Medicare Plan N: Coverage, Cost and How It Works

Medicare Supplement Plan N reduces how much Original Medicare enrollees have to pay out of pocket for health care. For example, Plan N pays 100% of the coinsurance for hospitalization (Medicare Part A) and medical care (Medicare Part B).

Plan N, one of 10 Medicare Supplement or Medigap policies, provides greater coverage than most of the other supplemental plans on the market. This includes Plans A, B, D, K, L and M.

It isn't the most comprehensive plan available. However, Plan N is best for those who want a good value with most medical expenses covered for an average cost of $152 per month.

How does Plan N work?

Like other supplemental policies, Plan N fills coverage gaps in traditional Medicare, thus making it easier for beneficiaries to meet their overall health care expenses.

Because only about 80% of medical costs are covered by Medicare Part A (hospitalization and inpatient care) and Medicare Part B (outpatient services), supplemental plans can help eliminate the cost by paying for the remaining 20% of costs.

Among other benefits, Plan N covers the coinsurance costs for Medicare Part A, Medicare Part B, hospice care and skilled nursing facilities. This means that instead of an enrollee being charged 20% of the bill, as would happen with Original Medicare, the supplemental plan would pay that 20% of the bill.

One of the most important features of Medigap Plan N is its copays — you pay a $20 copay for each physician visit and a $50 copay for each emergency room (ER) visit that does not result in hospitalization. Even though the supplemental plan pays the coinsurance charged by Original Medicare, the supplemental policy has its own copayments for these services. Most Medigap Plan N policies do not charge for visits to urgent care centers, though.

Beneficiaries buy supplemental Medigap plans through private insurance companies such as Aetna, Cigna and UnitedHealthcare, among others. However, policies sold by insurance companies are standardized across the country, meaning a Plan N policy sold by Aetna covers the same core benefits as a Plan N policy sold by Cigna or a different carrier.

What does Plan N cover?

Plan N does not provide coverage for the Medicare Part B deductible ($226 in 2023). Moreover, its copays do not count toward meeting the Part B deductible. Most Plan N policies do not carry a separate deductible aside from the Part B deductible.

Plan N also does not cover Medicare Part B excess charges — the amount providers can charge over and above Medicare costs if they do not accept Medicare-approved rates. And there are no out-of-pocket limits for Plan N.

Medigap Plan N vs. Plan G

Plan N and Plan G are often compared to one another. We recommend Plan N if you want lower monthly costs and are willing to have some expenses for medical care like doctor appointments. However, Plan G is a better option if you're willing to pay more each month for a plan that provides the most comprehensive coverage for new enrollees. Note that neither plan covers the Medicare Part B deductible.

The cost structures may determine which plan is better for you.

The standard Medicare Supplement Plan G has higher monthly premiums than Plan N, making Plan N a budget-friendly choice. Plan G, however, does not impose copays for physician office visits or trips to the ER that do not result in hospitalization, a major difference from Plan N, thus appealing to beneficiaries who do not like shelling out copays for these services. Conversely, other beneficiaries may not mind paying more in copays, especially if they do not make regular trips to physician offices or ERs.

With Plan N, low-end users of health services may come out ahead. High-end users of health care services will have a different experience.

High-deductible Plan G is a low-cost alternative

Insurance companies sell two types of Plan G plans: one called a standard plan and the other a high-deductible plan, which requires beneficiaries to meet a yearly deductible of $2,700 before the plan begins to pay. Once the deductible is met, the plan pays 100% of covered services.

With the high-deductible Plan G, beneficiaries pay low monthly premiums, typically around $30 a month and even less in some cases. The amount paid toward the plan’s deductible counts toward the Part B deductible. In other words, as beneficiaries meet the plan’s own deductible, they are also satisfying the Part B deductible.

Plan costs can vary. For example, a 65-year-old nonsmoking woman living in suburban Virginia, just outside of Washington, D.C., would pay $43 in monthly premiums for a high-deductible Plan G policy through UnitedHealthcare (UHC). That same woman would pay $112 a month in premiums for the standard Plan G or $89 a month for a Plan N policy.

The high-deductible Plan G may be a viable alternative for healthy Medicare beneficiaries who want the low monthly Medicare premiums associated with the high-deductible plan.

Many beneficiaries look at the high-deductible Plan G as a catastrophic plan because the beneficiaries who require little in the way of medical services may never come close to meeting the $2,700 deductible. But if they have a catastrophic event or illness, the deductible is quickly met, and the plan then pays 100% of covered services for the calendar year.

The standard Plan G has monthly premiums running as high as $250 to $300 in some states such as New York and Florida. In Iowa, the monthly premiums for the standard Plan G policy can be as low as $80 a month.

Like Plan N, neither the standard nor high-deductible Plan G has out-of-pocket limits. Plan G policies, like Plan N policies, also travel, picking up 80% of medical costs incurred during trips abroad.

Is Plan N or Plan G more popular?

Medigap Plan G is more popular than Plan N, with 27% of Medigap enrollees choosing Plan G and 10% of enrollees choosing Plan N. Note that Plan F is the most popular plan overall with 46% of enrollment, but it's not available to those who became eligible for Medicare in 2020 or later.

Plan G is a more popular plan than Plan N for two reasons — its coverage is more comprehensive and, most importantly, it does not impose copays for physician and ER visits that don’t result in hospitalization.

Also, your medical costs with Plan G are predictable because you'll usually only be responsible for the deductible. This can make it easier to budget for health care expenses. With Plan N, beneficiaries are required to pay copays for physician and ER visits, costs that can quickly add up during the course of a year. This means your expenses could vary based on your medical needs.

Is Plan N the best Supplement plan for you?

Plan N is cheaper than Plan F or Plan G, and you'll have some out-of-pocket costs for medical care. However, your medical costs will be minimal, and you won't pay anything for expensive medical care such as hospitalization.

There are multiple factors to consider when choosing the best plan for you.

Medicare Supplement Plan N reviews

Plan N is available from our three top Medicare Supplement companies: Aetna, Cigna and AARP/UnitedHealthcare. Among these providers, you'll save an average of $31 per month by choosing Plan N over Plan G.

Your actual costs for Medicare Supplement plans can vary by age, location and other factors.

Remember that coverage for Plan N is standardized, so you'll get the same medical benefits with all providers. However, providers have different rates, customer service and add-on benefits.

Aetna Medicare Supplement

The cost for Aetna's Medigap plans is consistently cheaper than its main competitors, and the combination of low costs and great customer service makes Aetna Medicare Supplement one of our top recommendations.

Aetna falls short based on the customer complaint index from the National Association of Insurance Commissioners, scoring a 1.57 for its Medicare Supplement product, meaning its complaint performance was much worse than the average of 1.00 across the country.

Cigna Medicare Supplement

Cigna Medicare Supplement is available in 48 states, but the company only offers four Medigap policies — A, F, G and N — in 46 states. These are the most popular Medigap plans, making it highly likely that beneficiaries will find a plan they like in these states.

Cigna's rates are generally higher compared to other competing companies. But the company offers a rewards program as part of its supplemental plan coverage, providing discounts on health and wellness programs and services, adding to the overall value of what you're getting if you sign up for Plan N.

Some Cigna members and providers complain about customer service, citing long hold times and other service delays as well as difficulty getting claims approved or paid.

AARP/UnitedHealthcare Medicare Supplement

AARP Medicare Supplement plans are a popular way to reduce medical expenses. Enrollees get discounts for vision, dental and hearing programs, as well as a 24/7 nurse line and free gym memberships where available. However, AARP/UHC Medigap customers must also be AARP members, adding a nominal membership fee of $16 a year.

With an AARP/UHC policy, a 65-year-old may pay slightly more for a supplemental policy, but yearly increases are generally lower with these plans, meaning a beneficiary could end up paying less for a plan when they are in their 70s or 80s.

Most complaints about UnitedHealthcare result from the company’s handling of claims. Other complaints cite too much junk mail generated by the company, overly aggressive marketing and poor customer service.

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Frequently asked questions

Methodology and sources

Sources for the above comparisons include Medicare.gov, insurance providers, the Better Business Bureau, J.D. Power and the National Association of Insurance Commissioners. Comparisons are based on plan details, coverage levels and cost data.