Quick answer
Plan G covers nearly all of your Original Medicare costs once you’ve paid the Part B deductible ($283 in 2026). Plan N covers most of the same things but leaves you with copays of up to $20 for some office visits and up to $50 for ER visits that don’t lead to an admission, and it doesn’t cover Part B excess charges. Plan N usually has a lower premium, so it tends to suit people who don’t see doctors often and whose doctors accept Medicare assignment. Plan G is simpler if you want the fewest surprise bills.
Key takeaways
- Neither Plan G nor Plan N covers the Part B deductible, which is $283 in 2026.
- Plan G pays the Part A deductible, Part B coinsurance, skilled nursing coinsurance and Part B excess charges in full.
- Plan N covers the same things except Part B excess charges, but you pay copays of up to $20 for some office visits and up to $50 for ER visits without an admission.
- Plan G averaged $164 a month in 2023, according to KFF, with state averages from $140 to $236.
- Your best chance to buy either plan without health questions is your six-month Medigap open enrollment period, which starts when you’re 65 and have Part B.
On this page
What Plan G and Plan N cover
Medigap plans are standardized in most states, so a Plan G from one insurer covers the same things as a Plan G from another. Only the price and the company’s service differ.
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A coinsurance and hospital costs | 100% | 100% |
| Part B coinsurance | 100% | 100%, except copays of up to $20 for some office visits and up to $50 for ER visits without an admission |
| Part A deductible | 100% | 100% |
| Skilled nursing facility coinsurance | 100% | 100% |
| Part B excess charges | 100% | Not covered |
| First 3 pints of blood | 100% | 100% |
| Foreign travel emergency | 80% | 80% |
| Part B deductible ($283 in 2026) | Not covered | Not covered |
The two plans are closer than people think. The differences come down to the office and ER copays and excess charges.
What excess charges are
Doctors who don’t accept Medicare assignment are allowed to bill up to 15% more than the Medicare-approved amount. That extra is called an excess charge. Plan G pays it; with Plan N, you do.
Most doctors accept assignment, so plenty of Plan N holders never see an excess charge. Some states also ban or limit excess charges. But if you see specialists who don’t take assignment, or you’re not sure, Plan G removes the risk. You can ask any doctor’s office whether they accept Medicare assignment before your visit.
What they cost
Premiums depend on your state, your age, the insurer and how the insurer prices its policies. KFF’s most recent analysis found Plan G averaged $164 a month in 2023, ranging from $140 in places like DC, Hawaii and New Mexico to $236 in New York. Plan N is usually priced below Plan G, since you take on the copays and excess charges yourself.
To compare, add up what you’d expect to pay in a year. With Plan N, that’s the premium plus the Part B deductible plus your likely office and ER copays. With Plan G, it’s the premium plus the Part B deductible. If the premium gap is bigger than your expected copays, Plan N comes out ahead.
Also check how the insurer prices its policies, because it affects future costs:
- Community-rated: everyone pays about the same premium regardless of age.
- Issue-age-rated: your premium is based on your age when you buy, so it doesn’t go up just because you get older.
- Attained-age-rated: your premium is based on your current age and goes up as you age. These often start cheaper and end up costing more.
There’s also a high-deductible version of Plan G. You pay the first $2,950 in 2026 before the plan pays anything, in exchange for a lower premium. The 2027 deductible hasn’t been announced yet.
When to buy, and whether you can switch later
Your six-month Medigap open enrollment period starts the first month you’re 65 or older and enrolled in Part B. During that window, insurers can’t turn you down or charge more because of your health. After it ends, in most states insurers can ask health questions and decline you, which means switching from Plan N to Plan G later isn’t guaranteed.
There are some exceptions:
- Trial right: if you join a Medicare Advantage plan for the first time and leave it within 12 months, you can buy a Medigap plan without health questions.
- Losing other coverage: after certain events, like losing employer coverage or your Medicare Advantage plan leaving your area, you generally have 63 days to buy a Medigap policy without health questions.
- State rules: Connecticut and New York require insurers to sell Medigap year-round regardless of health, and insurers in Massachusetts offer continuous open enrollment. California, Idaho, Illinois, Kentucky, Louisiana, Maryland, Nevada, Oklahoma and Oregon have “birthday rules” that let you switch each year to a plan with equal or lesser benefits. Missouri has a similar anniversary rule, and Washington lets you switch to equal or lesser coverage at any time.
- Minnesota (new for 2026): a one-time window for people ages 65 to 70, available during October 15 to December 7, though insurers can add a surcharge.
In Massachusetts, Minnesota and Wisconsin, Medigap plans aren’t labeled with letters, so you won’t find a “Plan G” or “Plan N” by name. Those states use their own standardized plans, like Minnesota’s Extended Basic or Wisconsin’s Basic plan with riders.
If you’re still deciding between Medigap and a Medicare Advantage plan, see Medicare Advantage vs. Medigap. Your Medigap plan doesn’t include drug coverage, so you’ll also want a Part D plan; see Medicare open enrollment.
Which one should you pick?
Plan G tends to fit people who see doctors often, see specialists who may not accept assignment, or want predictable costs. Plan N tends to fit people who are healthy, see doctors a few times a year, and live somewhere excess charges are rare or restricted. Whatever you choose, pick carefully during your open enrollment window, since switching later can be hard. Your State Health Insurance Assistance Program (SHIP) offers free, unbiased help comparing plans, and many state insurance departments publish Medigap rate guides.
More on Medicare: the Part B premium and IRMAA, late enrollment penalties, working past 65, Medicare Advantage vs. Medigap, Medicare open enrollment and who is eligible for Medicare.
Under 65 and need coverage until Medicare starts? Compare plans by ZIP code.
Frequently asked questions
Is Plan N cheaper than Plan G?
Plan N’s premium is usually lower, but you pay copays of up to $20 for some office visits and up to $50 for ER visits without an admission, plus any excess charges. Add those up to see which costs less for you.
Does Plan G cover the Part B deductible?
No. Neither Plan G nor Plan N covers the Part B deductible, which is $283 in 2026. Only Plans C and F cover it, and they can’t be sold to people who became eligible for Medicare on or after January 1, 2020.
Can I switch from Plan N to Plan G later?
Maybe. Outside your Medigap open enrollment period and a few protected situations, insurers in most states can use your health history to decide whether to sell you a policy. Some states, like those with birthday rules, make switching easier.
What are Medicare excess charges?
Doctors who don’t accept Medicare assignment can charge up to 15% more than Medicare’s approved amount. Plan G covers that extra amount; Plan N doesn’t.
Sources
This article is general information, not insurance or financial advice. Medigap premiums and switching rules vary by state and insurer. Last reviewed September 2026.