One of the most common questions we receive at Medicare Hero is which supplement plan is better, Medicare Plan N vs G? If you’re wondering the same thing then follow long as we explain the difference between Plan G and Plan G so you can make a well informed decision when choosing your Medicare coverage. Let’s get started by talking about the basics of how Medicare Supplement plans work.
How Do Medicare Supplement Plans Work?
Before we discuss what is the difference between Plan N and Plan G, there are two main key points that are first important to understand:
#1 – There are no networks for Medicare Supplement Plans. This means that you can use any doctor or any hospital in the country that accepts Medicare, regardless of which of Medicare Supplement Plan you choose. Additionally, there are no referrals required. Meaning you can see any doctor without any doctor referrals to see them.
#2 – All Medicare Supplement Plans are standardized. Meaning that every insurance company must offer identical coverage. For example, Medicare Supplement Plan G offered by Company A, is the exactly the same as Plan G offered by Company B. The coverage is exactly the same, no matter which company you choose. So you might be asking yourself… So then what’s the difference between companies? The difference is the price you pay.
What Is The Difference Between Medicare Plan G and Plan N?
First lets discuss what is Medicare G Plan and what does it cover? Previously, Plan F offered the highest level of supplemental insurance available until it started to be phased out at the beginning of 2020. Now that Plan F is no longer available for new Medicare beneficiaries, the highest level of Medicare Supplement coverage available is offered by Part G. Let’s take a look and see what does Medicare plan N cover? What Medicare Plan G covers? And finally, is Medicare Plan G is better then Plan N? Take a look at the comparison chart of Medicare supplement plans below:
In the chart above, you’ll see there are 4 key things to pay attention to for both Plan G and Plan N. Let’s break it down and explain what this means for both plans:
Medicare Part B Deductible: You may be wondering, does Medicare Supplement Plan N cover Part B deductible? The simple answer is no. Both Plan N and Plan G do not cover the small annual Part B deductible of $203. This means when you go to the doctor the first time in the beginning of the year, you will have to pay this $203 deductible out of pocket with either of these plans.
This is where the differences between Plan G and N start. Plan G covers 100% of all Medicare covered expenses once your Part B deductible has been met for the year. Medicare Plan N coverage on the other hand has a few additional out-of-pocket expenses you will have to pay, which we’ll cover next.
Doctor Visit Copay: As you can tell from looking at the chart, all doctor visit copays will be 100% covered by Plan G. On the other hand, Medicare Plan N benefits, you are required to pay a $20 copay for every doctor visit you go to. So, ultimately, if you are a person that visits the doctor frequently, this could definitely add up over the course of a year.
Emergency Room Visit Copay: Just like the doctor visits, if you chose Plan G, there will be no additional copays for unexpected ER visits. However, with Part N, there will be a $50 copay every ER visit.
Medicare Part B Excess Charges: This is one of the most important coverage differences between the two plans that could potentially cost you a lot more in medical bills than expected. So Plan N does not cover any excess charges, while Plan G does. So what this means if you choose Plan N is that medical providers can send you a balance bill if that provider does not accept Medicare’s assigned rates. They can bill you up to 15% more than Medicare’s allowed rates. This can get very expensive if you aren’t careful.
Excess Charges Explained
So here’s how excess charges work… Doctors and other healthcare providers that haven’t signed an agreement to accept something called “Medicare Assignment” can charge you up to 15% over the Medicare approved amount. This additional amount is considered a Medicare Part B excess charge.
Medicare Assignment is basically a “fee schedule” or “agreement” between Medicare and a doctor. Accepting assignment by a doctor, means that your doctor agrees to the payment terms set forth by Medicare. If your doctor has not accepted Medicare Assignment, then Medicare allows them to bill you up to 15% more then the Medicare Allowable amount. As mentioned above, Plan G covers those excess charges while Plan N does not.
Be sure to always ask your doctor, especially if it’s a specialist doctor… “Do you accept Medicare Assignment?” this is the only way to avoid being hit with those excess charges. But remember, this is only applicable if you choose Plan N. If you have Plan G, you won’t have to worry about excess charges since they are covered.
What Are My Rates Based On?
The rates for Medicare Supplement don’t just vary from company to company; plan rates also vary tremendously across the United States, and more importantly, from person to person. Medigap Rates are typically based on the following:
Let's Talk Numbers
You might be wondering what the cost of Medicare Plan N vs cost of Medicare Plan G; as that can be a great factor for which plan you choose. Since Medicare Part N does not provide the same amount of coverage as Plan G, clearly you will have a lower Medicare Plan N cost. However, the difference in cost is very minor. In most cases, the cost of Medicare Plan N will be an average of $15 – $30 per month less then Plan G. To see a real life example and get a behind the scenes look at the quoting software we use, click on this video HERE.
So Which Plan Provides The Best Value?
In our opinion, Plan G is the most valuable Medicare Supplement Plan available. It gives you the most coverage, and doesn’t save you a substantial amount when compared to Plan N. However, if you’re someone who doesn’t visit the doctor often, or plan to in the future, and overall you’re a really healthy person, this might be a good choice for you. Also, if you’re on a really tight budget.
However, if you only went to the doctor once a month, with that $20 co-pay that’s going to pretty much discount the savings in premiums that you would have with Plan N and it still leaves you exposed with the ER copay and the excess charges that you might incur.
Even if you go to the doctor a few times a year, we typically see Plan G providing the best value. Because, for even for $15 – $30 more, you don’t have to worry about any unexpected out-of-pocket expenses for any Medicare services, other than that $203 deductible.