Which Medigap plan is better?

Which Medigap plan is better?

March 29, 2022


Which Medigap plan is better?  Plan G or Plan N?

My Response:

Your decision will depend on your circumstances.

Medigap Plan G is the most comprehensive.  It covers 100 percent of the Medicare Part A coinsurance and hospital costs including an additional 365 days after Medicare benefits are used.

It also covers 100 percent of your Medicare Part B coinsurances or copayments after the $233 annual deductible in 2022.  Plan G even covers 80 percent of your foreign travel emergency medical costs up to the plan limits.

Essentially, once you have paid your $233 annual deductible, Medigap Plan G pays 100 percent of your Medicare-approved charges except for the limits applied to foreign travel.

Medigap Plan N is also a comprehensive plan, covering the same Medicare-approved charges except for excess charges, which are rare since approximately 99 percent of non-pediatric physicians accept Medicare.  (This should not be confused with Medicare Advantage plans.) 

The main difference between the two Medigap plans is that with Plan N you will have $20 copays for some doctor visits and a $50 copayment for emergency room visits that don’t result in an inpatient admission.

There is usually a significant premium difference between the two plans, so your choice is often based on two things:  1) How many healthcare providers do you typically see per month and 2) your philosophy.

If you normally visit 3-4 healthcare providers per month, that will point you in the direction of a Medigap Plan G, since the copays will narrow or cancel out premium advantage associated with a Medigap Plan N.

If you don’t see many doctors, your choice becomes a philosophical difference.  Are you comfortable dealing with the copays and coinsurances associated with Plan N, or would you rather have the convenience of the Medigap Plan G which only has the initial annual deductible? 

If you live outside of New York or are planning to move, there are other factors which you will need to consider such as future premium increases.  If you are a New York resident, however, you can change your plan without underwriting all year long, so you need not worry about that when you make your choice.

As always, please share this information if you consider it to be helpful, and don’t hesitate to call my office with questions about Medicare.  My advice is free to you.