Join Early Retirement Today
Reply
 
Thread Tools Display Modes
Medicare Plan N copays
Old 10-19-2021, 11:09 AM   #1
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Dash man's Avatar
 
Join Date: Mar 2013
Location: Limerick
Posts: 5,638
Medicare Plan N copays

We’re considering changing from our AARP Plan G to Plan N. We feel long term that Plan G premiums will increase faster than a Plan N. Our concern are the copays of up to $20 per office visit. We aren’t worried about the once or twice per month visits, but the possibility of multiple visits per week if we should need care for something requiring that, such as dialysis or radiation. Are the copays charged each time or only for the initial visits?
I’m interested in hearing from someone with experience with Plan N.
We are still in our 6 month initial enrollment period, so there is no problem making the change.
Dash man is offline   Reply With Quote
Join the #1 Early Retirement and Financial Independence Forum Today - It's Totally Free!

Are you planning to be financially independent as early as possible so you can live life on your own terms? Discuss successful investing strategies, asset allocation models, tax strategies and other related topics in our online forum community. Our members range from young folks just starting their journey to financial independence, military retirees and even multimillionaires. No matter where you fit in you'll find that Early-Retirement.org is a great community to join. Best of all it's totally FREE!

You are currently viewing our boards as a guest so you have limited access to our community. Please take the time to register and you will gain a lot of great new features including; the ability to participate in discussions, network with our members, see fewer ads, upload photographs, create a retirement blog, send private messages and so much, much more!

Old 10-19-2021, 01:46 PM   #2
Thinks s/he gets paid by the post
 
Join Date: Dec 2017
Posts: 1,594
Copays are per cpt code charged so there can be multiple. I agree that the office visits are not a big concern. For most folks plan N will be fine but I didn't like the uncertainty, so I went with G
RetMD21 is offline   Reply With Quote
Old 10-19-2021, 01:56 PM   #3
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Jun 2003
Location: Florida's First Coast
Posts: 7,666
I have plan G. It has been good, no coverage issues at all. $3,950 a year for Plan G and Standard Pert B and Part D premiums is cheap Max OOP health insurance these days.

Considering the average Max OOP for Advantage plans with all their restrictions is ~$7,800. I do not like to cut corners on my HI.
__________________
"Never Argue With a Fool, Onlookers May Not Be Able To Tell the Difference." - Mark Twain
ShokWaveRider is offline   Reply With Quote
Old 10-19-2021, 03:38 PM   #4
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,004
DW and I have had Plan N for 3+ years. The copay of up to $20 applies to office visits to our doctors, not to treatment appointments for physical therapy, radiation, dialysis, etc.

Here is a link to everything you'd wish to know (and more) regarding Plan N copays: https://www.cms.gov/Medicare/Health-..._Guidance2.pdf
__________________
Numbers is hard
REWahoo is offline   Reply With Quote
Old 10-19-2021, 03:39 PM   #5
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,004
Quote:
Originally Posted by ShokWaveRider View Post

Considering the average Max OOP for Advantage plans with all their restrictions is ~$7,800. I do not like to cut corners on my HI.
Plan N the OP is asking about is a Medicare Supplement, not Medicare Advantage.
__________________
Numbers is hard
REWahoo is offline   Reply With Quote
Old 10-19-2021, 03:53 PM   #6
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Dash man's Avatar
 
Join Date: Mar 2013
Location: Limerick
Posts: 5,638
Quote:
Originally Posted by REWahoo View Post
DW and I have had Plan N for 3+ years. The copay of up to $20 applies to office visits to our doctors, not to treatment appointments for physical therapy, radiation, dialysis, etc.

Here is a link to everything you'd wish to know (and more) regarding Plan N copays: https://www.cms.gov/Medicare/Health-..._Guidance2.pdf

Great! Thank you!! That’s what I was hoping to hear! Thank you for the link!
Dash man is offline   Reply With Quote
Old 10-19-2021, 04:00 PM   #7
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
 
Join Date: Jun 2003
Location: Florida's First Coast
Posts: 7,666
Quote:
Originally Posted by REWahoo View Post
Plan N the OP is asking about is a Medicare Supplement, not Medicare Advantage.
I know that, my point is G is a good deal for the most coverage and offers more advantages that N. I was just using Part C as an example of a high MOOP.
__________________
"Never Argue With a Fool, Onlookers May Not Be Able To Tell the Difference." - Mark Twain
ShokWaveRider is offline   Reply With Quote
Old 10-19-2021, 07:38 PM   #8
Recycles dryer sheets
grayv's Avatar
 
Join Date: Sep 2019
Posts: 102
Shok, thanks for describing the difference like that. I was teaching a couple friends about their choices recently (they just turned 65), and that comparison would have helped.
grayv is online now   Reply With Quote
Old 10-19-2021, 10:23 PM   #9
Thinks s/he gets paid by the post
Telly's Avatar
 
Join Date: Feb 2003
Posts: 2,395
I have Plan N. So far, once I have met the Part B deductible, the only place that has charged the Plan N copay is my Ophthalmologist. And the way that has worked is: Ophth submits claim to Medicare. Medicare pays their part, passes it on to my Plan N insurer, they subtract $20 or less from what they would have paid the Ophth. The Ophth bills me the $20 or less that is missing, and then I pay the Ophth for the missing $.
__________________
-- Telly, the D-I-Y guy --
Two fools dancing on the hands of time
Telly is offline   Reply With Quote
Old 10-20-2021, 07:53 AM   #10
Thinks s/he gets paid by the post
 
Join Date: Jun 2017
Location: Western NC
Posts: 4,610
Was it here that a poster on plan N claimed their doctors didn't bother with charging co-pays?

Also, I don't understand why people would pick G over G-HD since here the add'l premiums for G exceed the deductible for G-HD...is G really cheaper elsewhere?
ncbill is offline   Reply With Quote
Old 10-20-2021, 08:25 AM   #11
Give me a museum and I'll fill it. (Picasso)
Give me a forum ...
Dash man's Avatar
 
Join Date: Mar 2013
Location: Limerick
Posts: 5,638
Quote:
Originally Posted by ncbill View Post
Was it here that a poster on plan N claimed their doctors didn't bother with charging co-pays?

Also, I don't understand why people would pick G over G-HD since here the add'l premiums for G exceed the deductible for G-HD...is G really cheaper elsewhere?

G-HD is not available where I am.
Dash man is offline   Reply With Quote
Old 10-20-2021, 08:26 AM   #12
Give me a museum and I'll fill it. (Picasso) Give me a forum ...
REWahoo's Avatar
 
Join Date: Jun 2002
Location: Texas: No Country for Old Men
Posts: 50,004
Quote:
Originally Posted by ncbill View Post
Was it here that a poster on plan N claimed their doctors didn't bother with charging co-pays?
We've had office visits with two doctors over the past couple of years who didn't charge the N copay. Not sure if it was lack of understanding of how Plan N works or they felt the administrative cost wasn't worth the potential revenue.

Note that the N copay is "up to" $20. You are billed for 20% of the approved Medicare charge, up to a maximum of $20. IOW, if the Medicare amount is less than $100, your copay will be less than $20.
__________________
Numbers is hard
REWahoo is offline   Reply With Quote
Reply


Currently Active Users Viewing This Thread: 1 (0 members and 1 guests)
 
Thread Tools
Display Modes

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Plan F versus Plan G Medicare Supplement bookman51 Health and Early Retirement 9 01-23-2020 07:01 AM
Medicare eligibility for spouse that never paid Medicare tax PERSonalTime FIRE and Money 13 11-24-2016 11:38 PM
Question on Medicare vs private Medicare PPO Ready Health and Early Retirement 9 05-20-2014 12:48 PM
Classic Medicare & Medigap vs. Medicare Advantage haha Health and Early Retirement 23 05-21-2011 09:36 AM
Medicare+Medigap vs. Medicare Advantage haha FIRE and Money 2 02-01-2006 08:16 PM

» Quick Links

 
All times are GMT -6. The time now is 06:46 PM.
 
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2024, vBulletin Solutions, Inc.