Plan N vs Medicare Advantage: Value-Focused Comparison
Comparing budget-friendly options? Learn how Medigap Plan N and Medicare Advantage stack up for cost-conscious seniors.
Two Budget-Friendly Medicare Options
Plan N and Medicare Advantage both offer good value for cost-conscious seniors. Each takes a different approach to balancing coverage with affordability.
Understanding these approaches helps you choose the option that best fits your healthcare needs and budget.
Plan N Overview
What Plan N Covers
Plan N covers most Medicare gaps with small copays for routine services:
- Part A deductible and coinsurance
- Part B coinsurance (after deductible)
- Blood transfusion costs
- Skilled nursing facility coinsurance
- Hospice coinsurance
- Foreign travel emergency coverage
What You Pay with Plan N
- Monthly premium: $120-$180 (varies by area)
- Part B deductible: $240/year
- Doctor office copay: Up to $20 per visit
- Emergency room copay: Up to $50 per visit
- Part B excess charges: Not covered
Medicare Advantage Overview
What Medicare Advantage Covers
All Medicare benefits through one plan, often with extras:
- Parts A and B coverage
- Often includes Part D (prescription drugs)
- May include dental, vision, hearing aids
- Wellness programs and extras
- Maximum annual out-of-pocket limits
What You Pay with Medicare Advantage
- Monthly premium: $0-$100 (many are $0)
- Deductibles: Vary by plan
- Copays: $10-$50 for office visits
- Coinsurance: 10-20% for some services
- Maximum out-of-pocket: $3,000-$8,000/year
Key Differences
Provider Networks
Plan N: Access to any Medicare-accepting provider nationwide. No network restrictions.
Medicare Advantage: Limited to plan's provider network. May need referrals for specialists.
Predictability
Plan N: Predictable copays with few surprises. Most services covered after small copays.
Medicare Advantage: Variable costs depending on usage. Protected by annual out-of-pocket maximums.
Extra Benefits
Plan N: Medical coverage only. Need separate dental, vision, and Part D plans.
Medicare Advantage: Often includes dental, vision, and prescription coverage in one plan.
Cost Comparison Scenarios
Scenario 1: Light Healthcare User (4 doctor visits/year)
Plan N costs:
- Premium: $150/month × 12 = $1,800
- Part B deductible: $240
- Doctor copays: 4 × $20 = $80
- Total: $2,120
Medicare Advantage costs:
- Premium: $25/month × 12 = $300
- Deductible: $200
- Doctor copays: 4 × $25 = $100
- Total: $600
Medicare Advantage saves $1,520
Scenario 2: Moderate Healthcare User (10 doctor visits, 1 ER visit)
Plan N costs:
- Premium: $1,800
- Part B deductible: $240
- Doctor copays: 10 × $20 = $200
- ER copay: $50
- Total: $2,290
Medicare Advantage costs:
- Premium: $300
- Deductible: $200
- Doctor copays: 10 × $25 = $250
- ER copay: $100
- Total: $850
Medicare Advantage saves $1,440
Scenario 3: High Healthcare User (reaches out-of-pocket max)
Plan N costs:
- Premium: $1,800
- Part B deductible: $240
- Various copays: ~$500
- Total: $2,540
Medicare Advantage costs:
- Premium: $300
- Out-of-pocket maximum: $5,000
- Total: $5,300
Plan N saves $2,760
Who Should Choose Plan N
Moderate to High Healthcare Users
If you see doctors regularly or have chronic conditions, Plan N's predictable copays often cost less than Medicare Advantage's variable costs.
Travelers
Plan N works anywhere in the US without network restrictions, making it ideal for frequent travelers.
Those Who Value Provider Choice
If you want to see any Medicare-accepting doctor without referrals, Plan N provides that flexibility.
Who Should Choose Medicare Advantage
Light Healthcare Users
If you rarely see doctors and are generally healthy, Medicare Advantage's lower premiums can provide significant savings.
Those Who Want Extras
If dental, vision, or hearing aid coverage is important, Medicare Advantage often includes these benefits.
Local-Focused Seniors
If you stay primarily in your home area and are comfortable with network restrictions, Medicare Advantage can work well.
Important Considerations
Network Changes
Medicare Advantage plans can change networks annually. Your doctors might not be covered next year.
Switching Difficulties
Moving from Medicare Advantage to Plan N later requires medical underwriting. Health issues could prevent the switch.
Part D Coverage
Plan N requires a separate Part D plan for prescription drugs. Many Medicare Advantage plans include drug coverage.
Making Your Choice
Both options provide good value, but for different people:
Choose Plan N if you:
- Use healthcare moderately to frequently
- Travel often or value provider flexibility
- Want predictable costs
- Don't mind higher monthly premiums for lower copays
Choose Medicare Advantage if you:
- Use healthcare infrequently
- Want the lowest possible monthly premiums
- Value extras like dental and vision coverage
- Are comfortable with network restrictions
The Bottom Line
Plan N offers excellent value for people who use healthcare regularly and want provider flexibility.
Medicare Advantage can provide outstanding value for healthy seniors who use healthcare infrequently.
Consider your healthcare usage patterns, travel habits, and preference for predictable versus variable costs when making your decision.