Plan N vs Medicare Advantage: Value-Focused Comparison

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.