Medicare Supplement Insurance — Plan N


Get a no-obligation quote for Medicare Supplement coverage from Blue Cross and Blue Shield of Texas


If you are willing to share certain health care costs, this Medicare Supplement insurance plan can help you save on premiums while still receiving dependable coverage.

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Medicare Supplement insurance costs include monthly premium payments and may include deductibles, out-of-pocket expenses, copayments and coinsurance. Here are some of the costs you can expect to pay with Plan N:

  • Your Part B deductible
  • Part B excess charges
  • All hospitalization costs beyond the additional 365 days after the Lifetime Reserve are used
  • All skilled nursing facility costs after 101 days
  • A $20 copayment for office visits and $50 for emergency room visits – these copayments apply to Part B coinsurance only
  • Foreign travel: $250 per calendar year; 20 percent of costs within the first $50,000; all costs thereafter

For more information on costs, get a quick quote or see the Medicare Supplement Outline of Coverage.


  • Basic benefits:
    • Part A coinsurance for hospitalization services plus coverage for 365 additional days after Medicare benefits end
    • Part B coinsurance for medical expenses (generally 20% of Medicare-approved expenses) or copayments for hospital outpatient services
    • First three pints of blood each year
    • Part A coinsurance for hospice care
  • Skilled nursing facility coinsurance
  • Part A deductible
  • Foreign travel emergency care*

More Plan Details

It's important to know the critical features of the Medicare Supplement insurance plan you are considering. The Outline of Medicare Supplement Coverage provides brief descriptions of the basic provisions of the Medicare Supplement insurance plans, as well as details on policy renewability, benefit exclusions and coverage limitations.


* Plans cover medically necessary emergency care services needed immediately because of an injury or illness of sudden and unexpected onset, beginning during the first 60 days of each trip outside the USA.


Blue Cross and Blue Shield of Texas (BCBSTX) will never terminate or refuse to renew your Medicare Supplement Insurance policy because of the condition of your health. However, to protect you and the rights of all policy holders, there are situations when a Medicare Supplement insurance plan may be terminated or a renewal refused:

  • Failure to pay
  • Discovery of fraud or an intentional misrepresentation of facts (30 days prior written notice given)


Services Medicare Pays Plan Pays You Pay
HOSPITALIZATION*: Semi-private room and board, general nursing, and miscellaneous services and supplies
First 60 days All but $1,260 $1,260 (Part A deductible) $0
61st through 90th day All but $315 a day $315 a day $0
91st day and after:
– While using 60 Lifetime Reserve Days
– Once Lifetime Reserve Days are used:
   Additional 365 days

All but $630 a day

$0


$630 a day

100% of Medicare eligible expenses

$0

$0**
Beyond the additional 365 days $0 $0 All costs
SKILLED NURSING FACILITY CARE*: You must meet Medicare's requirements, including having been in a hospital for at least three days and entered a Medicare-approved facility within 30 days after leaving the hospital
First 20 days All approved amounts $0 $0
21st through 100th day All but $157.50 a day Up to $157.50 a day $0
101st day and after $0 $0
All costs
BLOOD
First three pints $0 Three pints $0
Additional amounts 100% $0 $0
HOSPICE CARE: You must meet Medicare's requirements, including a doctor's certification of terminal illness
  All but very limited copayment/coinsurance
for outpatient drugs and inpatient respite care
Medicare copayment/
coinsurance
$0

* A benefit period begins on the first day you receive services as an inpatient in a hospital and ends after you have been out of the hospital and have not received skilled care in any other facility for 60 days in a row.

** NOTICE: When your Medicare Part A hospital benefits are exhausted, the insurer stands in the place of Medicare and will pay whatever amount Medicare would have paid for up to an additional 365 days as provided in the policy's "Core Benefits." During this time the hospital is prohibited from billing you for the balance based on any difference between its billed charges and the amount Medicare would have paid.


Services Medicare Pays Plan Pays You Pay
MEDICAL EXPENSES—IN OR OUT OF THE HOSPITAL AND OUTPATIENT HOSPITAL TREATMENT, such as physicians' services, inpatient and outpatient medical and surgical services and supplies, physical and speech therapy, diagnostic tests, durable medical equipment
First $147 of Medicare-approved amounts* $0 $0 $147
(Part B deductible)
Remainder of Medicare-approved amounts Generally 80% Balance, other than up to $20 per office visit and up to $50 per emergency room visit.** Up to $20 per office visit and up to $50 per emergency room visit.**
PART B EXCESS CHARGES (above Medicare-approved amounts)
  $0 $0 All costs
BLOOD
First three pints $0 All costs $0
Next $147 of Medicare-approved amounts* $0 $0 $147
(Part B deductible)
Remainder of Medicare-approved amounts 80% 20% $0
CLINICAL LABORATORY SERVICES— TESTS FOR DIAGONOSTIC SERVICES
  100% $0 $0

* Once you have been billed $147 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.

** The copayment of up to $50 is waived if the insured is admitted to any hospital and the emergency visit is covered as a Medicare Part A expense.


Services Medicare Pays Plan Pays You Pay
HOME HEALTH CARE MEDICARE-APPROVED SERVICES
– Medically necessary skilled care services and medical supplies 100% $0 $0
– Durable medical equipment
First $147 of Medicare-approved amounts*
$0 $0 $147
(Part B deductible)
Remainder of Medicare-approved amounts 80% 20% $0

* Once you have been billed $147 of Medicare-approved amounts for covered services (which are noted with an asterisk), your Part B deductible will have been met for the calendar year.


Services Medicare Pays Plan Pays You Pay
FOREIGN TRAVEL —NOT COVERED BY MEDICARE: Medically necessary emergency care services beginning during the first 60 days of each trip outside the USA
First $250 each calendar year $0 $0 $250
Remainder of charges $0 maximum benefit of $50,000 over the $50,000
lifetime maximum


BCBSTX is not connected with or endorsed by the United States Government, the Federal Medicare Program or any other governmental agency.

TXMEDWEBN-REV 08/12