Plan N is a Medicare Supplement that covers some — but not all — of your out-of-pocket costs under Original Medicare

Plan N pays for certain expenses that Medicare Part A and Part B do not cover: coinsurance, copayments, and the Part B deductible. It does not cover your Part B excess charges (the amount doctors can bill above Medicare's approved fee) or your prescription drugs. Plan N is one of ten standardized supplement plans, meaning the coverage is the same no matter which insurance company sells it to you — the price and customer service are what differ between insurers.

Plan N is popular because it costs less per month than some other plans, particularly Plan G, while still covering many of your largest out-of-pocket risks. The trade-off is that you pay a copayment when you visit a doctor's office ($20) or an urgent care center ($50), and you cover any excess charges your doctor bills above what Medicare allows.

Key Takeaways

  • Plan N covers your Part A hospital coinsurance, Part B coinsurance, the Part B deductible, and emergency care outside the United States.
  • You pay a $20 copayment for doctor visits and a $50 copayment for urgent care visits; Plan N does not cover these costs.
  • Plan N does not cover excess charges (amounts doctors bill above Medicare's approved rate) or prescription drugs.
  • The monthly premium for Plan N varies by insurance company and your age, but is typically lower than Plan G or Plan F.
  • You can switch to Plan N during the Open Enrollment Period (October 15 to December 7 each year) or during your Medigap Open Enrollment Period if you are newly may be able to access for Medicare.

What Plan N Covers

Plan N covers your Part A hospital coinsurance — the amount you owe for hospital stays after Medicare's coverage ends. For stays longer than 60 days in a single benefit period, Medicare stops paying and you owe coinsurance; Plan N pays this. It also covers the first three pints of blood you need during a hospital stay, which Medicare does not.

Plan N pays your Part B coinsurance, which is normally 20 percent of the cost of doctor visits, lab work, imaging, and outpatient surgery after you have met your deductible. It covers your Part B deductible ($240 in 2024, though this amount changes yearly), which you must pay before Medicare begins to pay for most Part B services.

Plan N also covers skilled nursing facility coinsurance (the cost you owe after day 20 of a nursing home stay) and emergency care outside the United States during the first 60 days of travel. These are less common expenses, but they can be large when they occur.

What Plan N Does Not Cover

Plan N does not cover excess charges, which are the amounts doctors can bill above what Medicare allows. If Medicare approves $100 for a service but your doctor charges $120, you owe the $20 difference. Doctors who do not accept Medicare's approved amount can bill you for this gap. Plan G and Plan F cover excess charges; Plan N does not, which is one reason Plan N premiums are lower.

Plan N does not cover prescription drugs. If you take medications, you need a separate Part D prescription drug plan, which you can enroll in during the same Open Enrollment Period when you choose your supplement. Plan N also does not cover routine dental, vision, hearing aids, or long-term care — no Medicare Supplement plan covers these.

The Doctor Visit Copayments You Pay

Plan N requires you to pay a $20 copayment when you visit your doctor's office for an established problem or a new problem. This is different from other plans: Plan G and Plan F cover this copayment, so you pay nothing. Plan N also requires a $50 copayment for urgent care center visits. These copayments are your responsibility; Plan N does not pay them.

The copayments explore only to the visit itself, not to lab work or imaging ordered during that visit. If your doctor orders blood work or an X-ray, Plan N covers your 20 percent coinsurance on those services (after your deductible is met). The copayment structure means Plan N works best if you do not visit the doctor frequently; if you have multiple chronic conditions and see doctors often, Plan G may cost less overall despite a higher monthly premium.

How Plan N Premiums Compare to Other Plans

Plan N premiums vary by insurance company, your age, and your location. Generally, Plan N costs less per month than Plan G or Plan F, but more than Plan D or Plan L. The savings on the monthly premium can be offset by the copayments you pay at the doctor's office, so the true cost depends on how often you need care.

To compare actual prices, you need to contact insurance companies directly or use a Medicare Supplement comparison tool that shows rates in your area. Rates change yearly, usually on January 1, so the cheapest plan one year may not be the cheapest the next. Some insurers offer discounts for paying by automatic bank draft or for bundling with other insurance products.

When You Can Enroll in Plan N

You can enroll in Plan N during your Medigap Open Enrollment Period, which begins the month you turn 65 and are enrolled in Medicare Part B. During this six-month window, insurance companies cannot deny you coverage or charge you more based on your health history. This is the best time to enroll because you have may provide issue rights.

Outside this window, you can enroll during the Medicare Open Enrollment Period (October 15 to December 7 each year), but insurance companies can deny you or charge you more if you have health conditions. Some states have additional protections that extend may provide issue rights beyond the initial six months, so check your state's rules. If you already have a different Medicare Supplement plan, you can switch to Plan N during Open Enrollment, though some insurers may require medical underwriting if you are switching to a plan with less coverage.

Plan N Versus Plan G: Which Costs Less

Plan G covers everything Plan N covers, plus excess charges and the doctor visit copayments. Plan G has no copayments at the doctor's office, while Plan N charges $20 per visit. The question is whether Plan G's higher monthly premium is worth the savings on copayments.

If you visit the doctor once a month, the $20 copayments add up to $240 per year. If Plan G costs $30 more per month than Plan N, that is $360 per year — more than the copayments. But if you visit the doctor six times a month, the copayments total $1,440 per year, which may be less than the premium difference. Calculate your own situation: estimate how many doctor visits you expect, multiply by $20, and compare that to the monthly premium difference between the two plans in your area.

Frequently Asked Questions

Does Plan N cover my prescription drugs?

No. Plan N does not cover prescription drugs. You need to enroll in a separate Medicare Part D prescription drug plan. You can enroll in Part D at the same time you enroll in Plan N, during the Medicare Open Enrollment Period or your initial Medigap Open Enrollment Period.

What happens if my doctor charges more than Medicare allows?

You owe the difference. Plan N does not cover excess charges. If your doctor charges $150 and Medicare allows $100, you pay the $50 excess. Plan G covers this, but Plan N does not. Ask your doctor's office whether they accept Medicare's approved amount before your visit.

Can I switch from Plan G to Plan N to save money?

Yes, you can switch during the Medicare Open Enrollment Period (October 15 to December 7). However, switching from a plan with more coverage (Plan G) to one with less (Plan N) may trigger medical underwriting, meaning the insurance company can deny you or charge you more based on your health. Your state may have rules that protect you; check with your state insurance commissioner's office.

Do I need Plan N if I have employer health insurance?

Not necessarily. If you are still working and covered by your employer's plan, you may not need a Medicare Supplement at all. When you retire and lose that coverage, you can enroll in Plan N during a special enrollment period. Talk to your employer's benefits office about how Medicare coordinates with your current plan.

What if I cannot afford the Plan N premium?

Some states offer programs that help pay Medicare Supplement premiums for people with low income. Contact your state health insurance information program (SHIP) to learn whether you may have access to. SHIP is free and can also help you compare plans and understand your coverage options.