Plan N is the second most-popular plan. You pay up to $20 per office visit and $50 per ER visit (waived if admitted). For beneficiaries who don't visit the doctor frequently, the premium savings over Plan G can be substantial.
Best for
- Beneficiaries who use medical services moderately and want lower premiums
Watch out for
Per-visit copays and no Part B excess coverage.
What Plan N covers
- Part A coinsurance & 365 extra hospital daysCovered in full
- Part B coinsurance or copaymentCovered in full
- Blood (first 3 pints)Covered in full
- Part A hospice coinsurance / copayCovered in full
- Skilled nursing facility coinsuranceCovered in full
- Part A deductibleCovered in full
- Part B deductibleNot covered
- Part B excess chargesNot covered
- Foreign travel emergency (up to plan limits)Covered in full
Compare to other Medigap plans
- Plan AThe minimum-coverage Medigap plan - basic benefits only.
- Plan BPlan A plus the Part A deductible.
- Plan CComprehensive coverage - closed to anyone newly eligible after Jan 1, 2020.
- Plan DPlan G minus Part B excess. Modest savings, modest reduction in benefit.
- Plan FThe 'everything' plan - closed to newly eligible after Jan 1, 2020.
- Plan GToday's most popular Medigap plan - comprehensive coverage minus only Part B deductible.
- Plan KLower premium, partial coverage with out-of-pocket cap.
- Plan LLike Plan K but covers more - 75% of most cost-sharing.
- Plan MSplits the Part A deductible 50/50 between you and the plan.
What Is Medigap Plan N, and What Does It Cover?
Plan N is one of the two most popular Medicare Supplement plans. It covers nearly as much as Plan G for a lower monthly premium. In return, you pay a small copay at some visits.
Plan N sits on top of Original Medicare. Medicare pays first, and your policy picks up most of what is left. There is no network, so any provider who takes Medicare can treat you.
What Plan N covers in full
Part A hospital coinsurance
Your daily hospital coinsurance, plus 365 extra hospital days after Medicare benefits run out.
Part A deductible
The hospital deductible for each benefit period, paid in full. This is the biggest gap Original Medicare leaves.
Part B coinsurance
Your share of doctor and outpatient bills, minus the small office and emergency room copays.
Skilled nursing coinsurance
The daily coinsurance for a covered nursing facility stay that follows a qualifying hospital stay.
Blood and hospice
The first three pints of blood each year, plus your share of hospice drugs and respite care.
Foreign travel emergency
Emergency care outside the United States, up to the limits printed in your policy.
The short version
Plan N is close to full coverage. Three things stay with you: the yearly Part B deductible, small visit copays, and any Part B excess charges.
Where Do Plan N's Copays and Gaps Actually Show Up?
This is the part worth understanding before you enroll. Plan N asks you to share a little cost at the point of care. The federal plan design sets those limits, and they can change over time.
- Office visit copay. A small copay may apply when you see a doctor. Lab work and preventive care usually do not trigger it.
- Emergency room copay. A larger copay applies to an emergency room visit. It is waived if the hospital admits you.
- Part B deductible. You pay it once each calendar year, exactly as Plan G members do.
- Part B excess charges. Plan N does not cover them, and California does not ban them.
What is a Part B excess charge?
Most doctors accept the Medicare-approved amount as payment in full. A small number do not, and they may bill up to a set percentage above it. That extra amount is the excess charge, and under Plan N it is yours to pay. Ask a new specialist one question: do you accept Medicare assignment?
Drugs are still separate
No Medigap plan covers prescriptions. Plan N members add a stand-alone Part D plan. Part D now has a yearly cap on your out-of-pocket drug costs, and that cap changes each year.
Who Is Plan N Really Built For?
Who this is for
Plan N tends to fit you well if:
- You see a doctor a handful of times a year, not weekly.
- You want strong hospital coverage without the top premium.
- Your doctors already accept Medicare assignment.
- A small copay at the desk does not bother you.
- You still want travel coverage and no provider network.
The honest tradeoff is variability. Your monthly cost drops, but your yearly total depends on how often you seek care. A heavy year of specialist visits can erase the premium savings.
How Does Plan N Compare to Plan G?
Plan G is the closest alternative, and the comparison comes down to three lines. Everything else on the benefit chart matches.
Plan N vs. Plan G at a glance
Plan N
Lower premium, small copays, no excess charge coverage.
- Monthly premium
- Lower of the two
- Part A deductible
- Covered in full
- Part B deductible
- You pay it once a year
- Office visit copay
- A small copay may apply
- Emergency room copay
- Larger, but waived if admitted
- Part B excess charges
- Not covered
- Foreign travel emergency
- Covered to plan limits
- Best for
- Moderate care users who want a lower monthly bill.
Plan G
The most complete Medigap plan open to new enrollees.
- Monthly premium
- Higher of the two
- Part A deductible
- Covered in full
- Part B deductible
- You pay it once a year
- Office visit copay
- None
- Emergency room copay
- None
- Part B excess charges
- Covered in full
- Foreign travel emergency
- Covered to plan limits
- Best for
- Frequent care users who want zero surprises.
A three-minute way to decide
- 01
Count last year's visits
Add up your doctor visits and any emergency room trips from the past twelve months.
- 02
Estimate the copays
Multiply those visits by the plan's copay limits. That is roughly your added yearly cost on Plan N.
- 03
Compare to the premium gap
Take the monthly premium difference and multiply by twelve. If that number is larger, Plan N usually wins.
- 04
Check your doctors
Confirm they accept Medicare assignment. If any do not, Plan G may be the safer choice.
How Do California's Birthday Rule and Trial Rights Work?
California protects Medigap members better than most states. The birthday rule gives you a yearly chance to change carriers with no health questions asked.
- The window. It opens on your birthday each year and runs 60 days.
- The limit. You may switch to the same letter with another carrier, or to lesser benefits. Plan N holders can move to another Plan N, but not up to Plan G.
- The timing. Start about two months early. Some carriers want the application before the window closes.
- The overlap. Keep your current policy until the new one is issued, so no gap appears.
Trial rights are a separate federal protection. They exist for people who tried Medicare Advantage and want Original Medicare back. Each one is a guaranteed-issue right with no underwriting.
- You joined Medicare Advantage when you first turned 65. Leave within the first 12 months, and you may buy any Medigap plan sold in California.
- You dropped Medigap to try Medicare Advantage for the first time. Switch back within 12 months, and you may reclaim your old policy. If it is no longer sold, Plan N is on the list you may buy.
Put it on the calendar
These windows do not send reminders. We flag every client's birthday window as part of their annual review, then re-quote the same letter across carriers.
What Happens If You Apply Outside a Guaranteed-Issue Window?
Your easiest window is Medigap open enrollment. It runs six months from the month you turn 65 and have Part B. During it, no carrier may deny you or raise your price for health reasons.
Apply outside that window without a guaranteed-issue right, and the carrier may review your health first. That review is called medical underwriting.
- Health questions covering conditions treated in the past two to five years.
- A prescription history check, pulled electronically in minutes.
- Height and weight, measured against the carrier's build chart.
- Pending care, such as a scheduled surgery or a test with results still out.
- A brief phone interview at some carriers, to confirm your answers.
Never cancel coverage first
Do not drop a current policy until a new one is approved and issued. A decline costs you nothing if you still hold coverage. Rules also vary by company, so a history that stops one carrier may be routine at another.
How Do You Shop Plan N Carriers in Orange County?
Every Plan N policy pays the same benefits, because federal law standardizes them. Yet two healthy neighbors can pay very different premiums for identical coverage. That gap is where an independent agency earns its keep.
- Today's rate for your age and ZIP code across the carriers we represent.
- Rate increase history, so a low opening price does not sting later.
- Household and payment discounts, which several carriers offer.
- Copay handling, since carriers can apply the office copay a little differently.
- Underwriting appetite, if you are applying outside a protected window.
Let's compare it together
Harmony SoCal Insurance Services is an independent multi-carrier agency at 2135 N Pami Circle, Orange, CA 92867. Call (714) 922-0043 or request a review. California license #0718082. Meet us in person, by video, or by phone, in English and Spanish, with Korean, Mandarin, and Vietnamese available. Want the wider view? See the Medigap overview.