What is the difference between Medigap Plan G and Plan N?

Both Plan G and Plan N are standardized Medicare Supplement plans that cover gaps in Original Medicare. The key differences: Plan G covers Part B excess charges and has no copays after the Part B deductible. Plan N does not cover Part B excess charges and has copays of up to $20 for office visits and up to $50 for ER visits when you are not admitted. Plan N has lower monthly premiums.

Is Plan G or Plan N better for someone who sees the doctor frequently?

Plan G is generally better for frequent healthcare users. If you see doctors 4 or more times per year or have chronic conditions requiring ongoing specialist care, Plan G eliminates copays entirely after the Part B deductible ($274 in 2026). The premium difference may be offset by avoided copays.

Do Plan G and Plan N cover the Part B deductible?

No. Since January 1, 2020, no new Medigap plans can cover the Part B deductible. Both Plan G and Plan N require you to pay the annual Part B deductible ($274 in 2026) before supplemental coverage kicks in.

What are Part B excess charges and does it matter?

Part B excess charges occur when a doctor does not accept Medicare assignment and bills up to 15% more than the Medicare-approved amount. Plan G covers these charges; Plan N does not. In practice, over 98% of doctors accept assignment nationwide, and some states ban excess charges entirely — so this difference may not matter depending on where you live.

Can I switch from Plan G to Plan N or vice versa?

You can apply to switch at any time, but outside of your Medigap Open Enrollment Period (the 6 months starting when you turn 65 and enroll in Part B), insurers can use medical underwriting. If you have health conditions, you may be denied or charged more. Some states offer additional guaranteed-issue protections.

Is Medigap Plan G the same in every state?

Yes. Medigap plans are standardized by the federal government, so Plan G covers the same benefits whether you buy it in Texas or New York. The only thing that varies is the premium, which depends on your age, location, gender, and the insurance company.

Does Plan G or Plan N include prescription drug coverage?

No. Neither Plan G nor Plan N covers prescription drugs. You need a separate Medicare Part D plan for drug coverage. You can enroll in a Part D plan alongside either Medigap plan.

Can I use Plan G or Plan N with Medicare Advantage?

No. Medigap plans only work with Original Medicare (Parts A and B). If you have a Medicare Advantage plan, a Medigap policy cannot pay your cost-sharing. You must choose one path or the other.

Medicare Supplement Plan G vs Plan N: A Complete Medigap Comparison

Plan G and Plan N are the two most popular Medigap plans available to new Medicare beneficiaries. Both supplement Original Medicare — but they balance premiums and out-of-pocket costs differently. Plan G offers zero copays after the Part B deductible with higher premiums. Plan N offers lower premiums but adds copays of up to $20 per office visit and up to $50 per ER visit (if not admitted), plus no coverage for Part B excess charges. This guide breaks down every difference so you can make the right choice.

What Are Medigap Plans G and N?

Medigap (Medicare Supplement) plans are private insurance policies that help pay the out-of-pocket costs that Original Medicare doesn't cover — things like coinsurance, copayments, and deductibles. The federal government standardizes Medigap plans, meaning Plan G is Plan G no matter which insurer sells it. The same goes for Plan N. The only thing that varies between companies is the premium.

Since Plan F was closed to new beneficiaries in 2020, Plan G is now the most comprehensive Medigap plan available. Plan N is the next most popular, offering slightly less coverage in exchange for lower premiums.

Coverage Comparison: Plan G vs Plan N

Benefit	Plan G	Plan N
Part A coinsurance & hospital costs	✅ Covered	✅ Covered
Part B coinsurance (20%)	✅ Covered	✅ Covered (with copays)
Part A deductible ($1,676 in 2026)	✅ Covered	✅ Covered
Part B deductible ($274 in 2026)	❌ You pay	❌ You pay
Part B excess charges	✅ Covered	❌ Not covered
Copay for office visits	$0	Up to $20/visit
Copay for ER (not admitted)	$0	Up to $50/visit
Skilled nursing facility coinsurance	✅ Covered	✅ Covered
Foreign travel emergency (80%)	✅ Covered	✅ Covered
Part A hospice coinsurance	✅ Covered	✅ Covered
First 3 pints of blood	✅ Covered	✅ Covered

The three differences are highlighted: Part B excess charges (covered by G, not N), office visit copays (none for G, up to $20 for N), and ER copays when not admitted (none for G, up to $50 for N).

Cost Comparison: Premiums vs Out-of-Pocket

The core trade-off between Plan G and Plan N is straightforward: higher premiums and lower out-of-pocket costs (Plan G) vs lower premiums and higher out-of-pocket costs (Plan N).

Typical 2026 Premium Ranges

Plan G: $150–$250/month depending on age, location, and insurer
Plan N: $100–$180/month depending on age, location, and insurer
Typical difference: $40–$80/month ($480–$960/year)

Annual Cost Scenario: Plan G

Part B premium: $185/month × 12 = $2,220
Plan G premium: ~$180/month × 12 = $2,160 (example)
Part B deductible: $274
Out-of-pocket for Part B services: $0
Estimated total: ~$4,654/year

Annual Cost Scenario: Plan N

Part B premium: $185/month × 12 = $2,220
Plan N premium: ~$130/month × 12 = $1,560 (example)
Part B deductible: $274
Office visit copays: ~$100–$300/year (depends on usage)
Estimated total: ~$4,154–$4,354/year

For someone with average healthcare use, Plan N saves roughly $300–$500 per year. But if you see doctors frequently or visit the ER, that gap narrows or disappears.

Who Should Choose Plan G?

Plan G is typically the better choice if you:

See doctors frequently — 4 or more office visits per year, including specialists
Have chronic conditions — diabetes, heart disease, COPD, or other conditions requiring ongoing management
Want total predictability — after paying the $274 Part B deductible, your out-of-pocket costs are $0 for the rest of the year
Live in an area with excess charges — if doctors in your area don't accept Medicare assignment, Plan G protects you from the 15% surcharge
Prefer budgeting simplicity — one fixed monthly premium, one annual deductible, and that's it

Who Should Choose Plan N?

Plan N is typically the better choice if you:

Are generally healthy — few doctor visits per year (1–3 visits)
Want lower monthly premiums — and don't mind paying small copays when you do see a doctor
Live in a state that bans excess charges — Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont prohibit Part B excess charges, eliminating one of Plan G's advantages
Have a higher risk tolerance — you're comfortable with small, predictable copays in exchange for premium savings
Rarely visit the ER — the $50 ER copay (when not admitted) is unlikely to apply often

Understanding Part B Excess Charges

One of the three differences between Plan G and Plan N is coverage of Part B excess charges. Here's what that means in practice:

What they are: When a doctor doesn't accept Medicare assignment, they can charge up to 15% more than the Medicare-approved amount. You pay the difference.
How common they are: Over 98% of doctors nationwide accept Medicare assignment, meaning excess charges are rare
States that ban them: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont prohibit excess charges entirely
Bottom line: If you live in a ban state or your doctors accept assignment, this difference between Plan G and N is irrelevant

You can check whether your doctor accepts assignment on Medicare Care Compare.

Real-World Scenarios

Scenario 1: Healthy 66-year-old, rarely visits the doctor

3 doctor visits per year, no hospitalizations, no ER visits
Plan N copays: 3 × $20 = $60/year
Plan N premium savings: ~$600/year
Net savings with Plan N: ~$540/year
Verdict: Plan N is the clear winner

Scenario 2: 72-year-old managing multiple chronic conditions

Monthly doctor visits (12/year) + quarterly specialist visits (4/year) = 16 visits
Plan N copays: 16 × $20 = $320/year
Plan G premium difference: ~$600/year more
Net cost difference: ~$280 more for Plan G
Verdict: Plan G is worth it for the peace of mind and simplicity

Scenario 3: 70-year-old with occasional ER visits

6 doctor visits + 2 ER visits (observation, not admitted) per year
Plan N copays: (6 × $20) + (2 × $50) = $220/year
Plan G premium difference: ~$600/year more
Net savings with Plan N: ~$380/year
Verdict: Plan N still saves money, but the margin's thinner

The Break-Even Point

If the monthly premium difference between Plan G and Plan N is $50/month ($600/year), here is how many visits it takes for Plan G to break even:

At $20/copay: 30 office visits per year (unlikely for most people)
With ER visits ($50/copay): Fewer visits needed but still a high threshold

For most beneficiaries, Plan N saves money. Plan G pays for itself primarily through peace of mind and protection against excess charges — not through copay savings alone.

Important Enrollment Considerations

Regardless of which plan you choose, keep these timing rules in mind:

Medigap Open Enrollment Period: The 6-month window starting when you turn 65 and enroll in Part B. During this period, insurers must sell you any Medigap plan at the standard rate — no health questions, no denials.
After OEP: Insurers can use medical underwriting. Pre-existing conditions may result in higher premiums or denial.
Choose carefully the first time: Switching plans later is possible but not guaranteed, especially if your health has changed.
Neither plan includes drugs: You'll need a separate Part D plan for prescription coverage.

How to Compare Plans in Your Area

Because premiums vary significantly by location, age, and insurer, the best way to compare Plan G and Plan N is to get real quotes for your situation:

Use our Medigap plan comparison tool to see available plans and premiums in your area
Try our Medigap recommendation engine for a personalized suggestion based on your healthcare usage
Check whether your doctors accept Medicare assignment before deciding how much excess charge coverage matters