Senior Planning Digest
Practical guidance for living well, planning wisely, and protecting your future.
Matt Maresch
August 25, 2026
FEATURED ARTICLE
What’s the Difference Between Medicare Supplement Plans G and N?
Plan G and Plan N are two of the most popular Medicare Supplement options, and at first glance, they look very similar. The real difference comes down to what you want to pay each month, what you are comfortable paying when you use healthcare, and how much predictability you want from your coverage.
This week, we are going to break down those differences, look at the actual dollars, and show you why the cheapest plan today may not always be the best value over time.
What Do Plan G and Plan N Have in Common?
Both Plan G and Plan N work alongside Original Medicare. Medicare generally pays its share first, and your Medigap policy then pays according to the standardized benefits included in the plan.
Both plans include coverage for:
Medicare Part A coinsurance and hospital costs, including up to 365 additional days after Medicare benefits are used
Medicare Part A deductible
Skilled nursing facility care coinsurance
Part A hospice care coinsurance or copayments
The first three pints of blood
Most Medicare Part B coinsurance
80% of qualifying foreign travel emergency expenses, up to plan limits
For 2026, the Medicare Part B deductible is $283.
The biggest difference is how much cost-sharing you are willing to accept in exchange for the possibility of a lower monthly premium.
With Plan G, after you satisfy the annual Part B deductible, the plan generally pays the remaining standardized Part B coinsurance and also covers Medicare Part B excess charges.
With Plan N, you may have:
Up to a $20 copay for certain office visits
Up to a $50 copay for emergency room visits that do not result in an inpatient admission
Responsibility for Medicare Part B excess charges
In exchange for accepting these additional costs, Plan N will often have a lower monthly premium than Plan G.
Why Are Medicare Part B Excess Charges Important?
A Medicare Part B excess charge can occur when a non-participating Medicare provider does not accept Medicare assignment.
While uncommon, these providers can charge up to 15% above the Medicare-approved amount, subject to Medicare’s limiting charge rules.
If you have Plan N, here is an easy question to ask before a non-emergency visit: “Do you accept Medicare assignment?” If the answer is yes, the provider agrees to accept the Medicare-approved amount as payment in full for Medicare-covered services, so you would not face a Part B excess charge for those services.
Plan G covers Part B excess charges.
Plan N does not.
Most healthcare providers accept Medicare assignment, so excess charges may not be something you encounter frequently. However, it is still worth asking whether your physicians accept Medicare assignment, particularly before receiving non-emergency care.
Is Plan G More Predictable?
For many people, yes.
Plan G is designed to provide a high degree of out-of-pocket cost predictability. Once the annual Part B deductible has been satisfied, there are generally fewer Medicare-approved outpatient expenses left for you to pay yourself.
That can be attractive if you:
See physicians or specialists frequently
Prefer fewer bills at the point of service
Do not want to worry about Part B excess charges
Are willing to pay a potentially higher monthly premium for greater predictability
The trade-off is that Plan G premiums are generally higher than Plan N premiums, and that difference can become significant over time. For example, standard 2026 rates from one major carrier show an age-75 Plan G premium nearly $100 per month higher than Plan N for a male in the Dallas market, a difference of almost $1,200 per year.
Can Plan N Save You Money?
Maybe.
Plan N often has a lower monthly premium than Plan G, but the difference can vary significantly by insurance company, age, location, rating method, and other factors.
Instead of looking at the premium alone, compare the total potential annual cost.
For example, compare:
Annual Plan G premium versus Annual Plan N premium + expected office copays + possible ER copays + potential excess charges
If Plan N saves you $50 per month, that is $600 per year in premium savings.
Now do the math. At the full $20 office visit copay, it would take 30 of those copays to equal $600. You would still need to consider possible emergency room copays and Part B excess charges.
That is the real comparison. How much are you saving in premiums, and how much additional cost-sharing are you realistically likely to have?
The answer will be different for every person.
Who May Prefer Plan G?
Plan G may be worth considering if you:
Want more predictable healthcare expenses
Prefer fewer point-of-service costs
Visit physicians or specialists regularly
Want protection against Part B excess charges
Are comfortable paying a potentially higher monthly premium
For some people, paying more each month is worthwhile because they prefer knowing that most of the standardized Medicare gaps are already accounted for.
Who May Prefer Plan N?
Plan N may be worth considering if you:
Want to explore a potentially lower monthly premium
Are comfortable with limited office and emergency room copays
Understand that Part B excess charges are not covered
Prefer accepting some cost-sharing in exchange for potential premium savings
Plan N provides many of the same standardized benefits as Plan G, but it leaves a few specific costs for you to pay yourself.
Why Does Medigap Enrollment Timing Matter?
Your choice between Plan G and Plan N is important, but the timing of your application can be just as important.
Your federal Medigap Open Enrollment Period generally begins the first month you are both:
Age 65 or older, and
Enrolled in Medicare Part B
The enrollment period lasts six months.
During this period, you generally have important federal protections that allow you to purchase available Medigap coverage without medical underwriting.
After your Medigap Open Enrollment Period ends, an insurance company may be permitted to ask health questions, charge more, or decline an application unless you qualify for a guaranteed issue right or have additional protections under state law.
This means you should think beyond the premium you are paying today. Consider whether you would be comfortable keeping the plan if changing Medigap policies later required medical underwriting.
One important distinction: your Medigap Open Enrollment Period is generally a one-time six-month window. It does not come back every year like Medicare’s annual Open Enrollment Period. Changing to another Medigap plan later may require medical underwriting.
Are Plan G and Plan N the Same With Every Insurance Company?
In most states, the benefits of a Medigap plan are standardized by plan letter. That means a Plan G from one insurance company provides the same standardized medical benefits as a Plan G from another company. The same is true for Plan N.
Where insurance companies can differ, sometimes significantly, is in what they charge and how they manage the policy over time.
Those differences may include:
Premiums
Premium history
Household discounts
Underwriting requirements
Customer service
Rate increases
Rating methodology
This is why I would not recommend choosing a Medigap plan based only on which company has the lowest premium today. A company that looks inexpensive when you first enroll may not remain the least expensive several years from now.
You want to look at the entire picture, including the current premium, the company’s history of rate increases, available discounts, and how the policy is rated.
Massachusetts, Minnesota, and Wisconsin are different. Those states standardize Medigap coverage under their own systems, so the plan structure will not look the same as it does in most of the country.
Case Study: When Plan F Becomes Too Expensive
Let us assume you are 73 years old and paying $395 per month for Plan F.
That is $4,740 per year.
Now ask yourself a simple question: When was the last time you compared that premium with Plan G or Plan N?
Did you know you may be able to go through medical underwriting and qualify for a different Medigap plan with a lower premium?
If you are healthy enough to qualify through medical underwriting, you may have an opportunity to move to a lower-cost Medigap plan and keep much of the protection you value.
Plan G would require you to pay the annual Part B deductible. Plan N adds some additional cost sharing, including certain office visit and emergency room copays. But in exchange, the monthly premium may be considerably lower.
That is where the math becomes important.
If you find another Medigap plan that saves you $100, $150, or even $200 per month, the annual savings can add up quickly. You may find that paying a deductible or an occasional copay is a reasonable trade-off for saving thousands of dollars in premiums over time.
The point is not that everyone on Plan F should switch.
The point is that paying $395 per month without reviewing your alternatives could be an expensive assumption.
If you can qualify for Plan G or Plan N, it may be worth finding out what your options actually look like before simply accepting another year of higher premiums.
One important rule: do not cancel your existing Medigap policy just because you applied for another one. Make sure you have been approved for the new coverage and understand when it becomes effective before making any changes to the coverage you already have.
Could Plan N Eventually Become the New Plan G?
Here is a question I think more people should be asking. As healthcare costs and Medigap premiums continue to rise, could Plan N eventually become the more popular choice?
I do not know if that will happen, but the question is worth asking. If the premium difference between Plan G and Plan N continues to grow, more people may decide that paying a lower fixed monthly premium and accepting a few smaller costs when they use healthcare makes sense.
That does not make Plan N better than Plan G. It changes the math. For some people, predictability will still be worth paying more for. For others, keeping the monthly premium lower may become more important.
Remember That Medigap Does Not Include Part D
Neither Plan G nor Plan N includes outpatient prescription drug coverage.
If you want Medicare prescription drug coverage, you generally need to enroll separately in a Medicare Part D prescription drug plan.
Your Medigap decision should therefore be considered alongside your broader Medicare coverage, including your Part D plan and expected prescription needs.
Key Takeaways
Plan G and Plan N provide very similar standardized benefits, but they differ in premiums and what you may pay when you receive care.
Neither Plan G nor Plan N covers the annual Part B deductible.
Plan G covers Part B excess charges. Plan N does not, and Plan N may also require certain office and emergency room copays.
Do not compare premiums alone. Compare the total potential annual cost of each plan.
Do not overlook underwriting later in retirement if your Medigap premiums start getting out of control. You may have an opportunity to qualify for lower-cost coverage.
Your Medigap policy is not something you should set and forget. Review it every year, even if you ultimately decide that keeping your current coverage is still the right decision.
The decision between Plan G and Plan N does not have to come down to which plan is “better.” The better question is which plan gives you the right balance of premium, coverage, and predictability for you.
Do not just look at what the plan costs today. Think about what you are comfortable paying now, what you may pay when you use healthcare, and whether the plan still makes sense five or ten years from now.
Fun Fact
Your brain is 50% to 60% fat by dry weight, making it one of the fattiest organs in your body.
That sounds unhealthy, but those fats are essential. They help form cell membranes, insulate nerve fibers, and allow brain cells to communicate efficiently.
Sources
Have a blessed week!
Matt
Founder, Senior Healthcare Planning
Founder, Ashbury Boutique Wealth Management
For Journalists, Editors & Publishers
Journalist Quotes, Key Facts & Citation Resources
Everything you need for editorial reference is below. Use ready-to-quote expert commentary, key facts for reporting, and citation and source-reference tools related to this article.
Ready-to-Quote Expert Commentary
These comments are available for editorial use with attribution to Matt Maresch, NSSA®, CLTC®, Senior Healthcare Planning. Each Copy Quote button includes the quote, attribution, and source link.
“The real Plan G versus Plan N decision is not simply which plan has the lower premium. It is whether the premium savings from Plan N are enough to justify its office visit copays, possible emergency room copays, and exposure to Medicare Part B excess charges.”
Matt Maresch, NSSA®, CLTC® · Senior Healthcare Planning
“Plan G generally offers greater predictability because after the annual Part B deductible is satisfied, there are fewer standardized Medicare-approved outpatient costs left for the beneficiary to pay. Plan N can trade some of that predictability for a potentially lower monthly premium.”
Matt Maresch, NSSA®, CLTC® · Senior Healthcare Planning
“Medigap enrollment timing matters because the federal Medigap Open Enrollment Period is generally a one-time six-month window. Later changes may require medical underwriting unless the beneficiary has a guaranteed issue right or other applicable protection.”
Matt Maresch, NSSA®, CLTC® · Senior Healthcare Planning
Key Facts for Reporting
Quick reference points from the article for reporting and editorial research.
- Plan G and Plan N both work alongside Original Medicare and provide many of the same standardized Medigap benefits.
- Neither Plan G nor Plan N covers the annual Medicare Part B deductible.
- The Medicare Part B deductible for 2026 is $283.
- Plan G generally pays the remaining standardized Medicare Part B coinsurance after the Part B deductible is satisfied.
- Plan G covers Medicare Part B excess charges.
- Plan N does not cover Medicare Part B excess charges.
- Plan N may require up to a $20 copay for certain office visits.
- Plan N may require up to a $50 copay for emergency room visits that do not result in an inpatient admission.
- A Medicare Part B excess charge can occur when a non-participating Medicare provider does not accept Medicare assignment.
- Subject to Medicare limiting-charge rules, certain non-participating providers can charge up to 15% above the Medicare-approved amount.
- Plan N will often have a lower monthly premium than Plan G in exchange for accepting additional cost-sharing.
- Medigap policies are standardized by plan letter in most states, meaning the standardized medical benefits of Plan G are generally the same from one insurer to another, and the same principle applies to Plan N.
- Insurance companies can still differ in premiums, premium history, household discounts, underwriting requirements, customer service, rate increases, and rating methodology.
- Massachusetts, Minnesota, and Wisconsin use their own Medigap standardization systems.
- The federal Medigap Open Enrollment Period generally begins the first month a person is both age 65 or older and enrolled in Medicare Part B.
- The federal Medigap Open Enrollment Period generally lasts six months.
- After that enrollment period ends, changing Medigap coverage may require medical underwriting unless the applicant qualifies for a guaranteed issue right or other applicable protection.
- Neither Plan G nor Plan N includes outpatient prescription drug coverage. Medicare Part D coverage is generally obtained separately.
Citation & Source Reference
Use the citation below when referencing this article in published work.
Maresch, Matt, NSSA®, CLTC®. “What’s the Difference Between Medicare Supplement Plans G and N?” Senior Healthcare Planning. https://seniorhealthcareplanning.com/newsletter/medicare-supplement-plan-g-vs-plan-n
Editorial note: Please retain attribution when quoting expert commentary. Medicare costs, Medigap premiums, underwriting rules, guaranteed issue protections, and state-specific requirements can change. Time-sensitive information should be confirmed against current Medicare guidance and applicable state rules before publication.
