Medigap plans, also known as Medicare Supplement plans, are designed to help cover some of the out-of-pocket costs associated with Original Medicare, such as deductibles, copayments, and coinsurance. While selecting the right Medigap plan is important, it’s not a decision that’s set in stone. As your healthcare needs change over time, you may find that your current plan no longer meets your needs, or you may simply want to explore other options. In such cases, it’s possible to switch Medigap plans. However, the process of switching plans can be complex and may require some careful consideration. In this article, we’ll explore some of the key factors to consider when switching Medigap plans and provide some guidance on how to make a smooth transition to a new plan.
It is possible to switch from Medigap Plan N to Medigap Plan G. However, there are a few things you should keep in mind before making the switch. To start off, we will introduce you to the benefits that both Plan N and Plan G individually provide.
Medigap Plan N
Medigap Plan N is a Medicare Supplement plan that helps cover some of the out-of-pocket costs associated with Original Medicare. Medigap Plan N provides a variety of benefits, including:
Medicare Part A coinsurance and hospital costs
Plan N covers the coinsurance, copayments, and deductibles for hospital stays of up to an additional 365 days after Original Medicare benefits are exhausted.
Medicare Part B coinsurance and copayments
Plan N covers the 20% coinsurance for medical services that are covered by Medicare Part B, but does not cover the Part B deductible.
Blood
Plan N covers the first three pints of blood each year.
Hospice care coinsurance and copayments
Plan N covers the coinsurance and copayments for hospice care.
Skilled nursing facility care coinsurance
Plan N covers the coinsurance for skilled nursing facility care.
Foreign travel emergency
Plan N covers 80% of the cost of emergency care received outside of the U.S., up to plan limits.
Overall, Medigap Plan N may be a good fit for those who are willing to pay lower monthly premiums but are comfortable with copays for some services.
Medigap Plan G
Medigap Plan G is a type of Medicare Supplement insurance plan and like other Medigap plans, Plan G is sold by private insurance companies and is designed to work alongside Original Medicare.
Medigap Plan G offers comprehensive coverage, including the following benefits:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted
- Medicare Part B coinsurance or copayment
- Blood (first 3 pints)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible
- Part B excess charges (i.e., the difference between the Medicare-approved amount and what a provider charges)
Plan G does not cover the Medicare Part B deductible, which in 2023 is $226. Once you meet the Part B deductible, Plan G will cover 100% of your Part B coinsurance and copayments.
It’s worth noting that Plan G has become increasingly popular among Medicare beneficiaries in recent years, as it provides comprehensive coverage and often has lower premiums than Plan F, which is another popular Medigap plan. However, Plan F is no longer available to new Medicare beneficiaries as of January 1, 2020. Also, it is worth knowing that in some states there is a high-deductible Plan G, which has the same range of coverage as Plan G, but a higher annual deductible.
Cost-sharing Plans
Both Medigap Plan N and Medigap Plan G are cost-sharing plans, which means they require you to pay certain out-of-pocket costs for healthcare services. However, the specific cost-sharing requirements and benefits covered by each plan differ.
Medigap Plan N generally has lower premiums than other Medigap plans but requires you to pay copayments for certain medical services. For example, you would need to pay a copayment for each doctor’s office visit and emergency room visit, as well as a portion of the cost for some outpatient procedures. In exchange for these copayments, Medigap Plan N typically covers most of the cost of Medicare Part A coinsurance and copayments, as well as Part B coinsurance.
Medigap Plan G, on the other hand, does not require copayments for medical services, but it typically has higher premiums. Instead of copayments, you would generally be responsible for paying the Medicare Part B annual deductible before the plan begins covering your medical expenses. After that, Medigap Plan G covers most of the remaining costs for Medicare-approved services, including Part A and B coinsurance and copayments, skilled nursing facility care coinsurance, and Part A hospice care coinsurance or copayment.
Switching from Medigap Plan N to Medigap Plan G
It is possible to switch from a Medigap Plan N to a Medigap Plan G, but you will need to apply for a new Medigap policy and meet the eligibility requirements of the insurance company offering the plan.
Here are the general steps you can take to switch from Medigap Plan N to Plan G:
- Research Medigap Plan G options: You should research and compare different Medigap Plan G options offered by insurance companies in your area.
- Check eligibility requirements: Contact the insurance companies you are interested in and check their eligibility requirements. Generally, you will need to meet certain criteria to enroll, such as being enrolled in Medicare Part A and Part B and not having any medical conditions that would prevent you from being accepted into the plan.
- Apply for Medigap Plan G: If you are eligible for Medigap Plan G, you can apply for the policy through the insurance company.
- Cancel your Medigap Plan N: Once your application for Medigap Plan G is approved, you can cancel your Medigap Plan N. Be sure to check with your insurance company about their cancellation policy and any potential penalties for early cancellation.
When Can I Make The Switch?
You can generally switch from Medigap Plan N to Medigap Plan G at any time of the year. The same is applicable to high-deductible plans as well.- However, if you’ve had your Medigap Plan N policy for less than six months, you may be subject to medical underwriting when you apply for Medigap Plan G. If you have a pre-existing condition, you may face higher premiums or be denied coverage altogether. Therefore, it’s important to compare the costs and benefits of different plans before making a switch.
If you have had your Medigap Plan N policy for more than six months, you may be able to switch to Medigap Plan G without medical underwriting. This is because you may have what is called a “guaranteed issue right” under federal law. This means that insurance companies cannot deny you coverage or charge you more based on your health status or medical history.
However, it’s important to note that some states have different rules regarding Medigap plan switching. In some states, you may not have a guaranteed issue right and may be subject to medical underwriting when switching Medigap plans. Therefore, it’s always a good idea to check with your state’s insurance department to understand your options and eligibility requirements for switching Medigap plans.
