What do Medigap Plan G and Plan N have in common?

Thu, Jan 26, 2023 10:56 PM Medicare

When deciding between a Medigap Plan G or Plan N, there are several considerations that should be considered. Based on your personal situation, investments, and lifestyle, it simply comes down to making an educated decision. Some similarities and discrepancies between these two plans will be discussed below so that you will be better prepared to make your decision.

What do Medigap Plan G and Plan N have in common?

There are many parallels between Plan G and Plan N. They are, in truth, more alike than distinct, which may be why you are considering these two plans. They are considered by many to be the two best plans for Medigap. Here is a list of the following key similarities:

Hospitalization, eligible nursing care, blood, hospice care, and international travel are covered.

Whether you are registering during open registration or have a guaranteed problem situation, an application must go through medical signing.

Medicare Part A deductible is covered

The $203 (2021) annual Medicare Part B deductible is NOT covered.

Also Read : Will Medicare Cover Me if I Travel Overseas?

The Differences between Plan G and Plan N

Although there are many similarities, there are a few important distinctions between Plan G and Plan N as well:

Medigap Plan G

No excess charges for Medicare Part B of 15 percent (the difference in cost between the Medicare-approved payment amount for services and the amount your health care provider charges). They are unable to bill more than 15 percent over the allocated amount and are still Medicare-reimbursed.

No physician/outpatient copays in Medicare Part B
No Emergency Room Copay

Medigap Plan N

Medigap Part B Excess fees of up to 15 percent (if the provider charges excess fees for Part B and does not accept 'assignment' to Medicare)
Medigap Part B physician/outpatient copay of up to $20 per visit to the office
Medigap Part B co-payment of up to $50 per visit to an emergency room. Note: This copayment is waived if you are admitted to the hospital.

Also Read : What to Do When your Medicare Supplement Rate Increase?

Medigap Plan G Premiums vs. Medigap Plan N

Plan G usually runs about $20-25 more per month in most states than Plan N. It may be a safer option to sign up for Plan N, depending on the condition of your health, even if there is a copay and there may be 15 percent in excess charges associated with it.

Example 1: Seychelles is a sixty-nine-year-old woman living a sedentary life. She's a smoker, slightly overweight, and her blood pressure is large. Just about 1 or 2 days a week does she work out. She's on blood pressure medicine, and she even takes an antidepressant every day. At least four times a year, if not more, she visits her doctor. In the case of Seychelles, enrolling in Plan G will be more convenient for her. About why? Since she would have paid out more annually by the time she sums up all her medical appointments, likely incurring lab copays and 15 percent in excess costs, even though her monthly premium is lower.

Example 2: Marc is a guy who leads a safe lifestyle and is 72 years old. With the exception of vitamins and herbs, he takes no medicine and works out at the YMCA nearly every day. When he goes for his annual physical, the only time he sees a doctor is. In his case, choosing Plan N over Plan G would be more cost-effective for Marc. About why? And even though he's going to have to pay a copay and maybe more if his doctor doesn't approve a Medicare assignment, it's going to be less than if he paid Plan G's higher premium.

Additional considerations Between Plan G and Plan N

When deciding between Medigap Plan G and Plan N, the future is another consideration you have to take into account. A Medigap plan's initial open enrollment option is not inherently a "final" option. In the future, you can still adjust plans or companies. However, and this is a significant and widely overlooked issue, if you change plans later, you have to answer medical questions and be "approved."

So, what this means is that you should think about that decision on a long-term basis, even though your current health determines that you participate in a Plan N or maybe even in a Medicare Advantage Plan. When you have or grow health issues, what you initially enroll in might be what you retain out of necessity.

It could be a simple decision to choose the best plan to fulfill your needs or more difficult than you expected it to be. The bottom line is that, in the near and distant future, everything depends on your current personal health profile and what you expect your health status to look like. You may have an elective procedure coming up that may boost the number of visits you need to see a healthcare provider. Your investments could be affected as well. So, in your final decision between Plan G and Plan N, these are all things that should be taken into consideration.

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