The Buzz about Supplement Plan N

medigapInsurance companies first began to offer in June of 2010 Medicare Supplement Plan N.  Take a  closer look at the benefits of Plan N and you might find yourself with a very cost beneficial Medicare Supplement.  Plan N offers identical benefits to the more popular Plan F but the policyholder will have to pay in some areas of Plan N that  they did not have to pay before with Plan F.  The policy holder must pay the small Part B deductible of $166 as well as a $20 copayment for doctor appointments. Also, emergency room visits will have a copayment of $50.

One of the main differences between Plan F and Plan N is how “excess charges” are addressed.  Medicare offers the largest network of doctors and hospitals in the nation.  Most doctors are participating doctors who have agreed to accept the “Medicare assignment raters”.  This means the doctor will accept what Medicare assigns as reimbursement for a diagnosis or treatment.  Some doctors are not participating doctors.  They have the right to charge 15% above what the ordinary cost of medical services are as outlined by Medicare. This 15% is referred to as excess charges.

Under Medicare Part B beneficiaries are usually only responsible for 20% of charges after they have met the Part B annual deductible.  However, if a doctor charges an excess charge then the beneficiary may be responsible for 35% of the Medicare pre-approved rate.  The only Medicare Supplements that reimburse for excess charges are Medigap Plan F or Medigap Plan G.  These supplements will cover any excess charges that may occur.  Supplement Plan N will not reimburse for excess charges.

While Supplement N will not reimburse for excess charges it still may warrant your consideration.  Especially when one notes the significant cost savings to be found comparing Plan N to Plan F and Plan G.  In some cases the savings may be up to 40%.

As an example of how Plan G works; Mary receive s a bill from her provider for $100.  Mary is obligated to pay the provider a copayment of $20 and Medicare will pay the provider $80.  If the provider charged excess charge the amount would be $115 or 15% of the $100 amount.  Mary could be obligated to pay $20 plus $15 (the excess charge) or $35.

To have a better understanding of the opportunities and choices you have in regards to  Medicare we strongly recommend you consult with an independent insurance agent.  For further information please visit www.medigappro.com.  You may also reach us at 1-800-535-8016 or ted@tedguy.com.