Medicare enrollees, particularly those in good health who make few doctor visits, Plan N is the sweet middle ground of protection and price.
Keep in mind that the most suitable selection is one that best suits your unique situation and makes you comfortable with your healthcare coverage. A Medicare expert will help you navigate your options to ensure that you make the best decision for your future health.