Medicare Plan N is a Medigap policy that covers some costs Medicare Part B doesn't pay

Medicare Plan N is a supplemental insurance policy sold by private insurers. It works alongside Original Medicare (Parts A and B) to cover costs that Medicare leaves you responsible for — copayments, coinsurance, and deductibles. Plan N does not cover everything Medicare doesn't pay, which is why understanding what it does and doesn't cover matters before you choose it.

Plan N became available in 2020 as part of a change to how Medigap policies work. It replaced some of the coverage that older plans offered, particularly around preventive care and excess charges from doctors who don't accept Medicare's payment rates. If you're comparing plans or trying to understand a bill, knowing exactly what Plan N covers helps you spot gaps and plan for out-of-pocket costs.

Key Takeaways

  • Plan N covers your Part B coinsurance (usually 20% of approved costs) after you meet your deductible, but you pay a copayment for some office visits and emergency room trips.
  • Plan N does not cover excess charges — the amount a doctor can bill you above Medicare's approved rate — so you may owe more if your doctor doesn't accept Medicare's payment.
  • Plan N covers Part A hospital coinsurance, skilled nursing facility coinsurance, and your Part A deductible once per year.
  • You pay a monthly premium to the insurance company selling Plan N, separate from your Medicare Part B premium.
  • Plan N is less expensive than some other Medigap plans but leaves you with more out-of-pocket costs for certain services.

What Plan N covers for hospital and skilled nursing care

Plan N covers your Part A deductible — the amount you owe before Medicare hospital insurance kicks in. As of 2024, that deductible is $1,676 per benefit period, though this amount changes yearly. Once you meet it, Plan N covers your coinsurance for hospital stays: you pay nothing for days 1–60, and Plan N covers the coinsurance for days 61–90 and your lifetime reserve days.

For skilled nursing facility care, Plan N covers your coinsurance after day 20. If you stay in a skilled nursing facility, you pay coinsurance for days 21–100, and Plan N pays that amount. After day 100, you owe the full cost — Plan N does not cover it.

Plan N also covers hospice care coinsurance and blood transfusions that Medicare Part A covers. These are less common expenses, but they matter if you face them.

What Plan N covers for doctor visits and outpatient care

Plan N covers your Part B coinsurance — the 20% of approved costs you normally owe after you meet your Part B deductible. This applies to doctor office visits, lab tests, imaging, and most outpatient services. However, you must first pay your Part B deductible ($240 in 2024), which Plan N does not cover.

Plan N includes a copayment for office visits: you pay up to $50 per visit to a doctor's office, even after you meet your deductible. This is different from other Medigap plans that cover the full coinsurance. Plan N also charges a copayment for emergency room visits — up to $250 per visit — though this copayment is waived if you're admitted to the hospital.

For preventive care that Medicare covers at no cost (like annual wellness visits and cancer screenings), Plan N covers your share. You pay nothing for these services if your doctor accepts Medicare's approved amount.

What Plan N does not cover: excess charges and other gaps

The biggest gap in Plan N is excess charges. If your doctor does not accept Medicare's approved amount and instead bills you for more, Plan N does not cover that extra cost. For example, if Medicare approves $100 for a service and your doctor charges $120, you owe the $20 difference out of pocket. This can add up quickly if you see doctors who don't accept Medicare's rates.

Plan N also does not cover your Part B deductible ($240 in 2024). You pay this yourself before Plan N's coinsurance coverage begins. Plan N does not cover routine dental, vision, or hearing care, and it does not cover prescription drugs — you need a separate Part D plan for that.

Plan N does not cover services Medicare doesn't cover, such as long-term care, most physical therapy beyond what Medicare allows, or cosmetic surgery. It also does not cover out-of-network care outside the United States, though it does cover emergency care abroad for the first 60 days of a trip.

How Plan N premiums compare to other Medigap plans

Plan N premiums vary by insurance company, your age, your location, and whether you're new to Medigap or switching from another plan. Generally, Plan N costs less per month than Plan G or Plan F, which offer broader coverage. The trade-off is that you pay more out of pocket when you use services — the copayments for office visits and emergency room care, plus your Part B deductible and any excess charges.

To find the actual cost, you need to contact insurance companies directly or use Medicare's Plan Finder tool at Medicare.gov. Premiums can differ by hundreds of dollars per year between insurers in the same area, so comparing quotes matters. Some companies offer discounts for paying annually instead of monthly, or for setting up automatic payments.

When you turn 65 and first enroll in Medicare, you have a six-month window to buy any Medigap plan without medical underwriting — the insurance company cannot deny you or charge more based on your health. After that window closes, some companies may require a health questionnaire or deny coverage for pre-existing conditions. This makes the timing of your first Medigap purchase important.

When Plan N makes sense and when it doesn't

Plan N works well if you see doctors who accept Medicare's approved amounts and don't expect many office visits. The lower premium can save you money over time if your healthcare use is light. It also suits people who are comfortable with small copayments and want to avoid paying for coverage they won't use.

Plan N is less suitable if you see doctors who bill above Medicare's approved rates, because you'll owe those excess charges yourself. It's also a weaker choice if you have chronic conditions requiring frequent office visits, since the copayments add up. If you want the broadest coverage with the fewest out-of-pocket costs, Plan G or Plan F (if you were may be able to access before 2020) offer more comprehensive protection, though at a higher premium.

Your choice also depends on your health history and your doctor's billing practices. Before you choose Plan N, ask your doctors whether they accept Medicare's approved amount or bill excess charges. This single question can tell you whether Plan N will work for you.

How to enroll in Plan N and what to do if you change your mind

You can enroll in Plan N during your Initial Enrollment Period (the six months starting the month you turn 65 and enroll in Medicare Part B), or during the annual Medigap Open Enrollment Period (October 15 to December 7 each year). You can also enroll outside these windows, but the insurance company may deny you or charge more if you have pre-existing conditions.

To enroll, contact the insurance company directly by phone or through their website. You'll need your Medicare card and Social Security number. The company will ask health questions (unless you're in a protected enrollment period) and tell you when coverage starts — usually the first of the month following approval.

If you enroll in Plan N and later want to switch to a different Medigap plan, you can do so during the annual open enrollment period without medical underwriting. Outside that window, switching may require health approval. Some states have additional protections that allow switching under certain circumstances, so check with your state insurance commissioner's office if you need to change plans outside the standard windows.

Frequently Asked Questions

Does Plan N cover my Part B deductible?

No. You pay the Part B deductible ($240 in 2024) yourself before Plan N's coinsurance coverage begins. Plan N covers the 20% coinsurance after you meet this deductible, but not the deductible itself.

What happens if my doctor charges more than Medicare approves?

You owe the difference. Plan N does not cover excess charges — amounts a doctor bills above Medicare's approved rate. This is why it's important to ask your doctors whether they accept Medicare's approved amount before you choose Plan N.

Can I use Plan N if I travel outside the United States?

Plan N covers emergency care abroad for the first 60 days of a trip, after you pay a copayment. For longer trips or non-emergency care, you would need separate travel insurance. Plan N does not cover routine care outside the U.S.

How much will I pay for an office visit with Plan N?

You pay up to $50 per office visit after you meet your Part B deductible. This is a copayment, not coinsurance, so it's a fixed amount rather than a percentage of the bill. Some doctors may charge less than $50.

Can I switch from Plan N to another Medigap plan?

Yes, during the annual Medigap Open Enrollment Period (October 15 to December 7) you can switch to any other Medigap plan without medical underwriting. Outside this window, the new insurance company may require health approval before accepting you.