What Is the Difference Between Supplement Plan F and N?

Medicare Supplement Plan N is one of the newer Medicare Supplement plans  available to Medicare beneficiaries. Plan N fills the gaps that original Medicare does not cover, and is gaining serious traction in the marketplace.

Plan F is the most comprehensive plan out of the 11 standardized Medicare Supplement plans. As long as Original Medicare pays first, Plan F will cover the remainder of all expenses, leaving you with no out of pocket expenses. It will cover all remaining hospital and doctor visits after Original Medicare (Part A and B) has paid their respective portions.

Both Plan F and Plan N you pay $0 for the following Medicare Part A
Services:

  • Hospitalization (Both Plan F & Plan N cover the 2014 $1,216 Part A deductible)
  • Skilled Nursing Facility Care
  • Blood
  • Hospice Care 

The difference between Plan N & Plan F lies in the Medicare Part B sector of coverage.

With Plan F you pay $0 for the following Medicare Part B Services:

  • Physician services (Plan F pays the 2014 $147 Part B deductible)
  • Part B Excess Charges
  • Blood
  • Clinical Laboratory Services
  • Home Health Care (Medicare- approved services)
  • Durable medical equipment

With Plan N, you may be responsible for the following Medicare Part B Services:

  • Physician services – Plan N does not pay the 2014 $147 Part B deductible. You pay the $147.
  • In addition after the deductable has been met annually, you pay up to $20 per office visit and up $50 per emergency room visit (the copayment of up to $50 is waived if you are admitted to any hospital and the emergency visit is covered as Medicare Part A expense).
  • Part B Excess Charges – You pay all costs (Medicare Part B excess only applies if you go to a physician or medical facility that does not accept Medicare assignment)

Plan N is generally 25% less money than Plan F.Plan N provides the same comprehensive services like Plan F listed above however you may be responsible for some out of pocket costs.

PLAN N & F IN ACTION:

Corey was hospitalized for several days after a fall that left him with a broken hip. He was then released to skilled nursing care for 22 days and had a follow-up doctor’s appointment as well.

Below is what Corey’s out-of-pocket expenses could look like with only Medicare Parts A and B, as well as what his expenses could look like with Medicare supplement plans N and F:

 

Description of Service Medicare Parts A and B Only Medicare Supplement Plan N Medicare Supplement Plan F
Part A deductible for Hospital Stay $1,216 $0 $0
Part A co-insurance for two days in a skilled nursing facilityDays 1-20 are covered by Medicare. Days 21 and 22 would not be covered by Medicare.
(2 days @ $1152/day)
$304 $0 $0
Part B deductible
(Assumes Corey has not satisfied his Part B deductible for the year)
$147 $147 $0
Part B Co-insurance/co-payment
(20% of the Medicare-approved amount)
$29.4 $20 $0
Total Corey would pay for this medical event $1,696.4 $167 $0
  • Information in this chart reflects costs and cost-sharing information from 2014 for an example New York State supplement plan.
  • The Medicare- approved amount for each doctor visit is $147 and the doctor accepts Medicare’s assignment.
  • This is an estimated example. The situation above is fictitious and for illustrative purposes only.

DECIDING BETWEEN PLAN N & PLAN F:

For simplicity alone Plan F is the policy of choice.

Financially if you are relatively healthy and prefer lower premiums Plan N may make more sense.  On the other hand, if you need medical care and the copayments involved in Plan N would come close to or equal the extra cost of the Plan F premiums, then perhaps you might consider Plan F.

Plan Medicare can assist you in choosing the right supplemental plan- leaving you confident knowing that have enrolled in the right plan that will provide optimum coverage at the right price.  Please contact us today, we are here to help.

About Plan Medicare
Located in Melville, New York, Plan Medicare is a consulting agency formed to aid in understanding the many facets of Medicare.  Plan Medicare helps determine eligibility, clarify options and assist in the enrollment process.  Representatives are available 365 days a year to answer questions on payments, billing, policy, updates and changes and enrolling in new plans and policies. The health care landscape is constantly changing, it can be confusing and frustrating to try to figure out what kind of plan will work best.  Assistance is available, however. We make Medicare easy.