Updated June 17, 2026
Plan G and Plan N both cover the Medicare Part A deductible, skilled nursing facility coinsurance, and foreign travel emergencies, but Plan G covers Part B excess charges and has no office-visit copays, while Plan N costs less per month and charges up to $20 copays for office visits and up to $50 for emergency room visits that do not result in inpatient admission. Neither plan covers the Part B deductible for 2020-and-later enrollees.
What Both Plans Cover
Because Medigap plans are federally standardized, Plan G and Plan N from any insurer must include the same core benefits. You can review the full standardized benefit chart at the Medicare.gov Medigap plan finder. Both plans include:
- Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are used.
- Medicare Part A deductible (which is $1,676 per benefit period in 2025).
- Medicare Part A hospice care coinsurance or copayment.
- Skilled nursing facility care coinsurance.
- Medicare Part B coinsurance or copayment (with the copay exception for Plan N noted below).
- Foreign travel emergency coverage (up to plan limits).
- Blood (first three pints).
Where Plan G and Plan N Differ
| Feature | Plan G | Plan N |
|---|---|---|
| Part B excess charges | Covered | NOT covered |
| Office visit copays | None | Up to $20 per visit |
| Emergency room copay (non-admission) | None | Up to $50 |
| Monthly premium (relative) | Higher | Lower |
| Part B deductible | Not covered* | Not covered* |
*People who first became eligible for Medicare on or after January 1, 2020 cannot purchase plans that cover the Part B deductible under federal law. Plan F, which covered the deductible, is no longer available to this group.
Understanding Part B Excess Charges
Medicare sets an approved amount for each covered service. Most doctors accept Medicare assignment, meaning they agree to accept that approved amount as payment in full. However, providers who do not accept assignment can charge up to 15 percent above the Medicare-approved amount. That additional amount is called a Part B excess charge. Plan G pays this; Plan N does not.
In practice, excess charges are rare. According to data published by CMS, the large majority of Medicare-participating providers accept assignment. If your doctors and specialists all accept Medicare assignment, Plan N's exposure to excess charges may matter very little. If you live in a state (such as Massachusetts, Minnesota, or Ohio) that bans excess charges by law, Plan N's only meaningful difference from Plan G is the office-visit and ER copays.
How to Do the Math
The most useful comparison is a simple break-even calculation:
- Find the monthly premium difference between Plan G and Plan N from the same insurer in your ZIP code.
- Multiply that difference by 12 to get the annual premium savings with Plan N.
- Estimate how many doctor visits you average per year and multiply by $20.
- Add any expected ER visits (up to $50 each).
- If your estimated copays are less than your annual premium savings, Plan N may come out ahead for you.
You can run this comparison quickly using the Medigap cost calculator, which lets you enter your usage assumptions and see an estimated annual total for each plan type.
Who Plan G Tends to Suit
- People who see specialists frequently and want zero copays at each visit.
- People who see providers that do not accept Medicare assignment.
- People who value the simplicity of knowing Medicare and Medigap together will cover nearly all Part A and Part B costs.
- People in states that do not ban excess charges and who want protection against them.
Who Plan N Tends to Suit
- Generally healthy people who have few doctor visits per year.
- People whose providers all accept Medicare assignment, eliminating excess charge risk.
- People in states that prohibit excess charges, where Plan N's only cost exposure is copays.
- People who want lower monthly premiums and are comfortable with small, predictable copays.
Premium Differences and Long-Term Trends
Premium gaps between Plan G and Plan N vary by insurer, location, age, and gender. In many markets, Plan N premiums run $20 to $50 per month less than Plan G for the same applicant. Over a decade, that difference compounds. However, insurer pricing practices and rate increase histories matter. Comparing multiple carriers for both plans before enrolling is important. Medicare.gov lists licensed insurers in your area, and a SHIP counselor can help you compare carrier-specific rate histories at no cost.
Pricing Methods: Community, Issue-Age, and Attained-Age
Medigap insurers use one of three methods to set premiums:
- Community-rated: Everyone in the plan pays the same premium regardless of age.
- Issue-age-rated: Premium is based on your age when you first buy the policy and does not increase as you get older (though it may increase for inflation).
- Attained-age-rated: Premium is based on your current age and rises as you age.
Understanding which method an insurer uses is as important as the initial premium quote, especially when comparing Plan G vs Plan N over a 10- or 20-year horizon.
High-Deductible Plan G: A Third Option Worth Knowing
For completeness, there is a High-Deductible Plan G (HDG) available in many states. HDG carries a significantly lower monthly premium than standard Plan G, but you pay all Medicare cost-sharing out of pocket until you reach a federally set annual deductible ($2,870 in 2025). After that deductible, HDG covers the same costs as standard Plan G.
High-Deductible Plan G is worth considering if you are generally healthy, want very low monthly premiums, and are comfortable absorbing up to the deductible amount in a bad year. It is not a match for people who anticipate frequent hospitalizations or significant specialist use, since you would likely reach the deductible and might have been better served by standard Plan G.
The Role of Insurer Selection
Because Plan G from one insurer must offer the same core benefits as Plan G from another insurer, the main variables when comparing insurers are premium, premium pricing method, customer service reputation, and rate increase history. The same logic applies to Plan N.
Rate increase history matters because some insurers offer low initial premiums but raise rates aggressively after the first year or two as the insured pool ages. An attained-age-rated policy may start cheaper than a community-rated or issue-age-rated policy but can become significantly more expensive by your 70s or 80s. Asking an insurer for its historical rate increase data for the specific plan you are considering is a reasonable and important step before committing.
A SHIP counselor in your state can help you access carrier-specific rate histories and compare options without any commission motive. You can also verify insurer licensing and complaint records through your state insurance department, and review plan information at Medicare.gov.
Making Your Decision
The Plan G vs Plan N decision ultimately comes down to a personal risk tolerance and utilization calculation. If you see your doctor frequently, visit specialists without referrals, or simply value the peace of mind of knowing there will be no copays or excess charge surprises, Plan G is the more comprehensive choice. If you are in good health, have few routine visits, and your providers all accept Medicare assignment, Plan N's lower premium can deliver genuine savings year over year.
Whatever you decide, enroll during your Medigap Open Enrollment Period when possible to secure guaranteed-issue rights, and always verify current premium information at Medicare.gov or through a licensed insurer before applying.
Related reading
- Medigap vs Medicare Advantage: key differences in cost, coverage, and flexibility explained so you can choose the right plan for your needs.
- Your best window to buy Medigap is the 6-month Open Enrollment Period starting when you turn 65 and enroll in Part B. After that, medical underwriting usually applies.