Medigap Plan G vs. Plan N: Which Supplement Makes Sense for You?

Plan G and Plan N are currently the two most common Medigap choices for new Medicare enrollees. They look similar on the surface — but their differences matter. Here's a clear explanation of how each works, so you can understand the decision before you make it.

First, a Quick Reminder About Medigap

Original Medicare consists of two main parts. Part A — Hospital Insurance — covers inpatient hospital stays, skilled nursing facilities, and some home health services. Part B — Medical Insurance — covers physician visits, outpatient care, imaging, procedures, and many preventive services.

Original Medicare works well, but it has gaps in coverage. Part B typically covers 80% of approved medical charges — and the remaining 20% has no out-of-pocket cap. For a major illness or procedure, that uncapped 20% can become significant.

This is why many people purchase Medigap insurance — to fill in those gaps and make healthcare costs more predictable. If you're new to this structure, you may want to start with the Medicare Basics overview before comparing specific plans.

Plan G: The Most Comprehensive Option for New Enrollees

For people who become eligible for Medicare today, Plan G is generally the most comprehensive Medigap option available. Plan G covers the Part A hospital deductible, Part A hospital coinsurance, skilled nursing facility coinsurance, the Part B coinsurance (the 20%), Part B excess charges, and limited foreign travel emergency coverage.

The only cost Plan G does not cover is the Medicare Part B annual deductible — which in 2025 is $240 per year. Once that deductible has been paid, Plan G typically covers nearly all remaining Medicare-approved medical costs.

Because of this, many people appreciate Plan G for its simplicity and predictability. You pay your premium, you pay your annual Part B deductible once, and from that point forward your exposure to unexpected costs is minimal.

Plan N: Similar Coverage With Lower Premiums

Plan N covers most of the same benefits as Plan G — but with a few small trade-offs. Under Plan N, you may have a copay of up to $20 for some physician office visits and up to $50 for emergency room visits if you are not admitted. You are also responsible for Part B excess charges in certain situations.

In exchange for accepting those possible costs, Plan N usually carries a lower monthly premium than Plan G. For some people, that trade-off makes good sense.

What Are "Part B Excess Charges"?

This is the part of Medicare that often causes confusion, so it's worth explaining clearly.

Medicare sets an approved amount for physician services. Most physicians accept that amount as full payment — these are called participating providers. However, some physicians are allowed to charge up to 15% more than the Medicare-approved amount. This additional amount is called an excess charge.

The key difference between Plan G and Plan N: Plan G covers excess charges. Plan N does not.

In many areas of the country, excess charges are relatively uncommon because most physicians accept Medicare assignment. But it's something to understand before choosing between the two plans — particularly if you live in an area with a higher proportion of non-participating providers.

How the Monthly Premiums Usually Compare

Because Plan N asks you to accept small copays and possible excess charges, its monthly premium is typically lower than Plan G. The exact difference varies by location and insurance company, but the general pattern is consistent: Plan G costs more each month and delivers more predictability; Plan N costs less and asks you to absorb occasional small costs.

Some people prefer paying a slightly higher premium for the predictability of Plan G. Others prefer the lower premium of Plan N and are comfortable with occasional copays. Neither choice is universally right or wrong — it depends on your situation.

A Simple Way to Think About It

For someone who sees physicians frequently or values knowing exactly what their costs will be, the predictability of Plan G may feel worth the higher premium. For someone who sees physicians only occasionally and is comfortable with small, predictable copays, Plan N may be a reasonable way to reduce monthly costs.

The right answer depends on three things: how often you use outpatient care, how much you value cost predictability, and what the actual premium differential is in your specific area.

Why Timing Matters More Than the Plan Letter

One important point often gets overlooked in discussions about Medigap plan comparisons: the timing of your enrollment can be more consequential than which specific plan you choose.

When you first enroll in Medicare Part B, you enter a six-month Medigap Open Enrollment Period. During this window, insurance companies must accept you and cannot use medical underwriting — they're required to sell you any plan they offer at standard rates, regardless of your health history.

After this window closes, insurers in most states may require medical underwriting if you want to change plans or enroll for the first time. That means your ability to obtain or change Medigap coverage in the future could depend on your health at that time — and if you've developed significant health conditions, you may face higher premiums or be declined entirely.

This is why the initial Medicare enrollment decision and its timing is so important. I cover this in detail in the article on the five things I wish I'd known before helping my mother with Medicare, and it's one of the five dimensions in the Decision Brief.

The Bottom Line

Both Plan G and Plan N are strong Medigap options. Plan G offers maximum predictability, covering almost all Medicare-approved costs after the annual Part B deductible. Plan N offers lower premiums in exchange for occasional small copays and the possibility of excess charges in certain situations.

The right choice depends on your personal preferences, how frequently you use outpatient medical care, and the pricing available in your specific area. What matters most is understanding the structure of the decision before you enroll — and making sure you act within the windows that preserve your flexibility.