Nurse and Patient

Medigap Plan N Copays

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Let’s discuss Medigap Plan N Copays. The unique feature of having copays on a Medicare Supplement sets Plan N apart from the other standardized plans. At first, it may seem complicated, but when broken down into its two parts, it is really quite simple.

There are No Copays Until After the Part B Deductible is Met

With a Medigap Plan N, you will pay the Medicare Part B Deductible before any copayment is charged. Once the deductible is met, there is a $50 copay for emergency room visits and a $20 copay per office visit.

Medigap Plan N Copay for Emergency Room

With a Medigap Plan N, there is a $50 copay for emergency room services. The copay is only due if care received is on an outpatient basis.

Outpatient care refers to emergency department services, observation services, outpatient surgery, lab tests, or X-rays, or any other hospital services, performed without a doctor formally admitting you into the hospital. Overnight care on an outpatient basis is possible.

If you go to the emergency room, and eventually you are admitted to the hospital, you are officially considered an inpatient. Under this scenario, the $50 copay is waived.

Medigap Plan N Copay for Office Visits

With a Medigap Plan N, there is a $20 copay for doctor’s office visits. Whether or not a copay is due, depends on the billing code used by your doctor when requesting payment under Medicare Part B. Under most circumstances the copay $20 copay is due.

For a more detailed explanation visit www.cms.gov

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