Plan N covers doctor visits, hospital stays, and blood — but leaves some costs to you

Medicare Supplement Plan N pays for most of what Original Medicare does not. It covers the full cost of hospital stays after you meet your deductible, doctor visits with no copay limits, and blood transfusions. It does not cover prescription drugs, dental, vision, or hearing aids. You will still pay a copay when you see a doctor ($20 per visit, typically) and a copay for emergency room visits ($50, waived if admitted). Plan N also does not cover the Part B deductible — you pay that yourself each year.

Plan N is popular because the monthly premium is lower than Plans F or G, but it requires you to understand which costs stay your responsibility. The trade-off is straightforward: you save money on the monthly bill, but you share some costs with Medicare when you use care.

Key Takeaways

  • Plan N covers hospital deductibles, coinsurance, and copays for most doctor visits, but you pay a $20 copay per office visit and $50 per emergency room visit.
  • You remain responsible for the Part B deductible (the annual amount you must pay before Medicare starts covering doctor services), which changes each year.
  • Plan N does not cover prescription drugs, dental, vision, hearing aids, or long-term care — you need separate coverage or must pay out of pocket for these.
  • The monthly premium for Plan N is typically lower than Plans F or G, making it a good choice if you want to balance premium costs with some out-of-pocket expenses.
  • Plan N covers excess charges only if your doctor accepts Medicare assignment; if your doctor does not, you may owe more than the plan covers.

What Plan N pays for hospital care

Plan N covers your hospital deductible after you meet it — meaning Medicare pays the first portion, and Plan N picks up the rest. Once the deductible is met, Plan N covers all coinsurance for hospital stays, including semi-private room, meals, and standard nursing care. If you stay longer than 60 days in a hospital, Plan N covers coinsurance for days 61 through 90, and for an additional 60 "lifetime reserve days" that Medicare allows.

Skilled nursing facility care is also covered after a hospital stay. Plan N pays coinsurance for days 21 through 100 of a nursing facility stay (Medicare covers days 1 through 20 after a may have access to hospital stay). After day 100, you pay the full cost. Hospice care copays are covered by Plan N as well.

Doctor visits and outpatient services under Plan N

Plan N covers the coinsurance for doctor visits once you have paid your Part B deductible for the year. However, you will pay a $20 copay for each office visit to a doctor who accepts Medicare assignment — the standard arrangement where the doctor agrees to accept Medicare's approved amount as full payment. This copay is your responsibility; Plan N does not cover it.

For other outpatient services — lab tests, X-rays, physical therapy, and durable medical equipment — Plan N covers coinsurance after the Part B deductible. You do not pay a copay for these services, only the coinsurance amount (usually 20 percent of the approved cost). If your doctor does not accept Medicare assignment, you may owe more than Plan N covers, so confirm assignment status before your visit.

Emergency room visits and urgent care

Plan N covers coinsurance for emergency room visits. You will pay a $50 copay per visit. If you are admitted to the hospital from the emergency room, the $50 copay is waived — you will not owe it. This structure encourages you to use the emergency room only when necessary, while protecting you from the full cost if admission follows.

Urgent care centers and walk-in clinics that are not hospital-based may be treated differently depending on how they bill. If they bill as an office visit, you owe the $20 copay. If they bill as an outpatient service, you owe coinsurance. Ask the clinic before your visit how they will bill Medicare so you know what to expect.

What Plan N does not cover

Plan N does not cover the Part B deductible, which you must pay out of pocket each year before Medicare and Plan N begin sharing costs. In 2024, this deductible is $240, but it changes annually. You are responsible for this amount regardless of Plan N.

Prescription drugs are not covered by any Medigap plan, including Plan N. You need a separate Part D prescription drug plan through Medicare or private insurance. Dental, vision, hearing aids, and long-term care are also excluded from Plan N. If you need these services, you either pay out of pocket or purchase separate coverage.

Plan N also does not cover excess charges — the amount a doctor may bill above Medicare's approved amount — unless the doctor accepts Medicare assignment. If your doctor does not accept assignment and charges more than Medicare approves, you pay the difference. This is rare but possible, so confirm assignment before treatment.

How Plan N compares to other Medigap plans

Plan N has a lower monthly premium than Plan F (which covers the Part B deductible and has no copays) or Plan G (which covers the Part B deductible). The trade-off is that you pay the Part B deductible yourself and copays for doctor visits and emergency room use. If you see your doctor frequently or use the emergency room, these copays add up. If you rarely see a doctor, Plan N saves you money overall.

Plan G is similar to Plan N but covers the Part B deductible and has no copays for doctor visits. Plan G's premium is higher, but you have more predictable costs. Plan F covers everything Plan N does plus the Part B deductible and excess charges, but Plan F is only available to people who were first may be able to access for Medicare before January 1, 2020. Choose Plan N if the lower premium outweighs the copays you expect to pay.

Enrollment and timing for Plan N

You can enroll in Plan N during your Medigap open enrollment period, which begins the month you turn 65 and enroll in Medicare Part B. During this six-month window, insurance companies cannot deny you coverage or charge more based on health conditions. If you miss this window, you may face medical underwriting, higher premiums, or denial of coverage depending on your state.

You can also switch to Plan N from another Medigap plan at any time, though the new plan may require medical underwriting if you are outside your enrollment period. Some states have additional protections that allow switching without underwriting. Contact your state insurance commissioner's office to learn the rules in your state.

Frequently Asked Questions

Do I have to pay the $20 copay for every doctor visit on Plan N?

Yes, if the doctor accepts Medicare assignment. You pay $20 per office visit to a doctor who participates in Medicare. This copay is separate from any coinsurance. If your doctor does not accept assignment, the rules are different and you may owe more.

Does Plan N cover the Part B deductible?

No. You pay the Part B deductible out of pocket each year before Medicare and Plan N begin sharing costs. The deductible changes annually and was $240 in 2024. Plan F and Plan G do cover this deductible, but their premiums are higher.

What happens if I need prescription drugs on Plan N?

Plan N does not cover prescription drugs. You must enroll in a separate Medicare Part D prescription drug plan or use private insurance. You can enroll in Part D when you first become may be able to access for Medicare or during the annual enrollment period in the fall.

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

Yes, you can switch at any time, but switching outside your initial enrollment period may require medical underwriting. Some states protect your right to switch without underwriting. Contact your state insurance commissioner's office to learn what protections explore where you live.

Does Plan N cover excess charges if my doctor does not accept Medicare assignment?

No. Plan N only covers excess charges if your doctor accepts Medicare assignment. If your doctor does not accept assignment and charges above Medicare's approved amount, you pay the difference. Always confirm assignment status before your visit.