Medicare Supplement Plan N: What It Covers and Costs

For Medicare beneficiaries who want meaningful gap coverage without paying top-tier Medigap premiums, Medicare Plan N has become one of the most compelling options on the market. It covers the majority of out-of-pocket costs that Original Medicare leaves behind while keeping monthly premiums roughly $30 to $70 lower than Plan G in many markets. The trade-off involves modest copays at the point of service and the exclusion of Part B excess charges. For many enrollees, that trade-off represents smart budgeting rather than a sacrifice.

The figures below reflect 2026 amounts published by Medicare, but Medigap standardized benefits, deductibles, and premiums are reviewed regularly. Treat every dollar amount here as a planning estimate and verify the current numbers at Medicare.gov before you enroll.

What Medicare Plan N Covers

Plan N provides a robust set of standardized Medigap benefits. It covers Part A hospital coinsurance and 365 additional lifetime reserve days, the Part A deductible ($1,736 in 2026, verify current), Part B coinsurance at 100 percent (with the copay exceptions described below), skilled nursing facility coinsurance for days 21 through 100, the first three pints of blood, Part A hospice care coinsurance, and foreign travel emergency care up to plan limits. Because Medigap plans are standardized, a Plan N sold by one insurer carries the same core benefits as a Plan N sold by any other insurer in your state.

The coverage profile of Medicare Plan N is nearly identical to Plan G except for two differences. First, Plan N introduces small copays: up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission. Second, Plan N does not cover Part B excess charges, which are amounts a provider bills above Medicare’s approved rate. These two exclusions are what make Plan N less expensive.

What Plan N Does Not Cover

Two gaps deserve emphasis before you enroll. First, Plan N does not cover the annual Part B deductible — you pay that yourself each year before Medigap coverage kicks in for outpatient services. Second, Plan N does not cover Part B excess charges. This matters most if you see providers who do not “accept assignment.” A provider who accepts Medicare assignment agrees to Medicare’s approved amount as full payment; a non-participating provider can bill up to 15 percent above that amount, and with Plan N you would owe that difference out of pocket. Like every Medigap plan, Plan N also does not include prescription drug coverage, routine dental, vision, hearing aids, or long-term custodial care.

How Much Plan N Costs

Monthly premiums for Plan N typically range from about $80 to $180 for a 65-year-old, depending on your location, age, gender, tobacco use, and the carrier’s pricing model. In lower-cost markets you may find rates below $75, while in high-cost urban areas premiums can approach $200 or more. These ranges are illustrative only. Medigap premiums vary widely by ZIP code and insurer, so the only reliable number is a personalized quote — get quotes from several carriers and confirm plan details before enrolling.

Beyond the monthly premium, Plan N policyholders also pay the annual Part B deductible ($283 in 2026, verify current), plus the small copays described above. In a typical year, a Plan N enrollee who visits the doctor six to eight times might pay roughly $80 to $160 in copays. Adding the $283 deductible, total annual out-of-pocket costs beyond premiums might land somewhere in the neighborhood of $360 to $445 for a moderately active healthcare user — but your actual costs depend on how often you use care and whether your providers accept assignment.

Compare this to Plan G, where premiums are higher but out-of-pocket costs are largely capped at the Part B deductible. The breakeven logic is straightforward: if Plan G costs meaningfully more than $30 to $40 per month extra versus Plan N, and you are a low-to-moderate healthcare utilizer, Plan N likely saves you money overall. Run the math with real quotes rather than the illustrative ranges here.

Understanding the Copay Structure

Plan N’s copay structure is more limited than many people expect. The up-to-$20 copay applies to certain office visits, including primary care and specialist visits. Not all visits trigger a copay, and the copay is capped at $20 regardless of the service’s cost. Medicare’s annual wellness visit, for example, is covered at 100 percent by Medicare and does not generate a Plan N copay.

The up-to-$50 emergency room copay applies only when you visit an ER and are not admitted to the hospital as an inpatient. If the ER visit results in admission, the copay is waived. This provision discourages unnecessary ER use while protecting you fully during genuine emergencies that require hospitalization. If cost is ever a factor in deciding where to seek care, remember that a true emergency should never be delayed for financial reasons.

Part B Excess Charges Explained

The other notable exclusion in Plan N is Part B excess charges. Under Medicare rules, non-participating providers can charge up to 15 percent above Medicare’s approved amount. For example, if Medicare approves $200 for a service, a non-participating provider could bill up to about $230. Plan N does not cover that difference, while Plan G does.

In practice, this exclusion affects a relatively small share of beneficiaries because the large majority of physicians accept Medicare assignment, meaning they agree to accept Medicare’s approved amount as full payment. Excess charges tend to be most common among certain specialists in higher-cost urban markets, and a handful of states limit or prohibit them entirely. If all your providers accept assignment, this exclusion has essentially no financial impact on you — so it is worth asking each of your regular doctors whether they accept Medicare assignment before you choose Plan N over Plan G.

Plan N vs. Plan G

The Plan N vs. Plan G decision is the most common comparison among new Medigap enrollees. Plan G covers Part B excess charges and eliminates the copays that Plan N carries. Plan N costs less per month. The annual premium savings from choosing Plan N over Plan G commonly range from a few hundred dollars to $800 or more, depending on your market.

If you subtract the potential copay costs (roughly $80 to $200 per year for a moderate user) and any theoretical excess charges (often zero when your providers accept assignment), Plan N still saves many enrollees a meaningful amount annually. For healthy beneficiaries who see the doctor a few times per year and whose providers all accept Medicare assignment, Plan N is frequently the better financial choice. For a more detailed comparison, review our guide on Plan F vs Plan G, which also contextualizes Plan N’s position in the market.

Who Should Choose Plan N

Plan N suits beneficiaries who are generally healthy and do not expect frequent doctor visits beyond routine preventive care. It also works well for people whose healthcare providers all accept Medicare assignment, eliminating the excess-charge concern. Cost-conscious retirees who want strong catastrophic protection without the highest Medigap premium find Plan N an attractive middle ground.

Plan N may be less ideal for beneficiaries managing multiple chronic conditions requiring frequent specialist visits, as the copays, while small, accumulate over many appointments. It also may not suit beneficiaries who regularly see non-participating providers, particularly specialists who do not accept Medicare assignment. In those cases, Plan G’s broader coverage can justify its higher premium.

Enrollment and Availability

Plan N is available in most states plus the District of Columbia. Massachusetts, Minnesota, and Wisconsin standardize their Medigap policies differently and do not use the same lettered plans. Within states that offer Plan N, all carriers selling the plan provide the same standardized benefits, so your comparison is largely about premium pricing, financial strength, and customer service.

Unlike Plan F and Plan C — which closed to people newly eligible for Medicare on or after January 1, 2020 — Plan N remains open to newcomers, so it is a plan you can choose when you first age into Medicare. The best time to enroll is during your six-month Medigap Open Enrollment Period, which begins the month you are 65 or older and enrolled in Part B. During this one-time window, insurers must offer you any plan they sell at their standard rate without medical underwriting. Outside this window, most states allow carriers to apply health-based underwriting, which could increase your costs or limit your options. A few states offer additional guaranteed-issue protections. Check your healthcare policy guide and confirm current rules at Medicare.gov for your state.

Frequently Asked Questions

Does Plan N cover prescription drugs?

No. Like all Medigap plans, Plan N does not include prescription drug coverage. You need a separate Medicare Part D plan. If drug costs are a concern, look into Medicare Extra Help for subsidies on Part D premiums and copays.

Can I switch from Plan G to Plan N to save money?

You can apply to switch at any time, but outside your Medigap Open Enrollment Period the new carrier may require medical underwriting, which can raise your premium or lead to a denial. Some states have birthday-rule provisions or annual guaranteed-issue windows that allow switching without health questions. If you qualify, switching from Plan G to Plan N can save a meaningful amount in annual premiums — get quotes to see your actual numbers.

How often do Plan N copays actually apply?

The copays apply to office visits where Medicare Part B coinsurance would normally be charged. Preventive services covered at 100 percent by Medicare, such as the annual wellness visit, flu shots, and certain screenings, do not trigger Plan N copays. In practice, most Plan N enrollees pay a modest amount per year in copays, though frequent specialist users pay more.

Is Plan N a good choice if I travel frequently?

Plan N includes foreign travel emergency coverage, the same as Plan G. For domestic travel, Plan N works with Original Medicare, so you can see any Medicare-accepting provider nationwide. The only travel-related concern would be if you frequently see out-of-state providers who do not accept Medicare assignment, but this is uncommon.

What is the difference between Plan N and a Medicare Advantage plan?

Plan N is a Medigap policy that supplements Original Medicare, so you keep nationwide access to any provider who accepts Medicare and you add a separate Part D drug plan. Medicare Advantage replaces Original Medicare with a private plan that usually has networks and may bundle drug coverage. See our Medigap vs Medicare Advantage comparison to weigh the differences.

Is Plan N Right for You?

Medicare Plan N occupies a smart middle ground in the Medigap market: comprehensive enough to protect you from major medical expenses, affordable enough to ease the pressure on a fixed retirement income. If you are healthy, your providers accept Medicare assignment, and you are comfortable with modest copays, Plan N can save you hundreds of dollars per year compared to Plan G without meaningful sacrifice in coverage quality. Compare quotes from multiple carriers, enroll during your guaranteed-issue window, and pair your Plan N with a Part D drug plan for complete protection. For a broader look at all your supplemental coverage options, visit our Medigap vs Medicare Advantage comparison and healthcare costs guide.

Sources

• Medicare.gov — Medicare costs (2026 Part A and Part B deductibles)
• Medicare.gov — Medigap basics (standardized plans; open enrollment; MA/MN/WI)
• Centers for Medicare & Medicaid Services (CMS) — Medicare program guidance
• National Association of Insurance Commissioners (NAIC) — Medicare Supplement consumer guidance