Medicare Supplement Plan G vs Plan N: Which Medigap Plan Should You Choose in 2026?

This article is for general educational purposes only and is not insurance, medical, or financial advice. We are not affiliated with the U.S. government or Medicare. For official information, visit Medicare.gov or call 1-800-MEDICARE. See our Medical & Financial Disclaimer for details.

Once you have decided on Medigap rather than Medicare Advantage, the next question is nearly always Plan G or Plan N. The good news is that this is a much smaller decision than the one you have just made, because the two plans differ in exactly two places. Everything else about them is identical, by federal law.

This article sets out those two differences, and then gives you the arithmetic to work out which is cheaper for you, rather than a rule of thumb that assumes a person you may not be.

The Two Differences, and Nothing Else

Medigap benefits are set in federal law, and Medicare’s own guide is blunt about what that means: “Price is the only difference between policies with the same letter” sold by different companies. Within that framework, here is where G and N part company.

One: copayments. Plan N pays 100% of your Part B coinsurance, but you pay up to $20 for some office visits and up to $50 for an emergency room visit that does not end in admission. Plan G has neither charge. Note the emergency room rule: if you are admitted, the copayment does not apply.

Two: Part B excess charges. Plan G covers them. Plan N does not. An excess charge arises when a doctor has not accepted Medicare’s approved amount as full payment. Medicare says most providers do accept assignment, and where one does not, the charge in many cases cannot exceed 15% above the approved amount. So this is a capped, uncommon risk rather than an open-ended one — but “uncommon” is a statement about the country, not about your own specialist, and it is worth asking the specific question of any doctor you see regularly.

Everything else is the same on both: the Part A hospital deductible and coinsurance, 365 extra hospital days, Part B coinsurance, the first three pints of blood, hospice coinsurance, skilled nursing coinsurance and foreign travel emergency care at 80%. Both leave you the annual Part B deductible, $283 in 2026. Neither covers prescription drugs, so both need a separate Part D plan alongside.

	Plan G	Plan N
Part B deductible	$283 in 2026	$283 in 2026
Office visit	Nothing	Up to $20
Emergency room, not admitted	Nothing	Up to $50
Part B excess charges	Covered	Not covered, capped at 15% above the approved amount
Hospital and skilled nursing coinsurance	Covered	Covered
Foreign travel emergency	80%, to plan limits	80%, to plan limits
Prescription drugs	Not covered	Not covered
Monthly premium	Higher	Lower

The Arithmetic, With Your Numbers

We do not publish an average premium gap between the two, because Medigap rates are filed state by state and vary with your age, sex, ZIP code and tobacco use. Any national figure would be wrong for you. What you can do instead is put two real quotes into a calculation that takes a minute.

Get a Plan G quote and a Plan N quote from the same company, and take the monthly difference. Multiply by twelve: that is what Plan N saves you in a year, before you use any care. Call it your budget.

Now spend it. Each office visit on Plan N costs you at most $20, so the savings are worth that many visits divided by twenty. A $20 monthly difference gives you $240 a year, or twelve office visits before Plan N stops being cheaper. A $40 difference gives you $480, or twenty-four visits. Add $50 for each emergency room trip you would expect that does not end in admission.

Two rules that make Plan N cheaper than the simple sum

Most comparisons stop at “$20 a visit”. The official Plan N guidance, written when the plan was created and published by CMS, adds two rules that both work in Plan N’s favor.

The copayment only starts after the Part B deductible. The guidance says the Plan N policyholder meets the deductible “before any coinsurance or copayment is collected”. Both plans leave you the same $283 deductible, so the first appointments of the year cost you exactly the same on G and on N. The $20 begins only on the visits after that. If you see a doctor four times a year and the first two use up the deductible, Plan N’s extra cost is two copayments, not four.

The $20 is a ceiling, not a fee. The copayment is the lesser of $20 or the Part B coinsurance for that visit. On a short visit where your 20% share would be less than $20, you pay the smaller amount. So $20 a visit is the worst case, which is why we use it in the table below.

A year of care, after the deductible	Plan N’s worst-case extra cost in the year	Plan N is cheaper if its premium is lower by more than
Light: 2 office visits, no ER	$40	$3.33 a month
Moderate: 8 office visits, 1 ER visit not admitted	$210	$17.50 a month
Heavy: 20 office visits, 2 ER visits not admitted	$500	$41.67 a month

Pick the row that looks like your year and compare the last column with the monthly gap between your two quotes. If your gap is bigger, Plan N comes out ahead on copayments even at their maximum. If it is smaller, Plan G does, before you count anything for peace of mind.

Then ask how many times you actually saw a doctor last year, and count only the visits after the ones your deductible absorbs (the rule above). If the answer is three or four, you are nowhere near the break-even point and Plan N wins comfortably. For someone managing a condition across several specialists, twenty visits is not unusual, and the calculation tightens or flips.

Two things that calculation does not capture, and they both push toward Plan G. The excess-charge exposure is not in it, because you cannot predict it. And neither is the value of not thinking about it — Plan G’s appeal is that after the deductible, the bills simply stop, and some people will pay a real premium for that rather than reconcile copayments in their eighties.

Which One Suits You

Plan N suits someone who uses healthcare a few times a year, whose doctors accept assignment, and who would rather keep the savings and pay the occasional $20. On the arithmetic above, that describes most people newly eligible for Medicare.

Plan G suits someone with frequent specialist appointments, someone who cannot confirm that their providers accept assignment, and anyone who values a fixed monthly cost with nothing behind it. It is also the simpler thing to leave in place for a spouse or family member to manage later, which is not a trivial consideration.

The Decision That Matters More Than This One

Whichever letter you pick, when you buy matters more than what you buy. Your Medigap Open Enrollment Period is the six months beginning the first day of the month you are 65 or older and enrolled in Part B. Inside it, an insurer must sell you any policy it offers at the standard price, whatever your health. Once it closes, that protection closes with it, and in most states an insurer can then underwrite the application — which our guide to choosing a Medicare Supplement policy goes through, along with the states that add a second window of their own.

That window closes once and does not reopen, and it is the difference between choosing a plan and being assessed for one. We cover what happens on the other side of it in our guide to Medigap with pre-existing conditions, and what separates the companies selling identical letters in our guide to choosing a Medigap company.

Frequently Asked Questions

Can I switch between Plan N and Plan G later? You can apply, but outside your six-month open enrollment window most states allow the insurer to underwrite you, so your health history can affect the price or the answer. A few states provide an annual window instead.

Do either of them cover prescriptions? No. Neither Plan G nor Plan N includes drug coverage. You need a separate Part D plan, and going without one for 63 days or more triggers a permanent late enrollment penalty, which we cover in what happens if you miss a Medicare deadline.

Is Plan G always more expensive than Plan N? Within one company, yes. Across companies, no: one insurer’s Plan G is often priced below another’s Plan N, which is why comparing several quotes for the same letter matters more than choosing the letter.

Do my spouse and I need separate policies? Yes. Medigap policies are individual. You can hold different letters from different companies if that is what each of you needs.

What exactly is a Part B excess charge? It is the amount a provider who has not accepted assignment may bill above Medicare’s approved amount. Medicare says most providers do accept assignment, and that in many cases the extra cannot exceed 15%. Plan G absorbs it; Plan N leaves it with you.

Bottom Line

Plan G and Plan N differ in two places: up to $20 a visit and up to $50 at the emergency room, and whether excess charges are covered. That is the entire decision.

Take two quotes from one company, multiply the monthly gap by twelve, divide by twenty, and compare the result with how often you actually see a doctor. Then compare the same letter across several companies, because that gap is usually the larger one.

Before committing to either letter, get real quotes for both in your own ZIP code — Medicare’s Medigap policy search lists the companies selling them where you live — and ask each company which pricing method the policy uses, because that decides what the same letter costs you at 80 rather than at 65. A State Health Insurance Assistance Program counselor will run that comparison with you at no cost.

Sources

• Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare — Medicare.gov. Source for the standardization of benefits by plan letter, for price being the only difference between identical letters sold by different companies, and for the Plan N copayment amounts.
• Compare Medigap plan benefits — Medicare.gov. Source for what each letter covers, including the $20 office visit and $50 emergency room copayments on Plan N, Part B excess charges and foreign travel emergency coverage.
• Does your provider accept Medicare as full payment? — Medicare.gov. Source for most providers accepting assignment and for the limiting charge of no more than 15% above the Medicare-approved amount.
• 2026 Medicare Parts A & B Premiums and Deductibles — Centers for Medicare & Medicaid Services. Source for the $283 annual Part B deductible that both plans leave you.
• When can I buy Medigap? — Medicare.gov. Source for the six-month Medigap Open Enrollment Period and for what protections exist outside it.
• Plan N implementation guidance (questions and answers) — Centers for Medicare & Medicaid Services, based on the NAIC Medigap model regulation. Source for the Part B deductible being met before any Plan N copayment is collected, and for the copayment being the lesser of $20 or the Part B coinsurance.

All figures on this page were checked against the sources above on September 20, 2026. No average premium difference is quoted because Medigap rates are filed state by state and vary by age, sex, ZIP code and tobacco use; the worked example uses your own two quotes instead.

Update history

• September 16, 2026 — First published.
• October 18, 2026 — Added the two Plan N rules from the CMS and NAIC implementation guidance (copayments start only after the Part B deductible, and are the lesser of $20 or the coinsurance), and a worst-case cost table by level of use. Removed an unsourced statement about how often most people see a doctor.

Disclaimer: Figures reflect 2026 rules published by the Centers for Medicare & Medicaid Services (CMS) and Medicare.gov and are subject to change. State rules and individual circumstances vary. Always confirm current details directly with Medicare.gov, 1-800-MEDICARE, your state insurance department, or a licensed agent before making a decision.