Comparing Plans: Medicare Plan G and Plan N

As individuals approach Medicare eligibility, one of the crucial decisions they face is choosing the right plan to meet their healthcare needs. Medicare Supplemental Insurance (Medigap) covers medical expenses not covered by Original Medicare (Parts A and B). Two popular choices among Medicare beneficiaries are Medicare Plan G and Medicare Plan N. Each plan offers unique benefits and coverage options. In this article, we will help you understand the nuances between these two plans to make informed decisions about your healthcare coverage. 

​Medicare Plan G

Medicare Plan G is renowned for its extensive coverage.  Plan G covers nearly all out-of-pocket expenses, including deductibles, coinsurance, and copayments, leaving beneficiaries with minimal healthcare costs. The only out-of-pocket expense under Plan G is the Medicare Part B deductible, which is $240 as of 2024 (subject to change annually).
With Medicare Plan G, beneficiaries enjoy the peace of mind that comes with comprehensive coverage, knowing that most medical expenses are covered without significant financial strain. This plan is particularly attractive to individuals who prioritize comprehensive coverage and are willing to pay slightly higher premiums to avoid out-of-pocket costs. Medicare Plan G remains an option for both new and existing enrollees. 

Medicare Plan N

Medicare Plan N offers comprehensive coverage similar to Plan G but with slightly more cost-sharing responsibilities for beneficiaries. While Plan N covers many essential benefits, including hospitalization, skilled nursing facility care, and hospice care, it requires beneficiaries to pay certain out-of-pocket expenses.

Under Medicare Plan N, beneficiaries are responsible for copayments for some services, including up to $20 for doctor visits and up to $50 for emergency room visits that do not result in inpatient admission. Additionally, beneficiaries must pay the Medicare Part B deductible, similar to Plan G.
Additionally, under Medicare Plan N, beneficiaries can be charged excess charges of up to 15%. Medicare excess charges refer to the additional costs that may be incurred when a healthcare provider charges more for a medical service than the Medicare-approved amount. These charges typically occur when beneficiaries receive services from healthcare providers who do not accept assignment, meaning they do not agree to accept the Medicare-approved amount as full payment for their services.

Despite these cost-sharing requirements, Medicare Plan N often features lower monthly premiums compared to Plan G, making it an appealing option for beneficiaries who are willing to share some healthcare costs in exchange for more affordable monthly premiums.

Key Differences

The primary difference between Medicare Plan G and Medicare Plan N lies in the extent of cost-sharing responsibilities for beneficiaries. While Plan G covers almost all out-of-pocket expenses except for the Part B deductible, Plan N requires beneficiaries to pay copayments for certain services in addition to the Part B deductible.
Another significant distinction is the monthly premiums associated with each plan. Medicare Plan N typically offers lower monthly premiums compared to Plan G, making it a more budget-friendly option for beneficiaries who are comfortable with some cost-sharing responsibilities.

Choosing the Right Plan

When deciding between Medicare Plan G and Medicare Plan N, it's crucial to consider your healthcare needs, budget, and preferences. If you prioritize comprehensive coverage with minimal out-of-pocket costs and are willing to pay higher monthly premiums, Plan G may be the right choice for you. Conversely, if you're comfortable with some cost-sharing responsibilities and prefer lower monthly premiums, Plan N could be a suitable option.

It's also essential to review each plan's network of healthcare providers and prescription drug coverage to ensure they align with your specific needs. Consulting with a licensed insurance agent or Medicare advisor can provide valuable guidance and help you navigate the complexities of Medicare to make an informed decision.

Medicare Plan G and Medicare Plan N are both excellent options for beneficiaries seeking comprehensive coverage with varying levels of cost-sharing responsibilities. While Plan G offers extensive coverage with minimal out-of-pocket costs, Plan N provides comprehensive coverage at a more affordable price point with some cost-sharing responsibilities. Understanding the differences between these two plans and evaluating your healthcare needs and financial situation are crucial steps in selecting the right Medicare plan for you.

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​Rob Davies
Prairie Grove Insurance
800-254-5200
​608-839-0275