Medigap Plan G vs Plan N — premium vs out-of-pocket trade-offs
Plan G is the most popular Medigap plan for new Medicare beneficiaries — it covers nearly everything Original Medicare doesn't. Plan N is a lighter-weight alternative with lower premiums and modest out-of-pocket cost-sharing. Here's how they compare.
Key takeaways
- Plan G covers everything Plan F used to cover, except the small Part B annual deductible (~$257 in 2026).
- Plan N has lower premiums (often $30-50/month less than Plan G) but adds small office visit ($20) and ER ($50) copays plus the Part B deductible.
- Plan N also doesn't cover Part B excess charges — extra fees from doctors who don't accept Medicare assignment. This matters in some states more than others.
- If you see doctors often, Plan G usually wins. If you're a healthy beneficiary who rarely sees doctors, Plan N often wins.
What Plan G covers
Plan G is the most comprehensive Medigap plan still available to new Medicare beneficiaries (Plan F was retired for new enrollees in 2020). Plan G covers:
- Part A hospital deductible (~$1,676 in 2026)
- Part A coinsurance and 365 additional hospital days after Medicare benefits end
- Part B coinsurance (the 20% Medicare doesn't pay)
- Part B excess charges (extra fees from non-assignment doctors)
- Skilled nursing facility coinsurance
- First 3 pints of blood
- Hospice care coinsurance
- 80% of foreign travel emergency care (up to plan limits)
What Plan G does NOT cover: the small Part B annual deductible (~$257 in 2026). You pay that once a year, then Plan G picks up everything else.
Typical 2026 Plan G premiums: $130-220/month for a healthy 65-year-old, varying by state, age, gender (in some states), tobacco use, and carrier.
What Plan N covers
Plan N covers the same big-ticket items as Plan G — hospital deductibles, coinsurance, hospice — but with three differences that lower its premium:
- Part B deductible: NOT covered (you pay ~$257/year out of pocket).
- Office visit copay: Up to $20 per office visit.
- ER copay: Up to $50 per ER visit (waived if you're admitted).
- Part B excess charges: NOT covered. If your doctor doesn't accept Medicare assignment, you pay the extra (up to 15% above Medicare-approved amounts).
Typical 2026 Plan N premiums: $90-170/month for a healthy 65-year-old — typically $30-50/month less than Plan G in the same market.
The doctor-visit math
Whether Plan G or Plan N saves more depends on how often you see doctors and what your premium delta is. A worked example:
Say Plan G is $180/month and Plan N is $140/month — a $40/month difference, or $480/year of premium savings on Plan N.
On Plan N, you'd pay the $257 Part B deductible + $20 per office visit. To use up that $480 savings, you'd need to see the doctor about 11 times in a year (after the deductible).
If you see your doctors 6 times a year, Plan N saves you about $300 net.
If you see your doctors 15 times a year, Plan G saves you about $40 net.
If you have an unexpected ER visit, you pay the $50 copay on Plan N — typically not enough to flip the math.
The Part B excess charge issue
Most doctors accept Medicare "assignment" — meaning they take Medicare's approved fee as full payment. But some don't, and they can charge up to 15% extra. This is called a Part B excess charge.
Plan G covers excess charges. Plan N doesn't.
In states where non-assignment is common (parts of New York, Pennsylvania, and a few others), Plan G's excess-charge coverage matters more. In states where almost all doctors accept assignment (most of the country), it rarely comes into play.
Eight states ban Part B excess charges entirely: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. In those states, Plan N gives up almost nothing on the excess-charge issue.
Who typically picks which
Plan G is usually right for:
- People who see doctors frequently, have chronic conditions, or expect significant medical care.
- People who want the most comprehensive Medigap coverage available to new beneficiaries.
- People who want predictable monthly costs with very little out-of-pocket variability.
- People in states where Part B excess charges are common.
Plan N is usually right for:
- Healthy beneficiaries who rarely visit doctors (5-8 visits/year or fewer).
- Cost-conscious enrollees who want the lowest Medigap premium that still gives most of Plan G's protection.
- People in states that ban excess charges (8 states above) — where Plan N gives up almost nothing relative to Plan G.
Calculate your Plan G vs Plan N break-even
Enter your monthly premiums and how often you see the doctor. We'll show which plan saves you more — and your annual out-of-pocket difference.
Plan N has $20 office copays and $50 ER copays. Excess charges (up to 15%) not modeled — pick a guaranteed-issue state or assume Plan N participating providers only.
Questions about your specific situation?
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