A lot of people we talk to seem to ask this same question.
The difference between Plan F, G, and N is coverage and cost. These 3 Medicare Supplements are the most popular plans to choose from. They cover things like deductibles, copayments, and coinsurance – all in different amounts. It is important to choose a Supplement based on what your needs are and what you are trying to cover.
Your health, where you live, and how you travel all play a role in choosing a Medicare Supplement.
Everyone’s situation is different.
Hopefully, this article helps you decide on what Medicare Supplement is best for you.
We will talk about the 3 most popular Plans:
What is a Medicare Supplement?
Medicare supplements are plans that you can purchase in addition to original Medicare.
Read more about the basics of Supplements here.
Medicare covers about 80% of your medical expenses.
The other 20% is called coinsurance.
You are responsible for any coinsurance amounts if you do not have coverage in addition to Part A and Part B.
Supplements are designed to cover the gaps in traditional Medicare.
F covers 100% of everything Medicare Does not cover.
- Inpatient hospital stays.
- Outpatient services
- Doctors visits.
- Preventative care.
After Medicare pays, Plan F pays the rest of the bill.
No out of pocket.
Plan F is not available if you were new to Medicare on or after January 1, 2020.
So if your birthday is after January 1st, 1955 and you are new to Medicare, skip this section.
Plan F covers the annual Part B deductible of $198 (in 2020).
Plan F provides full medical coverage and is the most expensive Supplement available.
Let’s Look at an Example
Mary purchased Plan F three years ago when she was new to Medicare.
Mary has a lot of health issues, so she felt purchasing a plan that provided full coverage was the best decision.
In 2020, Mary went to her primary care physician three times, saw two different specialists three times each, and had one hospital admission.
Her Medicare, combined with Plan F covered 100% of these expenses.
For Mary, Plan F was the best option.
Because of Medical expenses, she wanted to minimize her out of pocket costs so she chose a plan that covers everything.
High Deductible Plan F
Plan F has a high deductible option.
The deductible on this plan is $2340 (in 2020) per year. This amount changes slightly every year, see the Medicare and you Guide for the updated amount.
Original Medicare still pays 80% of your medical expenses.
After that, you are responsible for the other 20% until you have paid $2340(2020) for the year.
After you meet this deductible, everything is covered at 100%.
Because of the high deductible, the monthly premium for these plans is much lower.
A high deductible plan can be a good plan option for people who do not utilize medical services often and would rather save money than spend it on monthly premiums.
Let’s Look at an Example
George purchased a High-Deductible Plan F 5 years ago when he was new to Medicare.
He is relatively healthy and feels that it makes more sense to save money on his monthly premium.
His premium is around $50 a month for his high deductible Plan F.
A traditional Plan F was $180 per month.
After being on his plan for 5 years, George went to the hospital with stomach pain.
He had surgery to remove his appendix.
The total bill was $45,000.
After Medicare and his Supplement paid their portion, George owed $2340 – his deductible.
Over the last 5 years, he saved $7800 in premium.
Difference in premium: $130 X 12 Months = $1560
$1560 X 12 = $7800
Even though he had to pay his deductible, he still saved $5460.
5 Year premium Difference $7800 – $2340 Deductible = $5460 net savings
In George’s case, High Deductible Plan F was the best option.
Now that he is getting older, and more health issues are likely to occur, he may want to consider going to a different plan with a lower deductible.
Medicare supplement Plan G is very similar to Plan F.
Plan G does not pay the Part B deductible like Plan F.
The annual premium on Plan G is usually lower which is typically a lot less than what the cost of the part B deductible is.
Let’s Look at an Example
Jack has Plan G in addition to Medicare.
He has seen his primary care physician, a cardiologist, and an ophthalmologist so far this year.
After he met the Part B deductible, Medicare and his supplement paid the rest.
When he bought Plan G, his premium was $110 per Month. He could have had Plan F for $145.
The annual difference in cost was $420. The part B deductible was $198.
Even though he had to pay the $198, he still saved $222.
$35 (difference in premium) x 12 mo = $420.
$420 (savings) – $198 (Deductible for 2020) = $222.
If he did not go to the doctor at all, his net savings would have been higher.
*High Deductible Plan G works exactly the same as High Deductible Plan F.
Like Plan G, Plan N does not cover the annual Part B deductible.
There are two critical components of Plan N that are different from Plan G:
- Excess charges
Continue reading, and we will talk more about each of these.
There are two copays you may be subject to on Plan N once you have met your annual Part B deductible.
Each doctor’s office visit costs a maximum of $20.
The copay is the same regardless of whether you see a primary care physician or a specialist.
Technically speaking, the copay is 20% of the Medicare-approved cost of the office visit – capped at $20.
So it is possible that your copay can be less than $20, but it will never be more than $20.
The charge for an emergency room visit is a maximum of a $50 copay.
You don’t pay the copay if your emergency room visit results in an inpatient hospital admission.
Here’s an Example
Dina has Plan N in addition to Original Medicare and pays around $100 per month.
She has to see an ENT specialist. While at the office, they collect a $15 copay for her visit.
Medicare and Plan N cover the rest at 100%.
It is possible on Plan N that you could receive excess charges.
You would only see an excess charge if you went to a healthcare provider who does not “accept assignment.”
Accepting assignment means that a healthcare provider accepts Medicare-approved payment amounts as payment in full.
Read more about Access Charges here.
If you see a provider who does not “accept assignment,” he or she can then charge an additional up to 15% of the Medicare-approved amount for the office visit cost.
Excess charges are very uncommon because most providers in the country who accept Medicare accept Medicare payment as payment in full.
Let’s Look at one more Example
Ted decides to visit a local psychologist because he has been feeling very anxious lately.
He has Medicare and Plan N.
The psychologist accepts Medicare but does not accept Medicare assignment.
The Medicare-approved amount for Ted’s visit is $150.
In addition to a $20 copay, Ted also receives a bill for a $22.50 excess charge ($15% of $150).
There are several different supplement plans to choose from that help minimize your out-of-pocket expenses on Medicare.
The more coverage a plan provides, the more it will cost in monthly premiums.
Different plans are better suited for other individuals depending on their health needs and budget.
As you age, your situation may change.
It is important to reevaluate your options every single year to maximize your benefits.
While F, G, N are not the only ones available, they are the most popular of the supplements because they have the right balance of coverage and price.
The best plan is the one that meets your specific needs the most.
Use your Medicare specialist to talk about your benefits every year.
As your situation changes, so should your coverage.
If you have any questions, use the search tool at the top of this page or on the home page.
Or, if you would like further detail on any of the topics we discussed, please fill out a contact form and submit your question.
If you prefer to speak by phone, call us at 888-209-5049.