Medigap Plan G vs Plan N: Real Cost Differences

When you are shopping for a Medicare Supplement (Medigap) policy, you quickly realize that two options dominate the conversation: Plan G and Plan N. Because legislative changes in 2020 removed older plans from the market for new enrollees, the Plan G vs Plan N debate is now the most important decision you will make regarding your supplemental coverage.

Both plans offer excellent, comprehensive coverage that fills the gaps left behind by Original Medicare. They both allow you to see any doctor or specialist in the United States who accepts Medicare, without needing referrals. They both protect you from catastrophic hospital bills. However, they take two very different approaches to your monthly budget and your out-of-pocket costs at the doctor's office.

Choosing the right plan requires looking past the sales pitches and doing the actual math. In this guide, we will break down the exact dollar-for-dollar differences between Plan G and Plan N using official 2026 Medicare figures. We will explore how copays work, the reality of excess charges, and how to calculate which plan makes the most financial sense for your specific healthcare needs.

Plan G vs Plan N: The Core Coverage Differences

To understand how these plans compare, you first need to know why they are the top choices. In 2020, a law called MACRA took effect, stating that anyone who became eligible for Medicare on or after January 1, 2020, could no longer buy Medigap Plans C or F. Those older plans covered the Medicare Part B deductible. Today, no Medigap plan available to new enrollees is legally allowed to cover the Part B deductible.

Because of this rule, Plan G became the most comprehensive plan available to new enrollees, and Plan N became the most popular budget-friendly alternative. Let's look at how their core benefits compare side-by-side.

As the table shows, the plans are identical in how they handle massive hospital bills and foreign travel emergencies. The differences all boil down to three specific things: office copays, emergency room copays, and Part B excess charges. In exchange for taking on those potential out-of-pocket costs, Plan N rewards you with a lower monthly premium.

How the $283 Part B Deductible Applies to Both Plans

The most common point of confusion when comparing Plan G and Plan N is the Medicare Part B deductible. In 2026, the official Part B deductible set by the Centers for Medicare & Medicaid Services (CMS) is $283. It is vital to understand that neither Plan G nor Plan N covers this deductible.

Here is exactly how this works in the real world. Let's say it is January, and you go to the doctor for a specialized test. The doctor bills Medicare, and the Medicare-approved amount for the test is $300. Because it is the beginning of the year, you have not paid any of your Part B deductible yet.

Medicare will process the claim and apply the first $283 to your deductible. You are responsible for paying that $283 directly to the doctor. The remaining balance of the bill is $17. Medicare pays 80% of that $17, and your Medigap plan (whether you have G or N) pays the remaining 20%.

For the rest of the calendar year, your Part B deductible is satisfied. This is where the plans split paths. If you have Plan G, you will pay absolutely nothing for covered medical services for the rest of the year. If you have Plan N, you will begin paying copays for certain visits. Because both plans require you to shoulder this $283 burden first, you must factor it into your annual healthcare budget regardless of which plan you choose.

How Plan G and Plan N Handle Part A Hospital Costs

While we spend a lot of time talking about doctor visits, the true purpose of a Medicare Supplement plan is to protect you from bankruptcy in the event of a catastrophic hospital stay. Medicare Part A covers inpatient hospital care, but it comes with a hefty deductible.

In 2026, the Part A deductible is $1,736. Unlike the Part B deductible, the Part A deductible is not an annual figure. It applies per "benefit period." A benefit period begins the day you are admitted to the hospital and ends when you have been out of the hospital for 60 consecutive days. If you go back to the hospital after those 60 days, you face another $1,736 deductible.

This is where both Plan G and Plan N prove their immense value. Both plans cover the $1,736 Part A deductible in full. Whether you go to the hospital once in a year or three separate times in different benefit periods, both Plan G and Plan N will absorb those deductible costs entirely. Furthermore, both plans cover your Part A coinsurance and provide up to an additional 365 days of hospital coverage after your Original Medicare benefits are exhausted.

When it comes to inpatient hospital care, Plan G and Plan N are identical. You do not sacrifice any hospital protection by choosing the less expensive Plan N.

Understanding Plan N Copays for Office and ER Visits

Once your annual Part B deductible is met, Plan N requires you to pay copays. However, these are not fixed, flat-rate copays like you might be used to from an employer-sponsored health insurance plan. The rules are specific, and understanding them is key to deciding if Plan N is right for you.

The "Up to $20" Office Visit Copay

Plan N requires a copay of up to $20 for an office visit. The phrasing "up to" is important. If the 20% coinsurance that Medicare leaves behind is less than $20, you only pay that smaller amount. If the 20% coinsurance is $40, your copay is capped at $20, and Plan N pays the rest.

This copay applies to visits with primary care doctors and specialists. However, it does not apply to everything. For example, if you go to a facility simply to get lab work done or receive a physical therapy treatment without seeing the actual doctor for an evaluation and management visit, the $20 copay typically does not apply. Preventive care services that are fully covered by Medicare (like your annual wellness visit) also do not trigger a copay.

The "Up to $50" Emergency Room Copay

If you visit the emergency room on Plan N, you will face a copay of up to $50. However, there is a major exception built into this rule: if you are admitted to the hospital as an inpatient, the $50 ER copay is waived.

This waiver exists because once you are admitted, your care falls under Medicare Part A (inpatient hospital care), and as we established earlier, Plan N covers Part A costs completely. The $50 copay only applies if you are treated in the ER and subsequently discharged to go home.

If you prefer to avoid copays entirely because you dislike the feeling of being "nickeled and dimed" every time you seek medical care, Plan G is the clear winner. With Plan G, once your $283 deductible is met, you simply walk out of the doctor's office without opening your wallet.

Part B Excess Charges: How Big Is the Financial Risk?

The single biggest fear most people have when considering Plan N is the lack of coverage for Part B excess charges. Plan G covers them; Plan N does not. But what exactly is an excess charge, and how likely are you to face one?

Most doctors in the United States "accept Medicare assignment." This means they have signed an agreement with Medicare to accept the Medicare-approved amount as payment in full for their services. If a doctor accepts assignment, they cannot legally bill you for an excess charge.

However, a small percentage of doctors are "non-participating." They still see Medicare patients, but they do not accept assignment. Federal law allows these non-participating doctors to charge up to 15% more than the Medicare-approved amount. This 15% surcharge is the "excess charge."

For example, if Medicare approves $1,000 for a surgical procedure, a non-participating doctor can add a 15% excess charge, bringing the total bill to $1,150. Medicare will pay 80% of the original $1,000 ($800). Your Medigap plan will pay the remaining 20% of the original $1,000 ($200). If you have Plan N, you are responsible for paying the $150 excess charge out of your own pocket. If you have Plan G, the plan pays that $150 for you.

The Reality of Excess Charges

While the math sounds intimidating, the actual risk is incredibly low. According to the Medicare Payment Advisory Commission (MedPAC), fewer than 1% of all Medicare claims nationwide include an excess charge. The vast majority of providers simply accept Medicare assignment.

Furthermore, if you live in certain states, your risk of facing an excess charge is literally zero. Eight states have passed laws known as "MOM" (Medicare Overcharge Measure) laws, which strictly ban doctors from billing excess charges to Medicare patients. As of our current data, these states are:

• Connecticut
• Massachusetts
• Minnesota
• New York
• Ohio
• Pennsylvania
• Rhode Island
• Vermont

If your primary residence is in one of these eight states, Plan N becomes an incredibly attractive option. The main negative feature of Plan N—the lack of excess charge coverage—is completely neutralized by state law, leaving you to enjoy the lower premiums without the risk.

The Underwriting Trap: Can I Switch From Plan N to Plan G Later?

A common strategy people attempt is to enroll in the cheaper Plan N while they are healthy in their 60s, with the intention of "upgrading" to Plan G if they develop a chronic illness in their 70s. This is a dangerous misconception that can lead to severe financial consequences.

When you first enroll in Medicare Part B at age 65 or older, you trigger your Medigap Open Enrollment Period. This is a one-time, six-month window. During these six months, you have "guaranteed issue" rights. This means insurance companies must sell you any Medigap policy they offer, at the best available rate, regardless of your health history. They cannot ask you medical questions or deny you coverage.

Once that six-month window closes, your guaranteed issue rights generally vanish. If you have Plan N and decide three years later that you want to switch to Plan G, the insurance company will require you to go through medical underwriting. You will have to answer a long questionnaire about your health history, recent hospitalizations, pending surgeries, and chronic conditions like heart disease, diabetes, or cancer.

If the insurance company determines you are too high of a risk, they can legally deny your application to switch plans, or they can approve you but charge a significantly higher monthly premium. Therefore, you must choose your Medigap plan with the assumption that you will keep it for the rest of your life. Do not rely on the ability to switch Medigap plans during open enrollment later, as the annual fall open enrollment period applies to Medicare Advantage and Part D drugs, not Medigap guaranteed issue.

How to Calculate Your Break-Even Point Between G and N

Because Plan N requires copays but charges a lower monthly premium, there is a mathematical "break-even" point where the cost of the two plans intersects. Finding this point requires looking at the average premium differences and estimating your annual doctor visits.

Based on 2026 market data for a 65-year-old, Plan G premiums average between $177 and $220 per month. Plan N premiums average between $155 and $171 per month. For our example, let's use a conservative, middle-of-the-road estimate: let's say Plan G costs $200 per month, and Plan N costs $160 per month.

That is a difference of $40 per month, or $480 in premium savings per year by choosing Plan N.

To wipe out that $480 in savings, you would have to pay quite a few $20 office copays. Specifically, you would need to visit the doctor 24 times in a single calendar year ($480 divided by $20 = 24). Let's look at how this plays out for different types of healthcare users.

As the math shows, Plan N is almost always the better financial value unless you are going to the doctor more than twice a month, every single month of the year. However, math is only half the equation. Peace of mind is the other half. Many seniors gladly pay the extra $480 a year for Plan G simply so they never have to worry about pulling out a checkbook at the front desk. The predictability of a fixed monthly cost is highly valuable on a fixed retirement income.

Factoring in Total Costs: Part B and Part D Changes for 2026 and 2027

A major mistake consumers make is choosing a Medigap plan in a vacuum. Your Medigap premium is just one piece of your overall Medicare budget. You also have to pay your Original Medicare Part B premium, and you must purchase a standalone Part D prescription drug plan.

In 2026, the standard Part B premium is $202.90 per month. The Medicare Trustees Report projects this will rise to roughly $209.50 per month in 2027. You must pay this premium to the government regardless of which Medigap plan you choose.

More importantly, major legislative changes are reshaping Medicare Part D. The Inflation Reduction Act is ending temporary stabilization programs in 2027, which is altering the landscape of drug coverage. In 2027, the Part D out-of-pocket maximum cap will be permanently set at $2,400, and the maximum allowable Part D deductible will rise to $700. Because insurance companies are absorbing more of the drug costs under this new cap, standalone Part D premiums are rising.

Why does this matter for the Plan G vs Plan N debate? Because your total fixed costs are increasing. If you are on a strict budget, the $40 to $50 a month you save by choosing Plan N instead of Plan G might be exactly what you need to afford the rising premiums of your Part D drug plan. When fixed costs rise in one area of Medicare, finding safe savings in another area becomes critical.

The Impact of Rate Increases: Will Plan G or Plan N Cost More Over Time?

When you buy a Medigap policy, the premium you pay at age 65 will not be the premium you pay at age 75. Insurance carriers raise their rates over time due to inflation and the rising cost of medical care. A crucial factor to consider is how these rate increases affect Plan G compared to Plan N.

Historically, Plan N has often experienced slightly lower, more stable annual rate increases than comprehensive plans like Plan G or the older Plan F. The reasoning is tied to human behavior. Because Plan G covers 100% of costs after the deductible, enrollees have no financial disincentive to visit the doctor. If a Plan G enrollee has a minor sniffle, they might go to the doctor because it is "free." This drives up the total claims the insurance company has to pay out.

Plan N enrollees, on the other hand, know they have to pay a $20 copay. This small financial hurdle acts as a deterrent against frivolous doctor visits. Because Plan N enrollees tend to file fewer small claims, the insurance pool remains slightly healthier and less expensive for the carrier to maintain, which can result in gentler annual premium increases.

While we can never guarantee future rate increases, historical market data suggests that the price gap between Plan G and Plan N often widens as you age. The $40 monthly savings you see at age 65 could easily become an $80 monthly savings by the time you are 75.

Common Mistakes When Choosing Between Plan G and Plan N

Navigating Medicare is difficult, and even small misunderstandings can lead to expensive errors. Here are the most common mistakes we see consumers make when deciding between these two plans:

• Ignoring state laws on excess charges: If you live in one of the eight states that ban excess charges (like New York or Ohio), paying extra for Plan G simply to get excess charge protection is a waste of money. You are buying coverage for a risk that does not legally exist in your state.
• Assuming "up to $20" means exactly $20 every time: People often overestimate their Plan N copays. If your doctor visit only generates a $12 coinsurance bill, your copay is $12, not $20.
• Forgetting that ER copays are waived if admitted: Fear of a $50 ER bill pushes many people to Plan G. They forget that if the emergency is severe enough to require hospital admission, Plan N waives the copay entirely.
• Planning to "just upgrade later": As discussed, medical underwriting is a massive hurdle. You should never buy Plan N assuming you can easily switch to Plan G if you get cancer or require a knee replacement.

Which Plan Fits Your Budget and Healthcare Use?

There is no universally "best" plan. The right choice depends entirely on your financial personality, your health, and your state of residence. Use this short checklist to help finalize your decision.

You should seriously consider Plan G if:

• You prefer predictability and want a strict, fixed monthly healthcare budget.
• You suffer from chronic health conditions that require frequent visits to specialists.
• You travel frequently to different states and want absolute zero risk of encountering a Part B excess charge.
• You simply hate the administrative hassle of receiving small bills in the mail or paying copays at the front desk.

You should seriously consider Plan N if:

• You are generally healthy and only visit the doctor a few times a year.
• You live in one of the eight states that legally ban Part B excess charges.
• You are comfortable doing a little math and paying small copays in exchange for long-term premium savings.
• You need to free up room in your monthly budget to account for rising Medicare Part D drug costs.

How to Compare Medicare Supplement Rates on Rebel Rates

Understanding the difference between Plan G and Plan N is only the first step. Because Medigap plans are standardized by the government, a Plan G from one company offers the exact same medical benefits as a Plan G from another company. The only difference is the price.

That is why comparing rates from multiple carriers is absolutely essential. Insurance companies charge wildly different premiums for the exact same coverage based on your zip code, gender, and age. At Rebel Rates, we believe in giving you the plain truth without the sales pressure.

You can compare Medicare quotes directly on our site to see real numbers for your specific area. If you want to explore all of your insurance options, including life and final expense, head over to the Rebel Rates home page to start your independent research. No BS, just the lowest rates.