Medigap Plan G vs Plan N
Written by My65 Playbook Editorial Team
Last reviewed
Medigap plans are standardized by federal law under 42 U.S.C. § 1395ss. That means a Plan G is a Plan G and a Plan N is a Plan N — the letter defines the benefits, and every company selling that letter sells the same coverage. So this comparison is not about finding a better version of either one. It is about which cost-sharing structure suits how you actually use care.
How to think about this
Because the benefits inside each letter are fixed by statute, the question is not which plan is better but where you would rather absorb small costs. Plan G removes almost all cost sharing after the annual Part B deductible, so what you pay is concentrated in the premium. Plan N keeps the same broad structure but leaves a few things with you: modest copays at some visits, and exposure to what are called Part B excess charges. If you rarely see a doctor, that trade can work in your favour. If you see specialists often, the copays add up quietly.
At a glance
| What changes | Plan G | Plan N |
|---|---|---|
| Part A hospital coinsurance | Covered in full, as the standardized benefit requires. | Covered in full. Identical to Plan G on this point. |
| Part B annual deductible | Not covered. You pay it once a year, then coverage begins. | Not covered. Same as Plan G. |
| Copays at office and emergency visits | None. After the deductible, covered visits leave nothing to pay. | A set copay may apply at some office visits and emergency visits that do not lead to admission. |
| Part B excess charges | Covered. If a provider is permitted to bill above the Medicare-approved amount, the plan absorbs it. | Not covered. That difference is yours to pay if you see a provider who bills that way. |
| Where your costs sit | Almost entirely in the monthly premium, which makes budgeting simple. | Split between a lower premium and small amounts at the point of care. |
| Foreign travel emergency care | Included at the standardized level. | Included at the same standardized level. |
Plan G
- You see doctors or specialists often enough that per-visit copays would accumulate.
- You want the most predictable possible year, with almost everything in one monthly figure.
- You would rather not have to check whether a provider accepts the Medicare-approved amount as full payment.
- You value simplicity over squeezing out the last bit of monthly savings.
Plan N
- You see doctors rarely and a copay at those few visits does not concern you.
- You are comfortable confirming that your providers accept assignment, so excess charges never arise.
- You would rather keep the monthly cost lower and handle small amounts as they come.
- Your regular providers are in a market where billing above the approved amount is uncommon.
Watch out for
- Excess charges are the difference that catches people out. They only arise with providers who do not accept the Medicare-approved amount as payment in full, and how common that is depends heavily on where you live — a few states effectively prohibit the practice altogether. Because it varies by state and even by specialty, it is worth confirming for your own doctors rather than assuming the national picture applies to you.
- Standardization means the coverage is identical between companies, but the price and the service are not. Since the benefits inside a letter cannot differ, comparing letters is the useful exercise; comparing the same letter across companies is a question about cost and service, not coverage.
- The copays in Plan N apply per visit, so their impact is entirely a function of how often you go. Two people with the same plan can have very different years. Estimate from how you actually used care last year, not from how you hope to use it.
- Neither letter covers prescription drugs. Whichever you choose, you would enrol in a separate Part D plan, and enrolling on time matters — going without creditable drug coverage can create a lasting late-enrollment penalty.
Common questions
- Is Plan G from one company better than Plan G from another?
- The coverage cannot differ. Federal standardization fixes what each letter includes, so every Plan G provides the same benefits. What differs between companies is price, rate history and service — not what is covered.
- What exactly is a Part B excess charge?
- Some providers are permitted to bill more than the amount Medicare approves for a service. That difference is the excess charge. Plan G covers it; Plan N does not. Providers who accept assignment never bill it, and in a few states the practice is not allowed at all.
- Which one costs less overall?
- It depends entirely on how much care you use. Plan N carries a lower premium but leaves copays and possible excess charges with you, so a year with many specialist visits can erase the difference. Plan G concentrates the cost in the premium and leaves very little at the point of care.
- Can I switch from Plan N to Plan G later?
- Sometimes, but it is not guaranteed. Outside your one-time Medigap open enrollment window, an insurer may be allowed to review your health before accepting you, and the rules on that vary considerably by state. Worth confirming what applies where you live before assuming you can move later.