Medicare Plan N versus Plan F: An examination of their features and differences
In the world of Medicare supplemental insurance, two popular options are Medigap Plan N and Plan F. While both offer benefits that complement Original Medicare, there are significant differences in coverage and eligibility after 2020.
Medigap Plan N, a cost-effective choice, is available to new Medicare beneficiaries. It covers Part A coinsurance, hospital costs, hospice care coinsurance, skilled nursing facility coinsurance, and Part A deductible, similar to Plan F. However, it does not cover the Part B deductible or excess charges, meaning that these costs must be paid out-of-pocket by the policyholder. Copayments are also required, with up to $20 for some doctor visits and up to $50 for emergency room visits that do not result in an inpatient hospital admission.
On the other hand, Medigap Plan F, which was once available to anyone with Medicare, is no longer open to new enrollees after January 1, 2020. Those who were already eligible before this date may continue to enroll. Plan F offers the most comprehensive coverage, covering all out-of-pocket costs, including Part B deductible and excess charges. However, its premiums are generally higher due to its extensive coverage.
The key differences between the two plans can be summarised in the table below:
| Feature | Medigap Plan N | Medigap Plan F | |-----------------------------|-----------------------------------------------------|-----------------------------------------------------| | **Eligibility after 2020** | Available to new Medicare beneficiaries | Closed to new Medicare beneficiaries after Jan 1, 2020; only available if eligible before this date | | **Coverage of Part B deductible** | Does *not* cover the Part B deductible; you pay it out-of-pocket | Covers the full Part B deductible | | **Coverage of Part B excess charges** | Does *not* cover excess charges (up to 15% more if doctor does not accept Medicare assignment) | Covers all Part B excess charges | | **Out-of-pocket costs (copayments)** | Requires copayments: up to $20 for some doctor visits and up to $50 for emergency room visits that don't result in admission | No copayments; covers all out-of-pocket costs after deductible | | **Premium costs** | Typically lower premiums than Plan F | Higher premiums due to more comprehensive coverage | | **Hospital coverage** | Covers Part A coinsurance, hospital costs, hospice care coinsurance, skilled nursing facility coinsurance, and Part A deductible | Covers all same hospital costs as Plan N, plus all Part B costs | | **Coverage comprehensiveness** | Less comprehensive than Plan F due to copayments and uncovered deductible/excess charges | Most comprehensive Medigap plan, covers all out-of-pocket costs including Part B deductible and excess charges |
Original Medicare, including Part A (inpatient hospital stays) and Part B (outpatient services), remains federally funded health insurance coverage for adults aged 65 years and over, as well as adults with specific medical conditions. For those seeking additional coverage, the Medicare website offers an online tool for comparing plans.
It's worth noting that Medicare Advantage plans, which often include Part D and may cover more services than original Medicare, are an alternative option. A person may choose to enrol in Medicare Advantage (Part C) instead of a Medigap plan along with Original Medicare.
Wisconsin, Minnesota, and Massachusetts have differences in the standardization of supplemental insurance. For instance, Plan G, which covers all the same benefits as Plan F, except it does not cover the Medicare Part B deductible, is available in most states but not in Wisconsin, Massachusetts, or Minnesota.
In summary, Plan F is more comprehensive and fully covers Medicare’s out-of-pocket costs but is no longer available to new Medicare enrollees after 2020, while Plan N has lower premiums, requires some cost-sharing, and remains available to new enrollees but does not cover the Part B deductible or excess charges. This makes Plan N a more budget-friendly but less extensive supplement compared to Plan F after 2020.
Health organizations should be aware that Medigap Plan F, which offers the most comprehensive coverage, is no longer open to new Medicare beneficiaries after January 1, 2020. Science and research in the field of health-and-wellness could focus on comparing the cost-effectiveness of Medigap Plan N, a cost-effective choice available to new Medicare beneficiaries, with other health insurance options available under Medicare, such as Medicare Advantage plans, for individuals seeking additional coverage. Healthcare providers may also need to inform their patients about the differences in coverage and eligibility between Medigap Plan N and Plan F, as this knowledge can impact the financial decisions of Medicare beneficiaries.
