One of the most common questions that we receive regards the difference between “G” and “N”. Generally, the “N” plan typically saves upwards of $500/year in premium and that savings attracts interest by folks shopping their options. So, what’s the difference between Plan G and Plan N?
Medigap Plan G and Plan N have mostly the same set of Medicare benefits, but there are a couple of key differences.
Benefits that are the same in both Plan G and Plan N
Here are the Medicare benefits that both Plan G and Plan N cover, according to Medicare.gov:
- Part A coinsurance and hospital stays up to an additional 365 days after Medicare benefits are used up.
- Part A deductible.
- Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Blood transfusion (first three pints).
- Medically necessary emergency health care service for the first 60 days when traveling outside the U.S. Deductible and limitations apply.
Benefits that differ between Plan G and Plan N
Medigap Plan G and Plan N have two differences in coverage.
- Part B excess charge coverage - Medicare Supplement Plan G covers Medicare Part B excess charges, while Plan N doesn’t. If a health care provider is legally permitted to charge more than Medicare’s approved amount and does so, what’s left over after Medicare’s approved amount is an excess charge.
- Part B coinsurance coverage - Medicare Supplement Plan G and Plan N both include Medicare Part B coinsurance coverage, but the level of coverage differs between the two plans. Plan G covers all of your Part B coinsurance, but Plan N doesn’t. Rather than covering your entire Part B coinsurance, Medigap Plan N requires you to pay out of pocket for these visits:
- Office visits: Copay is up to $20 for certain office visits.
- Emergency room visits: Copay is up to $50 if you’re not admitted to hospital inpatient care.
After those copays, Plan N covers any additional Part B coinsurance for the visit. Plan N also pays the full Part B coinsurance for other types of visits covered by Medicare Part B. Please be aware that if the anesthesiologist, surgeon, specialist or whoever bills you more than the Medicare approved amount, with a Plan N you’ll owe that difference in addition to any required copays.
One other important item - In the state of Missouri, there exists the policy anniversary date rule that allows you to change from your existing insurance carrier to another without medical underwriting as long as the Plan designation remains the same. For example, if your anniversary date was March 1, effective within 30 days either side of that date, you can change your Medicare Supplement plan from one carrier to another without undergoing medical underwriting. All Medicare Supplement policies are standardized and thus, the medical benefits are identical from one carrier to another. This option allows you to shop your coverage and change to another carrier that provides you with the best overall value. This capability is available for policyholders who have a Plan G but it is not available for those with a Plan N. With a Plan N, you must be medically underwritten to be able to change from one insurance company to another.
This material was developed and prepared by a third party for use by your Financial Consultant. The content is developed from sources believed to be providing accurate information. Cetera Advisors LLC cannot guarantee or represent that it is accurate or complete.
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