What Are the Differences Between Medigap Plans F, G, and N? - Trusted Senior Specialists

Medicare Supplements, also known as Medigap plans, are a great option for those who are wanting a plan that will help pay for costs that Original Medicare does not cover. Medicare Supplements offer the basic benefits PLUS some additional benefits such as skilled nursing coinsurance, foreign travel, extended hospital stays. They also offer the freedom of choosing any doctor or hospital that accepts Medicare, so there are no network restrictions.

The plans are standardized, meaning, each plan is identified with a letter designation and all plans with that letter will have identical benefits, regardless of the carrier. There are 10 plans available in every state, sold by various insurers, so premium may vary by carrier, but remember, benefits will be the same by letter.  Out of these ten Medigap policies there are three that are the most popular because of the benefits that they offer. We did a little breakdown of those 3 plans, F, G and N, below so you can do a little comparing for yourself.

Plan F

The reason this plan is so well liked is because it will pay for ALL of the gaps in Original Medicare, including both hospital and outpatient deductibles. It even pays the 20% of Medicare Approved Services that Part B does not cover, this means zero out of pocket costs for beneficiaries at the doctor’s office. 

Plan F benefits also include:

• Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits have been used up
• Part A hospice care copayment or coinsurance
• Part A deductible
• Medicare Part B copayment or coinsurance
• Part B deductibles
• Part B excess charges
• First 3 pints of blood
• Skilled nursing Facility care(SNF) coinsurance
• Foreign travel emergency coverage 80% (up to the plan limit)

Plan F also offers a high deductible plan. If you were to pick this option it would mean that you must pay Medicare covered costs up to the deductible amount of $2,300 in 2019 before your Medigap plan will pay for anything, however, these plans typically have a very low monthly premium and may be a great option for those who don’t go to the doctor often. 

Plan G:

Plan G is another popular Medigap plan. This plan also covers the same things Plan F covers except for the annual Part B deductible. For 2019 this amount is $185. For example, for outpatient care, Supplement G covers all but the fist $185 in expenses, which is our Part B deductible. Meaning that the first time you have outpatient care for the year, you will pay the $185 and after that Plan G will cover the remaining expenses. Medicare will cover 80% of your outpatient costs, and your supplement will pay the other 20%. If you were to need hospitalization, it would cover all of your hospital expenses. Most importantly it pays the $1,364  Part A deductible (in 2019) that you would normally owe for a hospital stay. Part G generally has a lower premium payment than Plan F, so even with having to pay your Medicare Part B deductible, your premium rates may be considerably cheaper with Plan G, which could mean savings for your wallet. 

* It is worth noting that both Plans F and G cover Medicare Part B excess charges. They are the only 2 plans that do so. If you see a non participating provider they are allowed to charge you up to 15% of what Medicare has approved for a covered service, which you would normally be responsible for paying. 

Plan N: 

Supplement Plan N covers all of the same benefits as Plan F does except for your 

• Medicare Part B deductibles
• Medicare Part B excess charges

These cost differences would need to be paid out of pocket. Plan N also differs from Plan F because although it pays 100% of Part B coinsurance in most cases, there are exceptions: You will need to pay up to $20 for certain office visits, and up to $50 dollars for emergency room visits that do not result in an inpatient hospital stay.

Recap:

*Medicare Supplement plans, are also referred to as Medigap policies, they are private health insurance that is designed to supplement Original Medicare Coverage. This insurance helps pay for some of the health costs that are not covered by Original Medicare such as copays, coinsurance and deductibles. These supplemental policies do not replace Original Medicare, they only work to supplement Original Medicare benefits.

*Medigap plans will not work with a Medicare Advantage Plan, and cannot be used to pay for Medicare Part C costs. Meaning you cannot be enrolled in both a Medigap plan and a Medicare Advantage plan. It is illegal for anyone to sell you either of these plans if the know you are enrolled in the other unless you are making the switch back to Original Medicare.

*Medigap plans do not include prescription drug coverage. If you would like prescription drug benefits in addition to your coverage you will need to enroll in a stand alone Prescription Drug Plan. We can assist with that as well.

*If you live in Massachusetts, Minnesota or Wisconsin, be sure to speak with an agent prior to enrollment, as the Medigap plans in these states follow a different standardization.

*You must be enrolled in both Medicare Part A and Part B to enroll in a Medigap

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