A Quick View of Medicare Supplemental Plan N

Medicare Supplement Plan N is nearly identical to Plan G, which pays virtually all your medical costs after the Part B deductible ($233 in 2022).

Plan N has several differences that make the premium a little lower than Plan G.

  • You pay: up to $20 per office visit copay
  • You pay: up to $50 per emergency room visit copay (waived if admitted to hospital)
  • Medicare providers can charge up to 15% more than what Medicare allows. This is called an excess charge. While Plan G covers this potential extra charge, with plan N you are responsible for this extra cost.

Part A is extremely important. It is possible to have a $500,000+ hospital bill. In contrast, a surgery may only cost $5,000. The hospital bill is often the most expensive part of the total medical bill. Medicare Part A covers the costs for facility stays such as at a hospital or skilled nursing facility.

Medicare (Part A) – Hospital & Skilled Nursing Facility Services

Services
Medicare Pays Plan N Pays You Pay
Hospitalization –
First 60 Days
All but $1,556 $1,556
(Part A deductible)
$0
Skilled Nursing Facility –
First 20 days
All approved amounts $0 $0
Skilled Nursing Facility –
21st through 100th day
All but $194.50 a day Up to $194.50 a day $0

For the first 60 days you are in the hospital—which is a substantial amount of time—Medicare Part A pays all of the expenses except $1,556. This is called the Part A deductible.

Medicare Supplement Plan N pays the Part A deductible. Your net cost is $0. Zero is nice! 🙂

Normally hospitalization is for acute care. Once you are stabilized—often around 3 to 7 days—you are moved to a Skilled Nursing Facility to recover. For the first 20 days in a Skilled Nursing Facility, Medicare pays all the expenses. For days 21 to 100, Medicare pays all except $194.50 per day. Your Medicare Supplement Plan N pays the $194.50 per day. Your net cost is, once again $0. Zero is nice! 🙂

Medicare Part B pays for non-facility, professional services such such as doctor’s visits, lab work, x-rays, MRIs, CT Scans, surgeons, assistant surgeons, anesthesiologists, chief bottle washer, you name it!

Medicare (Part B) – Medical Services 

Services
Medicare Pays Plan N Pays You Pay
Medical Expenses – In or Out of Hospital and Outpatient Hospital Treatment
First $233 of Medicare Approved Amounts $0 $0 $233
(Part B deductible)
Remainder of Medicare Approved Amounts Generally 80% Generally 20% $0
Exceptions:
$20 office visit copay
$50 Emergency Room Visit

Clinical Laboratory Services
Tests for Diagnostic Services 100% $0 $0

For the first $233 of non-facility medical services, Medicare Part B pays $0. That $233 is your Part B deductible.

Exceptions:

  • For doctor visits you only pay a $20 copay. The deductible is waived for doctor visits.
  • For Emergency Room visits, you pay a $50 copay. The deductible is waived.

Your medical expenses for a year will be: The Part B deductible ($233 for 2022) plus the copays for doctor visits and emergency room visits.

If you have Medicare Supplement Plan N, how much will you pay for the following scenario?

You go to the doctor complaining about fatigue. Your doctor requests a variety of blood tests, and when you return, there is a frown on the doctor’s face. “I’m concerned about your health and want you to get an MRI and a CT Scan.”

When the doctor reviews your scans, he informs you that you have a very serious medical condition. You are admitted to the hospital right way, have extensive surgery; and end up in hospital for 14 days, with another 60 days spent recovering in a skilled nursing facility.

The total cost is north of $500,000.

If you have Medicare Supplement Plan N, how much will you be required to pay?

    1. $500,000
    2. $250,000
    3. $233 + copays  🙂