There’s a new debate going around the Medicare circle. Up until the last year or two, the debate has always been around Plan F versus Plan G and which was the better Medigap option.
The only difference between Plans F and G is that Plan F covers the Medicare Part B deductible. Otherwise, the two plans offered the exact same coverage. Plan G typically had lower premiums since it offered slightly less coverage, hence the big debate.
Due to some changes that happened in January of 2020, the debate about the best option changed and now revolves around Plan G and Plan N.
Whew, that’s a big question! What didn’t happen in 2020?! But if we stick to talking about Medicare, it’s a little easier to answer.
MACRA stands for the Medicare Access and CHIP Reauthorization Act. (And in case you’re wondering, that acronym within the acronym stands for the Children’s Health Insurance Program.) The act prohibits any Medigap plan from paying the Medicare Part B deductible for newly eligible beneficiaries.
Since Part F coverage included the coverage of the Part B deductible, Medicare beneficiaries who turned 65 on or after January 1, 2020, are not eligible for this plan. Plan F coverage remains in effect for individuals who turned 65 before January 2020.
With Plan F out of the picture for new Medicare beneficiaries, Plan G gets to boast of having the most comprehensive coverage. But as we saw with Plan F, that comprehensive coverage comes with a higher price tag than other plans.
Plan N comes in at a close second in regards to benefits. Let’s talk about their differences.
Plan G Coverage Details
Plan N Coverage Details
We’ve already said that neither plan covers the Part B deductible. In 2022, the deductible is $233.
Plan N has up to $20 copay for office visits and up to a $50 copay for emergency room visits. Plan G does not have these copayments. However, if you have Plan N and are admitted as an inpatient, the $50 emergency room copay is waived.
Plan N does not pay for any Part B excess charges. (This is an amount that you may be charged by a provider who does not accept Medicare assignment. It can be up to an additional 15% of the service cost.)
That being said, if you live in a MOM state, you won’t have to worry about Part B excess charges. MOM stands for Medicare Overage Measure. MOM prohibits providers from charging excess charges to Medicare beneficiaries. There are currently eight MOM states: Vermont, Rhode Island, Pennsylvania, Ohio, New York, Minnesota, Massachusetts, and Connecticut.
You decide! Like everything else in Medicare, the best plan on the market is the one that fits all of your needs.
Sure, Plan G is now considered by most to be the “Cadillac” plan for those who can’t enroll in Plan F. But really, Plan N has nearly the same coverage and may be a better value, especially if you live in a MOM state and can’t incur Part B excess charges.
You may also consider that because Plan G is the guaranteed issue plan for people newly eligible for Medicare, its premiums may increase and be higher over time than premiums for Plan N.
The winner is up to you. Ultimately, you’ll have to choose between coverage and premiums. If you choose to enroll in either Plan G or Plan N, know that you’ve got excellent coverage that is going to go a long way to reduce your medical expenses.
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