If you are a Medicare recipient or are about to become one, you may have noticed that Original Medicare (Parts A and B) does not cover all of your medical costs. Therefore, you will likely need a Medicare Supplement Plan to help cover out-of-pocket expenses. The good news is, you have plenty to choose from, there are 10 different plans available all with different levels of coverage. However, Plan G and Plan N are currently the most popular. Choosing between these two plans can be hard because they do have a lot in common, in fact they have more similarities than differences. It is essential to understand what each plan covers. Being misinformed can leave you with extra unnecessary out-of-pocket costs. So, let’s compare these plans so you can get an idea of which one fits you better.
What Both Plans Cover
- Medicare Part A deductible – In 2023, if you are hospitalized for inpatient care, you have to pay the Part A deductible of $1,600 per each 60-day benefit period. The Benefits period restarts after you have been out of the hospital for 60 consecutive days. This is not an annual deductible, you could end up paying this deductible more than once in a single year. Having these plans cover this deductible means it’s not coming out of your pocket.
- Part A hospital care and coinsurance – Part A partially covers hospice care leaving you copays or coinsurance. Certain prescription drugs will also have a copayment. However, you will be responsible for all of these copayments without a Medicare Supplement Plan that covers them.
- Part B coinsurance – Medicare Part B requires a coinsurance payment for each covered service. Meaning Part B will pay 80% of the Medicare-approved amount for each covered service. Leaving you to pay the remaining 20% as your coinsurance payment (after you meet your annual Part B deductible). Plans N and G will both cover 100% of the Part B coinsurance.
- Blood – If you need a blood transfusion for any reason, Original Medicare will only start covering the pints of blood after you have already paid for the first 3. Plans G and N will cover those first 3 pints for you so you’ll never have to pay for blood.
- Skilled Nursing Facility Care – Medicare Part A will require you to pay a daily coinsurance if you are admitted for more than 20 days. As of 2023, your coinsurance could reach up to $200 a day. Thankfully, Plans G and N cover this coinsurance entirely.
- Foreign Travel Emergencies – Typically, Original Medicare does not cover any medical care that you receive outside of the U.S. Plans G and N will both cover 80% of the costs of qualifying emergency medical care if you need it outside of the country.
What Neither of Them Cover
The only benefit that both of these plans will not cover is the Part B deductible. This is because of the Medicare Access and CHIP Reauthorization Act, or MACRA. This law altered Medicare with a modification to regulations that say plans are not allowed to offer any first-dollar coverage. This is also why Plans C and F are no longer available to new Medicare beneficiaries because both plans offered the Part B deductible coverage.
The Coverage Differences
Now that we know what benefits these plans both have in common, let’s look at the differences between them.
- Doctor Visit Copays – While Plan G will cover 100% of doctor visit copays, Plan N will not. With Plan N you will still have a $20 copay for each doctor’s visit. Therefore, if you visit your doctor fairly often this could really add up over the course of the year.
- Emergency Room Copay – First, keep in mind that visiting the emergency room and being admitted are two different things. Just coming to the emergency room and then being released will cost you a $50 copay with Plan N. However, with Plan G there are no additional costs or copays for an emergency room visit.
- Medicare Part B excess charges – Doctors and other healthcare providers can sign an agreement to accept “Medicare Assignment”. Which is essentially a fee schedule between Medicare and the provider saying that Medicare believes services should cost a specific amount and the doctor agrees to accept those prices. If the healthcare provider does not sign this agreement then they are allowed to charge up to 15% more than the Medicare-approved amount. That 15% is what is known as the Part B excess charge. Excess charges are one of the most significant coverage differences between Plan N and G as it could leave you with significantly higher medical expenses if it’s not covered. Plan G covers 100% of these excess charges whereas Plan N doesn’t cover them at all.
Cost is another difference, obviously even though the coverage differences are slight any plan with more benefits will be more expensive even if it’s only by a small margin. The price of Medicare Supplement Plans vary based on your location, age, and smoking status. In areas with higher costs of living, monthly premiums are generally more expensive. In general, Medicare Supplement Plans are priced in three ways: community-rated, issue-age-rated, and attained-age-rated.
Everyone, regardless of age, who has the same Medicare Supplement Plan pays the same monthly premium under this pricing structure. Your premiums may increase due to inflation and other factors but never due to your age.
With this structure, your Medicare Supplement Plan premium is baked on your age at the time you purchase it. The younger you are the lower your premiums will be, and they will not increase with your age. Just like with community-rated, these plans will only ever become more expensive due to inflation and other outside factors but not your age.
This type of pricing will calculate your premium based on your current age and does increase as you get older. Your premiums will be lower when you’re younger, but will steadily rise with your age. Increases can also happen due to inflation and other factors as well as your age.
Having Said that Plan G premiums range between $100 and $300 on average. Now, if you’re interested in a Plan G plan but the premium is a bit too expensive there is an alternative. Plan G also has a high-deductible version that offers all the same benefits with a lower premium. In exchange for the lower monthly cost you have to meet a higher deductible than you would with the standard Plan G. As for Plan N the average premium is between $120 and $180 as of 2023. When you factor in all the variables that can affect your premium Plan N can cost as low as $70 or be as expensive as $400.
So Which One Is Better?
The answer to this all depends on you. But in our opinion Plan G is the most valuable. Compared to Plan N, it provides the most coverage and saves you a significant amount of money. However, if you don’t need to visit your doctor frequently, you may easily be better off with Plan N. Overall if you’re a healthy person on a tight budget Plan N does have fantastic benefits. Although, even if you only visit the doctor a few times a year, Plan G does offer that extra bit of protection for only a little bit more money. With Plan G the only out-of-pocket Medicare cost you have to worry about is the $226(2023) Part B deductible.
How To Enroll
The best time for you to enroll is during your Medicare Supplement Open Enrollment Period. This is because if you enroll during this time you automatically receive guaranteed issue rights. Meaning you can’t be denied coverage or charged more due to your health or any pre-existing conditions. You only get one Medicare Supplement Plan Open Enrollment Period, so it is important to make use of it while you have it. The Medicare Supplement OEP begins once you turn 65 and enroll in both Medicare Part A and Part B; it continues for 6 months.
Need Some Help?
Financial planning and figuring out which benefits you need and don’t need can be time-consuming and frustrating. That’s what EZ.Insure is here for. A Medicare agent can do all of that research and compare plans for you. As well as take the time to get to know your budget and explain everything that will affect you personally. This means you’ll have professional help ensuring you get the best coverage. EZ.Insure provides you with your own personal agent. You’ll never have to worry about bouncing from agent to agent, yours will always be there to answer your questions, compare plans, and enroll you all for no extra cost. They can even help you after you’ve enrolled by reviewing your coverage annually or helping submit claims. To get started with your agent today simply enter your zip code in the bar below or give us a call at 877-670-3602.