Christine Gibson
Licensed Insurance Agent
With so many Medicare Supplement Plans available, it is often hard for some consumers to understand the differences between all of them. Previously, I have written about Medicare Supplement Plan G. This month we will dive into Medicare Supplement Plan N.
Medicare Supplement Plans are also known as Medigap Plans because they fill in some of the gaps of Original Medicare Parts A & B. Medicare Supplement Plans are offered by various insurance companies as secondary coverage to Original Medicare. These plans may vary in cost, but the coverage is the same.
Medicare Supplement Plan N will pay the Medicare Part A (in-patient/hospital coverage) deductible, which is $1600 for the year 2023. After 60 days of in-patient/hospital coverage, Plan N will pay the $400 daily copay through day 90. After Plan N will pay the $800 daily copay through day 365. After a full year of in-patient care, the consumer is responsible for all costs.
For skilled nursing care, Original Medicare covers the first 20 days in full. Afterward, there is a $200 daily copay, which Plan N will pay through day 100. Because Original Medicare does not cover more than 100 days in skilled nursing, neither will a Medicare Supplement Plan.
Out-patient care, lab work, testing, durable medical equipment as well as some other services are covered under Original Medicare Part B. A consumer with Plan N would be required to pay the $226 deductible for the year 2023. So, that means the consumer would be required to pay the first $226 of out-patient medical services covered under Part B. After that a consumer would have a $20 copay for an office visit and $50 for an emergency room visit. (However, if the consumer is admitted to the hospital, the $50 copay is waived.) The consumer is also responsible for any Part B Excess Charges that providers charge above the Medicare-approved amounts.
As for durable medical equipment, after the consumer pays that $226 Part B deductible, Medicare will pay 80%. The remaining 20% coinsurance will be covered by Plan N, leaving no other costs due by the consumer.
Keep in mind, the Part B deductible of $226 is only met once. So, a consumer might pay $100 towards an office visit and another $126 towards their durable medical equipment to meet their annual deductible for 2023.
Finding the right Medicare Insurance Plan can be tricky. It is strongly advised that consumers consult with a licensed agent when looking at available plans.
Christine Gibson is a State Licensed Insurance Agent who helps local residents with Health and Medicare Insurance questions in Waynesville. For more information, call 828-246-9950.
Published in Positively Haywood, May 2023