Medigap Plan F vs N

Which is best for you?

Medigap plans cover the “gaps” in Medicare policies and are available to all Medicare recipients who are enrolled in Parts A and B. Comparing Medigap plans can seem daunting at a first glance. With 10 plans available, each offering different levels of coverage, it’s hard to know where to even begin. In this post, we’ll compare two of the most popular plans: Medigap Plan F and Plan N. Learn more below, or speak with an agent today to see which may be best for your needs.

If you already know which plan you prefer, you can get a free price report to compare premiums in you area!

The Basics

Choosing a Medigap plan largely depends on which you prioritize more—security or cost savings. Plans with higher monthly premiums offer more comprehensive coverage, giving you peace of mind with your medical needs. Plans with lower monthly premiums cover fewer gaps, saving you money but leaving open the possibility of higher out-of-pocket costs.

Medigap Plan F is one of the most popular options for people prioritizing security. It covers all gaps in Medicare, making it the most comprehensive plan but also the most expensive. Medigap Plan N, on the other hand, offers a medium-range set of benefits for people looking for a balance between cost savings and security.

Plan F vs Plan N Coverage

Our Medigap plans comparison gives a comprehensive overview of coverage across plans, but here’s a quick rundown on the differences between Plans F and N:

Plan F Covers

  • Medicare Part A coinsurance and hospital costs
  • Medicare Part A hospice care coinsurance or copayment
  • Medicare Part A deductible
  • Medicare Part B coinsurance or copayment
  • Medicare Part B deductible
  • Medicare Part B excess charges
  • First three pints of blood used in an approved medical procedure (annually)
  • Foreign travel emergency care (up to 80%)
  • Skilled Nursing Facility (SNF) coinsurance
  • Coverage for any doctor in-network for Medicare (that’s more than 800,000 doctors nationwide).

Plan N Covers

  • Medicare Part A coinsurance and hospital costs
  • Medicare Part A hospice care coinsurance or copayment
  • Medicare Part A deductible (50%)
  • Medicare Part B coinsurance or copayment
  • First three pints of blood used in an approved medical procedure (annually)
  • Foreign travel emergency care (up to 80%)
  • Skilled Nursing Facility (SNF) coinsurance
  • Coverage for any doctor in-network for Medicare (that’s more than 800,000 doctors nationwide).

You’ll notice the main differences between the two is the coverage of the Medicare Part B deductible and Part B excess charges. Plan F covers these, but Plan N does not. Plan N additionally covers the Medicare Part A deductible at 50%, as opposed to Plan F which covers 100%. Next, we’ll break down what these costs mean for your health, wallet and plan choice.

Part B Deductible

The Medicare Part B deductible is the amount of money you have to pay out of pocket for general medical and outpatient care until Medicare coverage kicks in. Plan F covers this, while Plan N does not. Note, however, that this is one of Medicare’s lower-costing expenses, at only $189 for annually in 2019. So not having this coverage for Plan N may not be such a significant issue to you.

Part B Excess Charges

Another difference between these plans is coverage of Plan B excess charges, which Plan F covers but N does not. Excess charges can be tricky to understand. They’re essentially an additional amount that an outpatient healthcare provider can charge over and above the Medicare-approved cost. While many doctors accept the Medicare-allowed charge, some do not, charging additional costs up to 15%.

For instance, if you go to the doctor and have a $100 procedure done, if that doctor does not accept the Medicare assignment, they can charge you for co-insurance plus an additional 15% of the total allowed charge ($15, in this case). The allowed charge is $100, which Medicare would pay 80% of, or $80. You are responsible for the remaining 20% ($20), as well as the 15% ($15) excess charge—for a total of $35.

In this example, Plans F and N would both cover the co-insurance, or that remaining $20 that Medicare doesn’t cover. But while Plan F would cover the additional $15, with Plan N would not—you’d pay that out of pocket. Note that several states do not allow medical service providers to charge these additional costs, including Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. If you’re in one of these states, then this lack of coverage in Plan N likely will not matter to you.

Which Plan Is Right For Me?

When weighing your decision, consider the tradeoffs. Would you rather save money on your monthly premium but pay more out of pocket for gaps that aren’t covered? Or do you prefer to pay more monthly and less out of pocket? These are questions you’ll want to discuss with an agent when choosing your plan.

Important Changes To Plan F

If you’re not eligible for Medicare until after January 1, 2020, then the decision between Plan F and Plan N may already be made for you. After that date, no Medigap policies covering the Medicare Part B deductible (i.e., Medigap plans F and C) may be sold or issued to a newly eligible Medicare beneficiary. This means that people who turn 65 on December 31, 2019 will be the last group eligible to enroll in Medigap Plans F and C.

The law only affects new enrollees. If you’re already enrolled in Plan F, you can keep that plan. However, if you’re currently enrolled in Plan F or C and are considering switching plans, after 2020 you will not be able to re-enroll.

Working With Your Insurance Company

Medigap plans are government standardized. This means that regardless of where and from which private insurance company you buy your plan, you will get the same exact benefits for that plan. The premiums associated with Medigap plans, however, do vary across states and insurance companies. Insurance companies in your area may use one of the following systems to set their premium prices:

  • Community-rated: Regardless of age, everybody pays the same amount for the policy. The policy price cannot change due to your age.
  • Issue-age-rated: Price is based on your age at the time of purchase. The premium will cost less for those who purchase their Medigap Plan at a younger age but will not change based on your age once you purchase it.
  • Attained-age-rated: Premium starts low and increases as you age.

When weighing insurance company options, you’ll want to consider companies’ rating systems and understand which makes the most sense to you.

Compare Premiums In Your Area

Get Free Price Report to compare insurance companies and premiums for Medigap Plans F and N in your area. We make it easy to find the best rate for your preferred plan through a quick and easy survey.