Medicare Plan N vs Plan G: Which Medigap Plan Wins in 2026?

Two Medigap plans dominate the market for new Medicare beneficiaries, and choosing between them is one of the most consequential financial decisions you will make in retirement. The Medicare Plan N vs Plan G debate comes down to a straightforward tradeoff: lower premiums with modest copays versus higher premiums with virtually zero out-of-pocket costs at the point of care. Understanding exactly how these plans differ will help you pick the option that aligns with your health, budget, and risk tolerance. The plan-design rules below are set by federal law and do not change year to year, but the dollar figures do — so treat every dollar amount here as a 2026 snapshot to confirm, not a quote.

This article is independent educational information, not insurance advice. FMHC does not sell Medigap policies. Verify current amounts and coverage at Medicare.gov and get real quotes before you enroll.

Coverage Comparison at a Glance

Both Plan G and Plan N cover the Part A deductible ($1,736 in 2026), Part A coinsurance and hospital costs, skilled nursing facility coinsurance, Part B coinsurance (with a caveat for Plan N), the first three pints of blood, and Part A hospice care coinsurance. Both plans also include 80 percent coverage for foreign travel emergencies up to the plan lifetime limit. Because Medigap benefits are standardized by federal law, a Plan G from one insurer covers exactly the same services as a Plan G from any other insurer — only the premium and customer service differ. The same is true of Plan N.

The differences between the two are narrow but meaningful. Plan G covers the Part B coinsurance in full and also pays Part B excess charges, which are amounts billed above the Medicare-approved rate by providers who do not accept assignment. Plan N covers the Part B coinsurance as well, but it requires a copayment of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission. Plan N does not cover Part B excess charges at all — that is the single most important distinction to understand before choosing it.

Neither plan covers the annual Part B deductible ($283 in 2026, up from $257 in 2025). Both require you to pay that amount out of pocket before Medigap coverage applies to Part B services. (Plans C and F, which did cover the Part B deductible, are closed to anyone who first became eligible for Medicare on or after January 1, 2020, which is why Plan G and Plan N are now the two most popular choices for newcomers. Plan G and Plan N remain open to everyone new to Medicare.)

Monthly Premium Differences

The premium gap between these two plans is the core of the Medicare Plan N vs Plan G decision. Nationally, Plan N premiums tend to run roughly $25 to $60 per month less than Plan G premiums from the same insurer in the same ZIP code. As an illustration only, a 65-year-old nonsmoker might see Plan G premiums in the range of about $120 to $280 per month and Plan N premiums in the range of about $90 to $210 per month — but these are wide, illustrative ranges, and your actual premium depends on your insurer, ZIP code, age, tobacco use, and how the plan is rated (issue-age, attained-age, or community-rated).

A representative Plan N advantage of that size translates to annual savings of roughly $300 to $720 by choosing Plan N. Whether those savings offset the copays and excess-charge exposure depends on how often you visit the doctor and whether your providers accept Medicare assignment. Because premiums vary so much, the only reliable way to compare is to get actual quotes for your own ZIP code and age from several insurers, then run the math on your own expected usage.

Understanding Part B Excess Charges

Part B excess charges occur when a provider who accepts Medicare but does not accept assignment bills up to 15 percent above the Medicare-approved amount. Only “non-participating” providers can charge this extra amount, and they must still submit the claim to Medicare. Excess charges are relatively uncommon because the large majority of providers accept assignment, but they are the one gap Plan N leaves open and Plan G fills.

For beneficiaries who see specialists in high-cost areas or who use out-of-state providers, excess charges can add up over a year. If your doctors all accept Medicare assignment, which the vast majority do, this difference between Plan G and Plan N has no practical impact on your wallet. You can check whether a provider accepts assignment by searching the provider directory and Care Compare tools at Medicare.gov, or by simply asking the office directly before your visit.

A handful of states prohibit excess charges entirely. In those states — which have included Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont — a provider cannot bill more than the Medicare-approved amount, so the excess-charge gap in Plan N disappears and the plans become even more comparable. State rules can change, so verify your state’s current status.

When Plan G Makes More Sense

Plan G is the better choice if you want the simplest possible coverage with no copays and no risk of excess charges. It is particularly well suited for beneficiaries who see multiple specialists, have chronic conditions requiring frequent office visits, or travel often and may need to see unfamiliar providers whose assignment status they cannot control. With Plan G, your only annual out-of-pocket cost for Medicare-covered services is the $283 Part B deductible.

Plan G also appeals to beneficiaries who value predictability. You know almost exactly what your healthcare will cost each year: the Part B deductible plus your monthly premiums. There are no copays at the doctor’s office and no bills arriving weeks later for excess charges. For a deeper look at this plan, read our Medicare Supplement Plan G guide.

When Plan N Makes More Sense

Plan N is the smarter pick if you are relatively healthy, visit the doctor infrequently, and want to keep premiums as low as possible while still maintaining strong coverage. The copay structure is modest: up to $20 per office visit and up to $50 for non-admitted ER visits (the ER copay is waived if you are admitted as an inpatient). If you go to the doctor four times a year, your total copay exposure is roughly $80, far less than the $300 to $720 you might save on premiums.

Plan N is also a strong choice if all of your providers accept Medicare assignment, which eliminates the excess-charge concern entirely. The great majority of physicians who take Medicare accept assignment, and in the states listed above that ban excess charges outright, the gap between Plan N and Plan G narrows further. If you rarely travel out of state and have a stable set of assignment-accepting doctors, Plan N’s lower premium is often the better value.

Running the Numbers: A Real-World Example

Consider a 67-year-old woman in Ohio who visits her primary care doctor six times per year and sees one specialist twice per year. Her Plan G premium is $175 per month. Her Plan N premium from the same insurer is $135 per month. (These premiums are illustrative; use your own quotes.)

With Plan G, her annual cost is $175 × 12 plus the $283 Part B deductible, totaling $2,383. With Plan N, her annual cost is $135 × 12 plus the $283 Part B deductible plus up to $160 in office-visit copays (8 visits × $20), totaling $2,063. In this scenario, Plan N saves her about $320 per year. Over a 20-year retirement, a consistent difference of that size compounds to roughly $6,400 or more before any premium increases are factored in.

This example illustrates why the Medicare Plan N vs Plan G comparison often favors Plan N for beneficiaries with moderate healthcare usage and assignment-accepting providers. However, if this same person had 15 or more office visits per year, frequently used the ER without being admitted, or saw providers who charge excess fees, the math could tilt toward Plan G. Run your own numbers with your own expected visits and real quotes.

Switching Between Plans

If you start with one plan and later decide the other would serve you better, you can apply to switch. During your six-month Medigap Open Enrollment Period (which starts the month you are 65 or older and enrolled in Part B), you have guaranteed-issue rights and cannot be turned down or charged more for health reasons. Outside of that window, insurers in most states can require medical underwriting and can decline you or raise your premium based on your health.

Some states offer extra protections. States with “birthday rules,” such as California and Oregon, give you guaranteed-issue rights to switch to a plan with equal or lesser benefits during a set window around your birthday each year. Since Plan N covers slightly less than Plan G, switching from Plan G to Plan N under a birthday rule is typically straightforward. Switching from Plan N to Plan G outside of open enrollment may require passing medical underwriting, so if you are considering that move, apply before any new health conditions develop. Rules vary by state and change over time — confirm your state’s current protections before you rely on them. For more on enrollment timing, see our Medicare enrollment guide.

Frequently Asked Questions

Does Plan N cover preventive care visits without a copay?

Yes. Medicare-covered preventive services, such as the annual wellness visit and many screenings, are covered at 100 percent by Original Medicare with no coinsurance. Because there is no coinsurance for these visits, Plan N’s copay provision does not apply. You generally pay nothing for covered preventive care under either Plan G or Plan N.

Which plan has lower rate increases over time?

Rate-increase trends depend on the insurer, the state, and how the plan is rated rather than the plan letter itself. Some observers note that Plan N pools can attract younger, healthier enrollees, which may slow premium growth relative to some Plan G pools, but this is not guaranteed and varies by market. Reviewing an insurer’s history of rate increases and its financial strength rating is more useful than the plan letter alone. State insurance departments and the NAIC publish consumer guidance on comparing Medigap rates.

Can I have prescription drug coverage with either plan?

No. Neither Plan G nor Plan N includes prescription drug coverage. You need a separate Medicare Part D plan for medications. Learn about Part D costs in our Medicare Part D donut hole guide.

What if I rarely go to the doctor?

If you visit the doctor only once or twice a year, Plan N is often the more economical choice. Your copay exposure would be roughly $20 to $40 annually, while your premium savings could exceed $300. Some very healthy beneficiaries also consider a high-deductible Plan G for even lower premiums, accepting more out-of-pocket risk in exchange. Compare all options in our Compare Medicare Supplement Plans guide.

Are Plan F and Plan C still available?

Only for some people. Plans C and F, which cover the Part B deductible, are closed to anyone who first became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy them; if you are new to Medicare, Plan G and Plan N are the comprehensive options open to you.

Bottom Line

Plan G delivers maximum peace of mind with the least out-of-pocket exposure at the point of care — in 2026, your only routine cost is the $283 Part B deductible plus your premium. Plan N delivers strong coverage at a noticeably lower premium, with modest copays that most beneficiaries find manageable, but it leaves the Part B excess-charge gap open. Run the math based on your own visit frequency, your providers’ assignment status, and real local premium quotes. If the annual premium savings from Plan N exceed your expected copays and excess-charge risk, Plan N is the better financial choice; if you prefer zero-surprise billing or see providers who may not accept assignment, Plan G earns its higher premium. Verify all current figures at Medicare.gov. For broader plan comparisons, visit our Medigap plans overview and our healthcare policy guide.

Sources

• Medicare.gov — 2026 Part A and Part B costs (Part B deductible $283; Part A deductible $1,736; standard Part B premium $202.90)
• Medicare.gov — Medigap plan-benefit comparison (Plan G vs Plan N coverage, Part B excess charges, Plan N copays, and Plans C and F closed to those newly eligible on or after January 1, 2020)
• CMS / Medicare.gov — Medigap Open Enrollment, guaranteed-issue and medical-underwriting rules; provider directory and Care Compare for checking assignment status
• NAIC — state Medigap rate-filing patterns and consumer guidance on comparing Medicare Supplement rates