Plan N is a Medigap policy that covers some costs Medicare Part B doesn't pay
Plan N is a standardized Medigap insurance policy sold by private insurers. It pays certain out-of-pocket costs that Original Medicare (Part A and Part B) leaves you responsible for — mainly copayments, coinsurance, and some deductibles. Plan N does not cover prescription drugs; you need a separate Part D plan for that.
The main appeal of Plan N is cost: the monthly premium is usually lower than Plans F, G, or M, which cover more. The trade-off is that Plan N leaves you paying some costs that those richer plans would cover. Understanding exactly what Plan N does and does not pay is the only way to know whether the savings on premiums are worth the extra out-of-pocket risk.
Key Takeaways
- Plan N covers Medicare Part B copayments and coinsurance, the Part B deductible, and blood transfusions, but not the Part A deductible or skilled nursing facility coinsurance.
- You pay a monthly premium to the insurance company selling Plan N, separate from your Medicare Part B premium.
- Plan N does not cover prescription drugs — you must enroll in a Part D plan through Medicare if you want that coverage.
- You can switch to a different Medigap plan during your open enrollment period or if you move to a new state, but switching may involve medical underwriting and higher premiums based on age and health.
- Plan N is available only if you are already enrolled in Medicare Part A and Part B.
What Plan N covers and what it does not
Plan N covers the Part B deductible (the amount you pay before Medicare starts paying for doctor visits and outpatient services). It also covers Part B copayments and coinsurance — the percentage of costs you owe after Medicare pays its share. For example, if Medicare covers 80% of an outpatient procedure, Plan N pays your 20% coinsurance. Plan N also covers blood transfusions (the first three pints) and hospice care copayments.
Plan N does not cover the Part A deductible (the amount you pay for a hospital stay). It does not cover skilled nursing facility coinsurance — the daily cost you owe after day 20 in a skilled nursing facility. Plan N also does not cover excess charges if you see a doctor who does not accept Medicare assignment (though this is rare). And as noted, Plan N does not cover prescription drugs under any circumstances.
The difference between Plan N and Plan G is mainly the Part B deductible and excess charges. Plan G covers both; Plan N covers the deductible but not excess charges. The difference between Plan N and Plan F is larger: Plan F covers the Part A deductible and skilled nursing facility coinsurance, which Plan N does not.
How much Plan N costs
Plan N premiums vary by insurance company, your age, your location, and sometimes your health history (depending on when you enrolled). There is no single "Plan N premium" — you must get quotes from multiple insurers to compare. Some insurers offer discounts for paying annually instead of monthly, or for setting up automatic payments.
The monthly premium is separate from your Medicare Part B premium, which you pay to Medicare directly. You pay both. The Part B premium in 2024 is $174.70 per month for most people, though higher earners pay more. Your Plan N premium is on top of that.
Because Plan N leaves you responsible for some costs (mainly the Part A deductible and skilled nursing facility coinsurance), your total out-of-pocket spending could be higher than with a richer plan, even if your monthly premium is lower. The break-even point depends on how much medical care you actually use.
When you can enroll in Plan N or switch to it
You can enroll in Plan N only if you are already enrolled in Medicare Part A and Part B. The best time to buy Plan N is during your Medigap open enrollment period, which lasts six months starting the month you turn 65 and enroll in Part B. During this window, insurers cannot deny you coverage or charge you more based on health conditions — a may provide called may provide issue.
If you miss your open enrollment period, you can still buy Plan N, but insurers may require medical underwriting (asking about your health history) and can charge you higher premiums if you have pre-existing conditions. Some states have additional protections that let you switch plans without underwriting in certain situations, such as if you move out of state or if your current insurer stops selling Medigap in your area.
You can switch from one Medigap plan to another at any time, but switching outside your open enrollment period may trigger medical underwriting and higher rates. Many people stay with their original plan to avoid this cost.
How Plan N works when you see a doctor
When you visit a doctor who accepts Medicare assignment, the process is straightforward. Medicare pays its share, you owe a copayment or coinsurance, and Plan N pays that amount (except for the Part A deductible and skilled nursing facility coinsurance, which Plan N does not cover). You typically pay the copayment or coinsurance at the time of service, then Plan N reimburses you, or the provider bills Plan N directly.
If you see a doctor who does not accept Medicare assignment, Medicare still pays, but the doctor can charge you up to 15% more than Medicare's approved amount. Plan N does not cover this excess charge. This is rare — most doctors accept assignment — but it is a real cost to know about.
For hospital stays, Medicare Part A covers most costs after you pay the deductible. Plan N does not cover the Part A deductible, so you pay it out of pocket. After that, Medicare covers the rest (with some limits on length of stay). For skilled nursing facility stays, Medicare covers the first 20 days fully, then you owe coinsurance for days 21 to 100. Plan N does not cover this coinsurance.
Plan N compared to other Medigap plans
| Coverage | Plan N | Plan G | Plan F |
|---|---|---|---|
| Part B deductible | Covered | Covered | Covered |
| Part B copayments and coinsurance | Covered | Covered | Covered |
| Part A deductible | Not covered | Not covered | Covered |
| Skilled nursing facility coinsurance | Not covered | Not covered | Covered |
| Excess charges | Not covered | Covered | Covered |
| Typical monthly premium (varies widely) | Lower | Mid-range | Higher |
Plan G is often the next step up from Plan N. It covers excess charges and costs the same or slightly more per month. Plan F covers the most but is only available to people who were may be able to access for Medicare before January 1, 2020, so most new beneficiaries cannot buy it.
Newer plans like Plan K and Plan L cover less than Plan N and have lower premiums, but they also leave you responsible for a percentage of certain costs rather than covering them fully. These plans are less common and appeal mainly to people with very low expected medical spending.
How to get quotes for Plan N
Contact insurance companies directly or use Medicare's official plan comparison tool at Medicare.gov. You can also call 1-800-MEDICARE to request quotes. Provide your age, location, and the month you enrolled in Part B so insurers can calculate your rate correctly.
Get quotes from at least three insurers before deciding. Premiums for the same plan can differ by $50 or more per month between companies. Also ask about discounts for automatic payment or annual payment, and whether the company has a history of large rate increases.
Once you choose an insurer and plan, you enroll directly with that company, not through Medicare. The insurer will confirm your enrollment and send you a card and policy documents.
Frequently Asked Questions
Does Plan N cover prescription drugs?
No. Plan N covers only certain out-of-pocket costs for doctor visits, hospital stays, and other services. You must enroll in a separate Medicare Part D prescription drug plan if you want that coverage. You can enroll in Part D when you first join Medicare or during the annual open enrollment period.
What happens if I need a hospital stay and have Plan N?
Medicare Part A covers most hospital costs after you pay the deductible. Plan N does not cover the Part A deductible, so you pay it yourself. After that, Medicare covers the rest. For stays longer than 60 days, you owe coinsurance, which Plan N also does not cover.
Can I switch from Plan N to a different Medigap plan later?
Yes, but switching outside your open enrollment period may require medical underwriting and result in higher premiums. If you switch during your open enrollment period (which lasts six months from when you first enroll in Part B), insurers cannot deny you or charge more based on health. Some states offer additional switching windows if you move or if your insurer stops selling Medigap.
Is Plan N cheaper than Plan G?
Plan N usually has a lower monthly premium than Plan G, but the difference varies by insurer and location. However, Plan N leaves you responsible for some costs that Plan G covers, so your total out-of-pocket spending may be higher. Compare the premium difference against the costs you are likely to owe to decide which is better for you.
Can I buy Plan N if I have a pre-existing condition?
During your Medigap open enrollment period, yes — insurers cannot deny you or charge more based on health. Outside that period, insurers can require medical underwriting and may charge higher premiums or deny coverage. Enrolling in Plan N during your open enrollment window (within six months of turning 65 and enrolling in Part B) protects you from this risk.