Medigap Plan N In Wisconsin

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I have spent the last 3 months since going on Medicare researching the ins and outs of medigap policies. After changing my plan and provider 3 times while in my initial 6 month period, I've ended up with the AARP/UHC medigap plan N. I started with a WPS policy equivalent to a plan F for $179/mth. After reading how plan F is going away in 2020 and premiums could skyrocket I went with their plan G equivalent for $167/mth. Now I've ended up with the AARP plan N for $108/mth($106 with EFT withdrawal and the 27% discount which decreases 3% per year). The ONLY difference between the "G" and the "N" plans are the $20 copay to the Dr. and the $50 emerg. room copay...and not everyone seems to know this, in Wisconsin you can add a rider that covers the Part B excess payments. So if you live in Wis. and are looking at a Plan G or N, don't be afraid of the N because it's basically just a Plan G with the copays but at a lower premium.

 

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To clarify, the Plan N "up to $20 copay" only applies to office visit CPT codes. Hospital visits by doctors are billed using different CPT codes that are not subject to the copay. Also, the "up to $20 copay" is actually a 20% coinsurance capped at $20. Established patient office visit allowables are generally in the $70-90 range meaning the "copay" is usually in the $14-18 range.

Plan N Copay Explained: https://www.cms.gov/Medicare/Health-Plans/Medigap/downloads/Plan_N_Guidance2.pdf

The Mayo Clinic in MN does not accept Medicare assignment on Part B claims for out-of-state residents. This means they can bill the 15% excess charge not covered by Plan N. A rider to cover the Part B excess charges is not available in all states. Plan G covers the excess charge. Overall, Plan N is an excellent choice.

Mayo Clinic Medicare Billing: http://www.mayoclinic.org/patient-v.../accepted-insurance/medicare/more-on-medicare