Medicare Plan N is a Medigap policy that covers some of your Medicare costs
Medicare Plan N is a standardized Medigap insurance policy sold by private insurers. It pays for some of the costs that Original Medicare (Part A and Part B) does not cover — things like copayments, coinsurance, and deductibles. Plan N is less expensive than some other Medigap plans, but it also covers fewer costs.
Plan N became available in 2020 as part of a change to how Medigap plans work. If you enroll in Plan N, you keep your Original Medicare coverage and add Plan N on top of it. You pay a monthly premium to the insurance company that sells you Plan N, separate from your Medicare Part B premium.
Key Takeaways
- Plan N covers your Part A hospital deductible, Part B copayments and coinsurance, and skilled nursing facility coinsurance, but not your Part B deductible.
- You pay a copayment (usually $20) when you see a doctor, and Plan N does not cover that copayment — you pay it yourself.
- Plan N premiums are typically lower than Plan G or Plan F, but you have more out-of-pocket costs when you use healthcare.
- Plan N does not cover excess charges if your doctor does not accept Medicare assignment, so choosing in-network providers matters more with this plan.
What Plan N covers
Plan N covers your Part A hospital deductible — the amount you owe before Medicare hospital coverage kicks in. It also covers Part A coinsurance, which is the daily cost you pay for hospital stays that last longer than 60 days.
For doctor visits and outpatient care, Plan N covers your Part B coinsurance — usually 20% of the cost after you meet your deductible. It also covers Part B copayments for certain services, but not all. Specifically, Plan N covers copayments for office visits and emergency room visits, but you still pay a copayment (usually $20 for a doctor visit or $50 for the emergency room) out of your own pocket.
Plan N also covers skilled nursing facility coinsurance — the daily cost you owe after day 20 of a stay in a skilled nursing facility. It covers blood (the first three pints per year), and it covers hospice care coinsurance.
What Plan N does not cover
Plan N does not cover your Part B deductible — the amount you owe before your doctor visit coverage begins. In 2024, that deductible is $240, though it changes each year. You pay this amount yourself before Plan N starts helping.
Plan N does not cover excess charges. An excess charge happens when your doctor does not accept Medicare assignment (meaning they do not agree to charge only what Medicare allows). If your doctor charges more than Medicare allows, you pay the difference. With Plan N, the insurance company does not cover that overage. This is a real cost difference compared to Plan G or Plan F, which do cover excess charges.
Plan N also does not cover preventive care copayments, foreign travel emergency care, or routine dental, vision, or hearing services — but Original Medicare does not cover those either, so Plan N is not different from other Medigap plans in that way.
How Plan N premiums compare to other Medigap plans
Plan N premiums are typically lower than Plan G or Plan F. The exact amount depends on your age, where you live, and which insurance company sells the plan. Premiums also vary based on how the insurance company sets prices — some use age-attained pricing (your premium goes up as you get older), while others use issue-age pricing (your premium is based on your age when you first enroll and stays the same as you age) or community pricing (everyone in your area pays the same premium regardless of age).
Because Plan N costs less per month, it can be a good choice if you are generally healthy and do not see doctors often. However, you need to think about the copayments you will pay each time you use healthcare. If you see a doctor frequently, those $20 copayments add up, and Plan G or Plan F might cost less overall when you add up premiums and out-of-pocket costs together.
When you can enroll in Plan N
You can enroll in Plan N during your Medigap open enrollment period, which is the six-month window that starts the month you turn 65 and enroll in Medicare Part B. During this period, insurance companies must sell you Plan N without charging more based on your health history.
You can also enroll in Plan N outside this window, but insurance companies may deny you coverage or charge you more if you have pre-existing health conditions. Some states have additional protections that allow you to enroll in Plan N at any time, so check with your state insurance commissioner's office if you miss the open enrollment period.
Plan N and doctors who do not accept Medicare assignment
Because Plan N does not cover excess charges, the doctors you see matter more than they do with other Medigap plans. Before you choose Plan N, check whether your current doctors accept Medicare assignment. You can search for doctors on Medicare.gov or call your doctor's office and ask directly.
If your doctor does not accept assignment and charges more than Medicare allows, you will pay the difference yourself. For example, if Medicare allows $100 for a visit and your doctor charges $120, Medicare pays its share and Plan N pays its share, but you pay the $20 difference. With Plan G or Plan F, the insurance company would cover that $20. This is why it matters to know your doctors' assignment status before you choose Plan N.
How to compare Plan N with Plan G and Plan F
| Coverage | Plan N | Plan G | Plan F |
|---|---|---|---|
| Part A deductible | Covered | Covered | Covered |
| Part B deductible | Not covered | Not covered | Covered |
| Part B excess charges | Not covered | Covered | Covered |
| Doctor visit copayments | You pay $20 | Covered | Covered |
| Emergency room copayments | You pay $50 | Covered | Covered |
| Typical monthly premium | Lower | Medium | Higher |
Plan N makes sense if you want lower monthly premiums and do not mind paying copayments at the doctor. Plan G covers more than Plan N but costs more per month. Plan F covers almost everything but is the most expensive and is only available to people who were may be able to access for Medicare before 2020.
To decide which plan is right for you, add up what you expect to pay in premiums plus out-of-pocket costs for each plan. If you see doctors regularly or use the emergency room, Plan G or Plan F may save you money overall despite higher premiums. If you rarely see doctors, Plan N's lower premium may be the better choice.
Frequently Asked Questions
Do I have to use doctors who accept Medicare assignment with Plan N?
No, but it is strongly recommended. If you see a doctor who does not accept assignment, you will pay excess charges out of your own pocket because Plan N does not cover them. Doctors who accept assignment agree to charge only what Medicare allows, so you avoid that extra cost.
Can I switch from Plan N to a different Medigap plan later?
Yes, but switching outside your open enrollment period may be difficult. If you enroll in Plan N during your Medigap open enrollment period and later want to switch to Plan G or another plan, insurance companies can deny you or charge you more based on your health. Some states have protections that make switching easier — check with your state insurance commissioner's office.
Does Plan N cover prescription drugs?
No. Medigap plans, including Plan N, do not cover prescription drugs. You need to enroll in a separate Medicare Part D prescription drug plan. You can enroll in Part D when you first become may be able to access for Medicare, or during the annual enrollment period.
What happens if I do not enroll in Plan N during my open enrollment period?
You can still enroll later, but insurance companies may charge you more or deny your process based on your health history. Some states have rules that protect you, so contact your state insurance commissioner's office to learn what applies where you live.
Is Plan N the same from every insurance company?
Yes, the coverage is the same — all Plan N policies cover the same services. However, premiums vary widely by company and location. It is worth getting quotes from several insurers to find the lowest price in your area.