Medicare Supplement Plan G vs. Plan N: Which Is Right for You?

Understanding Medicare Supplement (Medigap) Plans

Original Medicare — Part A (hospital insurance) and Part B (medical insurance) — covers a wide range of health care services but leaves you responsible for deductibles, copays, coinsurance, and other out-of-pocket costs that can add up quickly. Medicare Supplement insurance, commonly called Medigap, is private insurance designed to fill those gaps.

The federal government standardizes Medigap plans by letter (A, B, C, D, F, G, K, L, M, and N). Every Plan G policy offers the same benefits regardless of which insurance company sells it. The same is true for Plan N. The only differences between carriers are price, customer service, and financial stability.

Since 2020, Plan F and Plan C are no longer available to newly eligible Medicare beneficiaries. That has made Plan G the most comprehensive Medigap plan available to new enrollees, and Plan N the most popular lower-premium alternative. Choosing between these two plans is one of the most important decisions a new Medicare beneficiary will make.

What Does Medicare Supplement Plan G Cover?

Plan G is the most comprehensive Medigap plan available to people who became eligible for Medicare on or after January 1, 2020. It covers virtually all of the out-of-pocket costs that Original Medicare leaves behind, with one exception: the annual Part B deductible, which is $257 in 2026.

Here is everything Plan G covers:

• Part A coinsurance and hospital costs — up to an additional 365 days after Medicare benefits are used up.
• Part B coinsurance or copayment — the 20 percent coinsurance you normally owe after meeting your Part B deductible.
• Blood — the first three pints of blood per year.
• Part A hospice care coinsurance or copayment — for palliative care services.
• Skilled nursing facility care coinsurance — the daily coinsurance for days 21 through 100 of a skilled nursing stay.
• Part A deductible — the hospital deductible of $1,676 per benefit period in 2026.
• Part B excess charges — the additional amount (up to 15 percent above Medicare-approved rates) that non-participating providers can charge.
• Foreign travel emergency care — 80 percent of emergency care costs during the first 60 days of a foreign trip, up to a $50,000 lifetime limit.

The only cost you pay out of pocket with Plan G (besides your monthly premium) is the annual Part B deductible. Once you have paid that deductible, Plan G covers 100 percent of Medicare-approved costs for the rest of the year with no copays, no coinsurance, and no surprise bills from excess charges. This predictability is Plan G's strongest selling point.

What Does Medicare Supplement Plan N Cover?

Plan N provides strong coverage at a lower monthly premium than Plan G, but it requires some cost-sharing in exchange. Like Plan G, it covers nearly all gaps in Original Medicare. However, Plan N has three important differences.

Plan N covers the following:

• Part A coinsurance and hospital costs — up to an additional 365 days after Medicare benefits are used up.
• Part B coinsurance or copayment — covered in full, except for copays of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission.
• Blood — the first three pints of blood per year.
• Part A hospice care coinsurance or copayment — for palliative care services.
• Skilled nursing facility care coinsurance — the daily coinsurance for days 21 through 100.
• Part A deductible — the hospital deductible of $1,676 per benefit period in 2026.
• Foreign travel emergency care — 80 percent of emergency care costs during the first 60 days of a foreign trip, up to a $50,000 lifetime limit.

Plan N does not cover two things that Plan G does:

• Part B excess charges — if a provider does not accept Medicare assignment, you pay the excess charge out of pocket (up to 15 percent above the Medicare-approved amount).
• Part B copay waiver — Plan N charges copays of up to $20 for some office visits and up to $50 for emergency room visits that do not lead to a hospital admission. Plan G has no copays at all.

Like Plan G, Plan N does not cover the annual Part B deductible. The trade-off is clear: Plan N costs less per month, but you take on modestly more out-of-pocket risk in the form of copays and potential excess charges.

Side-by-Side Comparison: Plan G vs. Plan N

The following comparison highlights the key differences between the two plans. Both Plan G and Plan N share a large common foundation of coverage, so the differences are narrower than many people expect.

Benefits covered by both Plan G and Plan N:

• Part A coinsurance and hospital costs (up to 365 additional days)
• Part A deductible ($1,676 per benefit period in 2026)
• Skilled nursing facility coinsurance (days 21 through 100)
• Part A hospice care coinsurance or copayment
• First three pints of blood
• Foreign travel emergency care (80 percent, up to $50,000 lifetime)

Where Plan G and Plan N differ:

• Part B coinsurance: Plan G covers 100 percent. Plan N covers 100 percent except for copays of up to $20 for some office visits and up to $50 for emergency room visits not resulting in admission.
• Part B excess charges: Plan G covers 100 percent. Plan N does not cover excess charges at all.
• Monthly premiums: Plan G premiums are typically $30 to $60 higher per month than Plan N premiums from the same carrier in the same area.

Neither plan covers the Part B annual deductible ($257 in 2026), prescription drugs, dental, vision, hearing aids, or long-term care.

Cost Comparison: Total Annual Spending

Choosing between Plan G and Plan N is ultimately a math problem. Plan G has higher premiums but virtually no out-of-pocket costs beyond the Part B deductible. Plan N has lower premiums but adds copays and potential excess charges. The question is whether the premium savings from Plan N exceed the additional out-of-pocket costs you might incur.

Consider a typical example. In many markets, Plan G premiums run approximately $150 to $250 per month for a 65-year-old, while Plan N premiums for the same person range from $100 to $190 per month. The annual premium difference is roughly $360 to $720 in favor of Plan N.

Now consider what Plan N might cost you in out-of-pocket expenses:

• Office visit copays: Up to $20 per visit. If you visit the doctor ten times a year, that is up to $200.
• Emergency room copays: Up to $50 per visit if not admitted. Most people have zero or one non-admission ER visit per year, so this is typically $0 to $50.
• Part B excess charges: This varies widely. If all your providers accept Medicare assignment, you pay $0. If you see a non-participating specialist for a $1,000 service, the excess charge could be up to $150.

For a relatively healthy person who sees the doctor four to six times per year, uses providers who accept Medicare assignment, and rarely visits the emergency room, Plan N copays might total $80 to $120 annually. If the premium savings is $400 to $600 per year, Plan N comes out ahead by $280 to $480.

For someone who visits the doctor frequently, sees non-participating specialists, or wants complete financial predictability, Plan G's higher premium eliminates all uncertainty. You pay the same amount every month and never worry about copays or excess charges. Over a lifetime of coverage, the peace of mind can be worth the additional cost.

Who Should Choose Plan G?

Plan G is the better choice if any of the following apply to you:

• You want maximum predictability. With Plan G, your only out-of-pocket cost is the $257 Part B deductible. After that, everything Medicare approves is covered at 100 percent. You can budget your health care costs to the penny.
• You see doctors frequently. If you have chronic conditions requiring regular office visits, specialist appointments, or lab work, the copays under Plan N add up. Plan G eliminates all of them.
• You see non-participating providers. If any of your doctors do not accept Medicare assignment, Plan G protects you from excess charges. This is especially important in areas with fewer providers or for certain specialties where non-participation rates are higher.
• You live in a state without excess charge protections. States like Connecticut, Massachusetts, and New York prohibit or limit excess charges. If your state does not have such protections, Plan G provides a valuable safety net.
• You value simplicity. Plan G is straightforward. You pay your monthly premium and the Part B deductible, and Medicare plus your Medigap plan handle the rest. There are no copays to track, no excess charge bills to worry about, and no financial surprises.

Who Should Choose Plan N?

Plan N is the better choice if any of the following apply to you:

• You want lower monthly premiums. Plan N typically saves $30 to $60 per month compared to Plan G. Over a year, that is $360 to $720 in premium savings. If you are on a fixed income, those savings can make a meaningful difference.
• You are generally healthy. If you only visit the doctor a few times per year for routine checkups, your annual copay costs under Plan N will be modest — likely $40 to $100 — far less than the premium difference.
• Your providers accept Medicare assignment. According to CMS data, approximately 98 percent of physicians participate in Medicare. If all of your doctors accept assignment, excess charges are not a concern, and Plan N's lack of excess charge coverage becomes irrelevant.
• You live in a state that limits excess charges. If your state prohibits or restricts Part B excess charges, you already have protection by law and do not need to pay Plan G's higher premium for that specific benefit.
• You are comfortable with small copays. Plan N copays are capped at $20 for office visits and $50 for non-admission ER visits. If you are comfortable budgeting for these modest out-of-pocket costs, Plan N provides excellent coverage at a lower price.

How Medigap Premiums Are Priced

Understanding how insurance companies price Medigap premiums can help you make a better long-term decision. There are three pricing methods:

• Community-rated (no-age-rated): Every policyholder pays the same premium regardless of age. Your premium will not increase just because you get older, though it may still rise due to inflation and rising health care costs.
• Issue-age-rated: Your premium is based on the age at which you buy the policy. A person who enrolls at 65 will pay less than someone who enrolls at 70. Your premium will not increase because of aging, but it can still increase for other reasons.
• Attained-age-rated: Your premium starts lower but increases automatically as you age. These policies may look like a bargain initially but can become the most expensive option over time. This is the most common pricing method.

Regardless of whether you choose Plan G or Plan N, ask your insurance agent about the carrier's pricing method. A community-rated or issue-age-rated policy may cost more initially but could save you thousands of dollars over the life of the policy.

How to Enroll in Plan G or Plan N

The best time to enroll in any Medigap plan is during your Medigap Open Enrollment Period. This is the six-month window that starts the month you turn 65 and are enrolled in Medicare Part B. During this period, you have guaranteed issue rights — insurance companies must sell you any Medigap policy they offer, cannot charge more because of health problems, and cannot deny coverage for pre-existing conditions.

Here is how to enroll:

1. Enroll in Medicare Part A and Part B. You must have both parts of Original Medicare before you can buy a Medigap plan. Most people get Part A automatically at 65 and need to sign up for Part B.
2. Compare plans and carriers in your area. Use Medicare's Plan Finder tool at Medicare.gov or contact a licensed insurance agent. Because Plan G benefits are standardized, focus on comparing premiums, carrier financial ratings, pricing methods, and customer service records.
3. Apply during your Medigap Open Enrollment Period. This six-month window starting at age 65 with Part B enrollment is the only time you are guaranteed acceptance with no medical underwriting. Missing this window means you may face health questions, higher premiums, or denial.
4. Enroll in a Medicare Part D drug plan separately. Medigap plans do not cover prescription drugs. You will need a standalone Part D plan for medication coverage. Enroll during your Initial Enrollment Period to avoid late penalties.
5. Review your plan annually. While Medigap benefits are standardized, premiums vary by carrier and change over time. Check each year whether a different carrier offers the same plan at a lower rate. You can switch carriers, though medical underwriting may apply outside of your Open Enrollment Period.

Important: You cannot have a Medigap plan and a Medicare Advantage plan at the same time. If you choose a Medigap policy, you must stay with Original Medicare (Parts A and B) for your primary coverage.

The Bottom Line

Both Plan G and Plan N are excellent Medicare Supplement plans that cover the vast majority of costs that Original Medicare leaves behind. The choice between them comes down to a simple trade-off: higher premiums with virtually no out-of-pocket costs (Plan G) versus lower premiums with modest copays and potential excess charges (Plan N).

Plan G is ideal for people who want complete peace of mind, see doctors frequently, or use providers who may not accept Medicare assignment. Plan N is ideal for generally healthy people who want to save on monthly premiums, use participating providers, and are comfortable with small copays.

Whichever plan you choose, the most important step is to enroll during your Medigap Open Enrollment Period. This guarantees your right to buy the plan at the best available rate with no medical underwriting. Compare carriers carefully, consider the pricing method, and pair your Medigap plan with a Part D prescription drug plan for complete coverage. A licensed insurance agent can help you compare rates and find the best value in your area.