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 $30 to $70 lower than Plan G. 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.
What Medicare Plan N Covers
Plan N provides a robust set of Medigap benefits. It covers Part A hospital coinsurance and 365 additional lifetime reserve days, the Part A deductible ($1,676 in 2026), 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.
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.
How Much Plan N Costs
Monthly premiums for Plan N typically range from $80 to $180 for a 65-year-old, depending on your location, gender, tobacco use, and the carrier’s pricing model. In lower-cost markets like rural Iowa or Alabama, you may find rates below $75. In high-cost urban areas like New York City or South Florida, premiums can approach $200.
Beyond the monthly premium, Plan N policyholders also pay the annual Part B deductible ($257 in 2026), plus the small copays described above. In a typical year, a Plan N enrollee who visits the doctor six to eight times might pay an additional $80 to $160 in copays. Adding the $257 deductible, total annual out-of-pocket costs beyond premiums might range from $337 to $417 for a moderately active healthcare user.
Compare this to Plan G, where premiums are higher but out-of-pocket costs are capped at the $257 deductible. The breakeven point is straightforward: if Plan G costs 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.
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.
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 charge up to $230. Plan N does not cover that $30 difference, while Plan G does.
In practice, this exclusion affects a relatively small number of beneficiaries. According to CMS data, approximately 97 percent of physicians accept Medicare assignment, meaning they agree to accept Medicare’s approved amount as full payment. Excess charges are most common among certain specialists in affluent urban markets. If all your providers accept assignment, this exclusion has zero financial impact on you.
Plan N vs. Plan G
The Plan N vs. Plan G decision is the most common comparison among new Medigap enrollees. Plan G covers the 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 typically range from $360 to $840.
If you subtract the potential copay costs ($80 to $200 per year for a moderate user) and any theoretical excess charges (often zero), Plan N still saves most enrollees $200 to $600 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 see non-participating providers regularly, particularly specialists who do not accept Medicare assignment. In those cases, Plan G’s broader coverage justifies its higher premium.
Enrollment and Availability
Plan N is available in 47 states plus the District of Columbia. Massachusetts, Minnesota, and Wisconsin use their own standardized Medigap systems and do not offer lettered plans. Within states that offer Plan N, all carriers selling the plan provide identical benefits, so your comparison is purely about premium pricing, financial strength, and customer service.
The best time to enroll is during your six-month Medigap Open Enrollment Period, which begins the month you turn 65 and have Part B. During this window, insurers must offer you any plan at the 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. Check your healthcare policy guide for state-specific enrollment protections.
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 Open Enrollment Period, the new carrier may require medical underwriting. 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 $360 to $840 per year in premiums.
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 between $40 and $200 per year in copays.
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-network specialists in different states who do not accept Medicare assignment, but this is uncommon.
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.