The first distinction to make here is that Plan G and Plan N are types of Medicare Supplement or Medigap Plans. In other words, these are not Advantage Plans (Part C) or Prescription Drug Plans (PDP). Medicare loves using letters to name benefit options and plans, which often makes the whole thing more confusing. Acronyms are another favorite as in MA Only, MAPD, DSNP, HMO, PPO, etc. We can address that another day! But not to worry, CDI is here for you! In this blog, I want to help highlight the difference in these two supplement plans which are currently the most popular and beneficial among the supplement offerings [as of 2023].
A Medigap Reminder
As a basic reminder, Medigap or Medicare Supplements come with a monthly premium and cover the 20% out of pocket medical expenses associated with Part B and the hospital deductible associated with Part A. That is why it is globally called ‘Medigap’ as it covers the ‘gap’ left by Part A and B of Original Medicare. Essentially, when you have this plan, you pay monthly on the front end but have little to no medical expenses on the back end. However, an important aspect to keep in mind is that the monthly premiums increase every year and thus can get quite pricey in later years. Another important feature is that if you wish to switch plans, you may be subject to underwriting. This means that your medical history, medications, and previous medical claims can be reviewed and lead the insurance company to deny you a change for a lower rate. So, once you decide a Medigap plan is the right path for you, there are more decisions. Here come the letters, and the most desirable currently are G and N.
How G and N are Similar
I’ll start with their similarities including the annual medical deductible. As of 2023, that deductible is $226. That means you pay the first $226 of medical care each year. They are also similar in that they both cover the same medically necessary services and include some emergency coverage outside of the US. There are limits to this so if you want to dive into that, see the blog https://www.cdi-cares.com/blog/medicare-and-travel-am-i-covered. Lastly, as with all Medigap or Supplement plans, there is no network. You can see any provider anywhere in the US with no referrals or restrictions.
How are G and N Different?
The most notable difference is the monthly premium. Plan G generally has a higher monthly premium than Plan N. Depending on the carrier and your zip code, the difference can be nearly $500 - $600 higher annually for Plan G. Why is that you say? This is because Plan N has copays associated with some services and Plan G does not. With Plan N, you will have up to a $20 copay for any doctor’s visit and up to a $50 copay for an ER visit. The last difference is not quite as impactful as it is a rare occurrence. Plan N does not cover Part B excess charges. What is this? Part B excess charges can occur if you see a provider that does not accept Medicare assignment. These providers are allowed to charge up to 15% more in fees, and with Plan N, you are responsible for those fees. With Plan G, you are not responsible. How often could this occur? In 2022, 98 percent of Medicare doctors, physicians and other providers accepted Medicare assignment.1 Therefore, it would be extremely rare to encounter this, and even if you do, the few percentage points above the fee would likely be minimal in cost. So many are happy with the Plan N coverage even given this difference.
So Which Plan is Best For Me?
Whether we are talking about Advantage Plans, Supplement Plans or Drug Plans, my answer is always the same. It depends on your health, your budget, where you live, and your preferences. Everyone is an individual so no one plan is best for everyone. So, I’ll throw it out there! The way to ensure you get the best individualized plan that meets your needs is to meet with a local independent insurance agent specializing in Medicare benefit plans. CDI can help you through this entire maze. We can meet in person or virtually. Reach out if you would like more information. Email carrie@cdi-cares.com or check out www.cdi-cares.com for a contact page and other helpful blogs.
“What happens when you eat too much alphabet soup?” –what?….
“You have a vowel movement!”
– Michael Connelly
1 Centers for Medicare & Medicaid Services. (March 25, 2022). Announcement
About Medicare Participation for Calendar Year 2023. https://www.cms.gov/files/document/medicare-participation-announcement.pdf