Plan N premiums vary by insurance company and age in Iowa

Plan N is a Medigap policy sold by private insurance companies, not Medicare itself. The monthly cost depends on which company you choose and your age when you first enroll. In Iowa, Plan N premiums for 2025 range from roughly $120 to $200 per month for someone in their mid-60s, but this varies significantly by insurer and can be higher or lower depending on your exact age and the company's pricing structure.

Unlike Original Medicare Part B, which has a single national premium set by the federal government, Medigap premiums are set by each insurance company. Three Iowa insurers currently offer Plan N: Mutual of Omaha, Medico, and AARP (underwritten by UnitedHealthcare). Each company prices its Plan N differently, and each uses its own method to adjust premiums as you age.

The actual premium you pay also depends on when you buy. If you enroll during your initial enrollment period—the six months after you turn 65 and sign up for Medicare Part B—you typically pay lower rates than if you wait. Some companies use "issue age" pricing, which locks in a lower rate based on your age at purchase. Others use "attained age" pricing, which increases your premium every year as you get older.

Key Takeaways

  • Plan N premiums in Iowa for 2025 typically range from $120 to $200 monthly, depending on the insurance company and your age.
  • Three insurers sell Plan N in Iowa: Mutual of Omaha, Medico, and AARP (UnitedHealthcare), and each sets its own price.
  • Enrolling during your initial six-month window after turning 65 usually costs less than waiting, because most companies charge higher rates if you enroll later.
  • Plan N covers some out-of-pocket costs that Original Medicare does not, including copays for doctor visits and emergency room visits.
  • Your actual monthly cost depends on the company's pricing method, your age, and whether you enroll on time or delay.

What Plan N covers that Original Medicare does not

Plan N pays for some costs that Original Medicare leaves you responsible for. It covers the Part B copay for doctor visits (usually $20 to $50 per visit), the Part B deductible ($240 in 2025), and copays for emergency room visits (though not if you are admitted to the hospital). It also covers skilled nursing facility copays after Medicare's coverage ends.

Plan N does not cover your Part B premium itself—you still pay that to Medicare every month. It also does not cover prescription drugs; you need a separate Part D plan for that. And Plan N has an important gap: it does not cover the excess charges that some doctors are allowed to bill above Medicare's approved amount. If a doctor charges more than Medicare allows and does not accept Medicare's approved amount as full payment, you pay the difference.

Because Plan N leaves some gaps, it typically costs less than Plan G, which is more comprehensive. The trade-off is that you may pay more out of pocket when you see a doctor or use the emergency room.

How to compare Plan N prices from Iowa insurers

To find the actual premium each company is charging in Iowa right now, contact them directly or visit their websites. Mutual of Omaha, Medico, and AARP all have online quote tools where you enter your age and zip code and receive a quote. You can also call each company's customer service line and ask for a Plan N rate quote.

When you get quotes, ask each company whether it uses issue age or attained age pricing. This matters because it affects how much your premium will increase over time. Also ask whether the company offers any discounts—some offer small reductions if you pay annually instead of monthly, or if you have a spouse who also buys a Medigap policy from them.

Keep in mind that the lowest premium now may not be the lowest over time. A company with lower issue age pricing might cost less initially but increase your premium faster each year than a competitor. Ask the company to show you what the premium is projected to be at age 75 and age 85, so you can compare the long-term cost, not just the first-year cost.

When you can enroll in Plan N and what happens if you miss the window

You have the strongest protection if you enroll in Plan N during your initial enrollment period, which runs for six months starting the month you turn 65 and sign up for Medicare Part B. During this window, insurance companies cannot deny you coverage or charge you more because of health problems. This is called may provide issue.

If you miss this window and try to enroll later, the rules change. Some companies will still sell you Plan N without asking about your health, but others may require you to answer health questions or may deny you coverage altogether. If they do sell you a policy, they can charge you a higher premium to account for the risk that you waited. In Iowa, there is no state law that forces companies to sell you Plan N outside the initial enrollment period, so your options may be limited.

The best time to enroll is during the three months before you turn 65, the month you turn 65, or the three months after. If you are already on Medicare and did not enroll in a Medigap plan at that time, you can still buy Plan N, but you may face medical underwriting and higher rates.

How Plan N premiums are expected to change

Medigap premiums generally increase each year, but the amount varies by company and by your age. Some increases come from inflation and rising healthcare costs. Others come from the company's pricing method: if you have attained age pricing, your premium goes up partly because you are older. If you have issue age pricing, your increase is smaller in early years but may accelerate later.

Insurance companies file their rate changes with the Iowa Insurance Division, but they do not announce them far in advance. You typically find out about a rate increase when your renewal notice arrives, usually 30 to 60 days before the increase takes effect. At that point, you have the right to switch to a different Medigap plan or a different company, though switching may involve medical underwriting if you have health problems.

Because rates change, it is worth shopping every few years to see whether a different company now offers better pricing. You can switch Medigap plans once per year during the annual enrollment period (October 15 to December 7) without medical underwriting, as long as you have had continuous coverage.

Plan N versus other Medigap options in Iowa

Plan N is not the only Medigap choice. Plan G is more comprehensive and covers the Part B deductible and excess charges that Plan N does not, but it costs more—typically $30 to $60 more per month. Plan F is the most comprehensive but is closed to new enrollees who turned 65 on or after January 1, 2020. Plan D, K, and L are less comprehensive and cost less but leave larger gaps in coverage.

For many people, Plan N makes sense because it balances cost and coverage. You pay a moderate premium and have predictable copays for doctor visits and the emergency room. But if you see doctors frequently or are concerned about excess charges, Plan G might be worth the extra cost. If you want the lowest possible premium and do not mind higher out-of-pocket costs, Plan K or L might work.

The right choice depends on your health, how often you see doctors, and your budget. There is no single best plan for everyone.

Frequently Asked Questions

Does Plan N cover my Part B premium?

No. Plan N covers some of the costs that come with Part B, such as copays and the deductible, but it does not pay your Part B premium itself. You pay that premium directly to Medicare every month, separate from your Plan N premium.

Can I switch from Plan N to a different Medigap plan later?

Yes, but the rules depend on when you switch. If you switch during the annual enrollment period (October 15 to December 7) and have had continuous Medigap coverage, most companies cannot deny you or charge more because of health problems. Outside that window, you may face medical underwriting.

What is the difference between Plan N and Plan G?

Plan G covers the Part B deductible and excess charges that Plan N does not. This makes Plan G more comprehensive, but it costs more—usually $30 to $60 extra per month. Plan N is a good choice if you want lower premiums and do not mind paying copays at the doctor.

Do I need a separate prescription drug plan with Plan N?

Yes. Plan N does not cover prescription drugs. You need to enroll in a Part D plan through Medicare to cover your medications. You can enroll in Part D when you first sign up for Medicare or during the annual enrollment period.

What happens if I enroll in Plan N after my initial enrollment period?

You may face medical underwriting, meaning the insurance company can ask about your health and may deny you coverage or charge a higher premium. Some companies in Iowa will still sell you Plan N without health questions, but others will not. It is best to enroll during your initial six-month window to avoid this risk.