Medigap Plan G vs. Plan N: Which Costs Less Over Time?

If you are shopping for a Medicare Supplement policy, two names come up more than any others: Plan G and Plan N. They cover most of the same things, they are sold in most states, and the monthly premium for Plan N is usually lower. The real question is whether that lower premium still wins after you add up the costs Plan N leaves to you.

This guide works through that question with arithmetic rather than adjectives. The aim is to give you a simple break-even test you can run with the actual quotes you receive, because premiums vary widely by insurer, ZIP code, age, and pricing method, and we will not quote any company's rates here.

The Short Version

Plan G and Plan N are both standardized Medigap plans. Under Medicare rules, a plan with the same letter must offer the same basic benefits no matter which company sells it, so the main differences between insurers are price and service.

Plan G pays everything Plan N pays and a bit more. Neither plan pays the Medicare Part B deductible, which is $283 in 2026. After that, Plan G covers your remaining Part B coinsurance and also covers Part B excess charges. Plan N covers Part B coinsurance too, 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, and Plan N does not cover excess charges.

So Plan N trades a lower premium for some small, predictable costs and one less predictable one.

What Each Plan Covers, Side by Side in Plain Words

Both plans pay the Medicare Part A coinsurance and hospital costs for an additional 365 days after Medicare benefits are used up. Both pay the Part A deductible, which is $1,736 per benefit period in 2026. Both pay the Part A hospice coinsurance or copayment, the first three pints of blood, skilled nursing facility coinsurance, and 80% of foreign travel emergency costs up to plan limits.

On the Part B side, both leave the annual Part B deductible to you. After the deductible, Medicare generally pays 80% of approved amounts and you owe 20%. Plan G pays that 20%. Plan N pays it too, minus the office and emergency room copays described above.

The last difference is the Part B excess charge. Doctors who do not accept Medicare assignment can charge up to 15% more than the Medicare-approved amount. Plan G pays that excess. Plan N does not, so you would owe it.

Building a Break-Even Test

Here is the core question: does the yearly premium savings on Plan N exceed the extra costs Plan N would leave you with in a typical year? To answer it, you need four numbers.

First, the monthly premium for Plan G and for Plan N from the same insurer or comparable insurers in your area. Second, the number of doctor and specialist office visits you expect in a year. Third, whether you have had emergency room visits that did not lead to an admission. Fourth, whether your doctors accept Medicare assignment.

Multiply the monthly premium gap by 12 to get the annual savings for Plan N. Then estimate Plan N's extra costs: up to $20 times the office visits that trigger a copay, plus up to $50 for each qualifying emergency room visit, plus any excess charges from doctors who do not accept assignment.

Example 1: A Fairly Healthy New Enrollee

The numbers below are hypothetical and are not quotes from any insurer.

Example: Dolores Martinez, 65, lives in Albuquerque and receives two quotes from the same company: $160 a month for Plan G and $120 a month for Plan N. The gap is $40 a month, or $480 a year.

Dolores sees her primary care doctor twice a year and a dermatologist once. Assuming each visit triggers the full $20 copay, that is $60. She has not been to the emergency room in years, and all her doctors accept assignment.

Her estimated extra cost on Plan N is $60, against $480 in premium savings. In this example, Plan N comes out about $420 ahead for the year. Even if she added an unexpected emergency room visit, the extra $50 would still leave her well ahead.

Example 2: A Frequent Specialist User

Example: Walter Nguyen, 71, lives in Sacramento and is managing heart and kidney conditions. With the same hypothetical $40 monthly gap, Plan N would save him $480 a year in premiums.

Walter sees specialists often. Assume 20 office visits that each trigger the full $20 copay, which is $400, plus two emergency room visits that did not lead to admission at $50 each, which is $100. His extra cost on Plan N is about $500, slightly more than the $480 he saves.

Now suppose one of his specialists does not accept assignment and bills $3,000 in Medicare-approved amounts over the year. The excess charge could be up to 15%, or $450, which Plan N would not cover. In this example, Plan G would cost Walter less overall, and it would also make his costs more predictable.

Why Plan F Is Not in This Comparison

Many older guides compare Plan G with Plan F, which also covers the Part B deductible. Under Medicare rules, plans that cover the Part B deductible, including Plan F and Plan C, are not available to people who became newly eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy one. For most people turning 65 now, though, Plan G is the most comprehensive standardized option on the market, which is why the practical choice tends to come down to G versus N.

That also explains why the Part B deductible appears in every scenario above. Whichever of these two plans you choose, you pay that deductible yourself each year, so budget for it separately.

The Excess Charge Question

Excess charges are the wildcard in the Plan N math. In many areas, most doctors accept assignment, which means excess charges never come up. Some states also limit or prohibit excess charges. If you live in such a state, or if all your doctors accept assignment, Plan N's exposure is smaller.

To check, ask each doctor's office whether they accept Medicare assignment, or use Medicare's online tools to look up providers. If you plan to see specialists at a large academic medical center, ask specifically about the specialists, not just your primary care physician.

Premiums Over Time: The Part Most Comparisons Skip

Your break-even test is a one-year snapshot, but you will likely hold the policy for many years. Two things affect how the comparison changes over time.

The first is how the insurer sets its prices. Medigap policies are generally priced one of three ways. Community-rated policies charge the same premium to everyone in an area regardless of age. Issue-age-rated policies set the premium based on your age when you buy, so it does not rise just because you get older. Attained-age-rated policies base the premium on your current age, so it increases as you age. All three can still rise due to inflation and other factors.

The second is that premiums generally go up over time. Medicare notes that insurers may offer discounts, such as for nonsmokers, women, or paying annually, and those can change the numbers. When you compare G and N, compare the same pricing method from the same insurer if you can, and ask how much each plan's premium has increased in recent years.

Because the gap between G and N is driven by dollars rather than percentages, the break-even point can shift. If both premiums rise 8% in a year, the dollar gap also grows, and so does Plan N's savings. If your health needs grow at the same time, the copay side grows too. Re-run the test each year with real numbers.

The High-Deductible Plan G Option

There is a third option worth knowing about. In some states, insurers offer a high-deductible version of Plan G. It covers the same benefits as Plan G but only after you pay a deductible, which is $2,950 in 2026. Premiums for high-deductible plans are typically lower.

High-deductible G can appeal to people who are healthy and have savings to cover the deductible if needed. The tradeoff is that a bad year could cost you several thousand dollars before the plan pays. Run the same break-even approach: compare the annual premium savings against the deductible you could owe.

Timing Matters More Than the Plan Letter

The best time to buy any Medigap policy is during your Medigap Open Enrollment Period. It is a one-time, six-month window that starts the first month you have Medicare Part B and are 65 or older. During that window, insurers generally cannot use medical underwriting to deny you a policy or charge you more because of your health, although a waiting period for preexisting conditions may apply in some cases.

After that window closes, insurers in many states can use medical underwriting. That could mean a higher premium or a denial. This matters for the G versus N choice in a practical way: if you start with Plan N to save money and later want to switch to Plan G, you may have to answer health questions. Some states give additional rights to switch, so check with your State Health Insurance Assistance Program.

What We Do Not Know Yet for 2027

The Part B deductible matters to both plans because neither covers it. As of November 1, 2026, the Centers for Medicare and Medicaid Services had not announced the 2027 Part B premium or deductible on its website, so we cannot give 2027 figures here. In 2026, the standard Part B premium is $202.90 a month and the deductible is $283. When CMS publishes the 2027 amounts, plug them into your budget, but note that they do not change the G versus N comparison much, since both plans treat the deductible the same way.

A Simple Checklist Before You Choose

Get quotes for G and N from at least two or three insurers, using the same pricing method where possible. Count your typical office visits from last year's Medicare Summary Notices. Ask your doctors whether they accept assignment. Check whether your state limits excess charges. Ask each insurer about available household or payment discounts. And note your Open Enrollment window so you do not lose guaranteed access.

Your State Health Insurance Assistance Program offers free, unbiased counseling and can help you compare offers in your area.

The Bottom Line

Pull last year's Medicare Summary Notices, count the visits, and call your doctors' billing offices before you sign anything. Those three steps take an afternoon, and they will tell you more about your real costs than any general rule can.