Plan G vs Plan N: Which Medigap Plan Fits You?

Welcome to Medicare! If you are preparing to enroll in a Medicare Supplement insurance policy (often called Medigap), you are likely staring down a very common dilemma: choosing between Plan G vs Plan N. These two options dominate the market today, offering excellent coverage that fills the gaps left behind by Original Medicare. But while they look similar on paper, the real-world financial differences can be significant, especially as you project your healthcare costs into the future.

In 2026, making the right choice is more critical than ever. Medigap premiums are currently experiencing massive rate increases across the country, averaging between 12% and 26% depending on your carrier and location. With inflation driving up the cost of care, every dollar in your retirement budget matters. Should you pay a higher monthly premium for the total peace of mind that Medigap Plan G provides? Or should you choose Medigap Plan N, pocket the monthly premium savings, and simply pay small copays when you actually need to see a doctor?

At Genie Medicare, our goal is to grant your Medicare rate wish by making these complex choices as clear as possible. In this comprehensive guide, we will break down the exact math between Plan G and Plan N. We will look at current 2026 official figures, project forward to the announced 2027 changes, and help you calculate your true out-of-pocket risk so you can confidently choose the plan that fits your life.

Plan G vs Plan N: The Core Differences at a Glance

Before we dive into the deep math, it is essential to understand exactly what Medicare Supplement plans do. Original Medicare is divided into two main parts: Part A (Hospital Insurance) and Part B (Medical Insurance). While Original Medicare covers a lot, it does not cover everything. It leaves you responsible for deductibles, copayments, and a 20% coinsurance on outpatient services. Medigap plans are designed to pay those remaining bills for you.

Both Plan G and Plan N are highly comprehensive. They both cover your Part A hospital deductible, which is a hefty $1,736 per benefit period in 2026. They both cover your Part A hospital coinsurance and provide up to an additional 365 days of hospital coverage after your Medicare benefits are exhausted. They also both cover skilled nursing facility care coinsurance and give you foreign travel emergency coverage (paying 80% of billed charges up to plan limits). But where they differ is in how they handle outpatient costs under Part B.

As the table shows, neither plan covers the Medicare Part B deductible. In 2026, this deductible is $283 for the year. This is not a monthly cost, but a single annual hurdle. Once you pay the first $283 out of your own pocket for outpatient care, Medicare begins paying 80% of your bills. It is at that exact moment that your Medigap plan steps in to cover the remaining 20%. Official projections from the 2026 Medicare Trustees Report suggest this deductible will rise to $292 in 2027. Regardless of whether you choose Plan G or Plan N, you must budget for this annual deductible.

How Plan G Became the Most Popular Supplement

If you have older friends or relatives, they might have told you to buy Medigap Plan F. For decades, Plan F was the undisputed king of Medicare Supplements because it covered absolutely everything, including the Part B deductible. You paid your premium, and you never saw a medical bill. However, a major piece of legislation called the MACRA rule changed the landscape entirely.

The government decided that seniors should have at least some "skin in the game" when seeking medical care, to discourage unnecessary doctor visits. Under MACRA, anyone who became eligible for Medicare on or after January 1, 2020, is legally barred from purchasing Medigap Plans C or F. If you are turning 65 today, you simply cannot buy them.

With Plan F off the table for new enrollees, Medigap Plan G immediately stepped up as the most comprehensive plan available. It offers the exact same coverage as Plan F, with one single exception: it does not cover the Part B deductible. Once that $283 deductible is met in 2026, Plan G acts exactly like Plan F, paying 100% of your approved medical costs. This comprehensive nature has made Plan G the default choice for millions of seniors who want predictable, worry-free healthcare.

However, as Plan G became more popular, its premiums naturally began to rise. This opened the door for Plan N to shine. Plan N was designed as a cost-sharing alternative. By asking you to pay a small copay when you visit the doctor, the insurance company takes on slightly less risk, and in return, they charge you a lower monthly premium. Today, Plan N is the fastest-growing Medigap plan on the market.

Understanding Plan N Copays: Doctor Visits and Emergency Rooms

The most noticeable difference in daily life between Plan G and Plan N is the copayment structure. If you have Plan G, you walk into your doctor's office, show your card, and walk out. You owe nothing at the desk (assuming you have met your annual Part B deductible). If you have Plan N, you will need to reach for your wallet.

The Office Visit Copay

Plan N requires a copayment of up to $20 for some office visits. It is important to note the words "up to." You will never pay more than $20 for a standard Medicare-approved office visit, but you might pay less if the 20% coinsurance amount is smaller than $20. This copay applies to both primary care physicians and specialists. However, it generally does not apply to telehealth visits or trips to an urgent care center, which is a nice hidden benefit of the plan.

Let us look at a real-world scenario. Imagine you are a generally healthy 65-year-old. You see your primary doctor twice a year for checkups, and you visit a cardiologist once a year. That is three office visits. Under Plan N, your maximum copay exposure for the year is just $60. When you compare that $60 to the hundreds of dollars you might save in annual premiums by choosing Plan N over Plan G, the math heavily favors Plan N.

Now, imagine a different scenario. You are 72 years old, and you have developed a chronic condition that requires physical therapy twice a week, plus regular visits to a rheumatologist and a pain management specialist. If those physical therapy sessions are billed as separate office visits, those $20 copays will stack up very quickly. In a high-utilization scenario like this, the $0 copay structure of Plan G provides immense financial relief.

The Emergency Room Copay

Plan N also features a copayment of up to $50 for emergency room visits. Emergency rooms are expensive, and this small copay helps keep the monthly premiums for Plan N low. However, there is a very important rule to remember: if you go to the ER and are subsequently admitted to the hospital as an inpatient, that $50 copay is completely waived. Your Medigap plan will cover the hospital stay under your Part A benefits.

This means the $50 copay only applies if you go to the ER, receive treatment, and are sent back home the same day. For most seniors, an ER visit that doesn't result in admission is a rare occurrence, making this a very manageable risk.

What Are Part B Excess Charges and Does Plan N Cover Them?

One of the most misunderstood concepts in Medicare is the "Part B excess charge." When a doctor agrees to treat Medicare patients, they usually accept "Medicare assignment." This means they agree to accept the Medicare-approved price for a service as payment in full. However, federal law allows doctors who do not accept assignment to charge up to 15% more than the Medicare-approved amount. This extra 15% is called an excess charge.

Here is how the two plans handle it: Medigap Plan G covers 100% of Part B excess charges. Plan N does not cover them at all.

If you have Plan N and you see a doctor who charges excess fees, you will be billed for that 15% surcharge out of your own pocket. This sounds frightening, which is why many insurance agents use excess charges as a scare tactic to push seniors into buying the more expensive Plan G. But how big of a risk is it really?

In practice, excess charges are incredibly rare. According to national data, more than 95% of doctors and medical providers across the United States accept Medicare assignment. Furthermore, several states—including Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont—have enacted laws that legally prohibit doctors from billing excess charges entirely. If you live in one of these "MOM" (Medicare Overcharge Measure) states, the lack of excess charge coverage on Plan N is completely irrelevant.

Even if you live in a state where excess charges are allowed, you can easily avoid them by simply asking your doctor's billing office, "Do you accept Medicare assignment?" before your appointment. If they say yes, you will never see an excess charge.

Standardized Coverage: Why Plan Letters Mean Identical Benefits

As you shop for a policy, you will notice that dozens of different insurance companies sell Medigap plans. You might see a Plan G from Company A for $140 a month, and a Plan G from Company B for $190 a month. You might wonder, "Is Company B's plan better? Does it have a larger network of doctors?"

The answer is no. Medicare Supplement plans are strictly standardized by the federal government. A Medigap Plan G sold by one company has the exact same medical benefits as a Plan G sold by any other company. There are no proprietary doctor networks with Medigap. If a doctor accepts Original Medicare, they must accept your Medigap plan, regardless of which insurance company's logo is printed on your card.

Because the benefits are identical, your primary focus when comparing Medicare Supplement rates should be the monthly premium, the company's history of rate increases, and their financial stability. Do not pay hundreds of dollars more per year for a brand name when the coverage is legally required to be exactly the same.

Calculating Your Out-of-Pocket Risk Between G and N

Now that we understand the benefits, let us do the math. To figure out which plan is truly the better deal, you need to calculate the "break-even" point. This involves comparing the annual premium savings of Plan N against the expected out-of-pocket costs of those $20 and $50 copays.

According to 2026 enrollment data from United Medicare Advisors, a 65-year-old applicant pays a median premium of $150 per month for Plan G. For Plan N, that same 65-year-old pays a median premium of $108 per month. (Keep in mind, rates vary wildly by zip code, gender, and tobacco use, but we will use these median figures for our example).

If you choose Plan N, you are saving $42 per month. Over the course of a full year, that equals $504 in premium savings. Now, we must ask: how many times would you have to visit the doctor to wipe out that $504 in savings?

To completely erase your $504 in premium savings, you would have to pay the maximum $20 copay 25 times in a single year. That is more than two doctor visits every single month. For the vast majority of healthy 65-year-olds, they will not see the doctor 25 times a year. In this median scenario, Plan N is the clear mathematical winner, leaving hundreds of dollars in your pocket.

However, this math changes as you age. If you are 75 years old and your Plan N premium is only $15 cheaper per month than Plan G (saving you $180 a year), it would only take 9 doctor visits to wipe out your savings. This is why comparing Medicare Supplement rates specific to your exact age and zip code is so vital before making a decision.

Premium Differences: When Plan N Saves You More Money

When analyzing premiums, it is crucial to understand that Medigap rates do not stay flat forever. In fact, 2026 is proving to be a turbulent year for the market. Due to soaring medical inflation, higher healthcare utilization by seniors post-pandemic, and rising administrative costs, Medigap premiums are experiencing massive rate hikes. According to KFF Health News and 2026 Medicare Market Insights, Plan G premiums increased by an average of 14.1% this year, while Plan N increased by 13.3%.

Because Plan G has a higher starting premium, a 14% increase hits your wallet much harder in raw dollars than a 13% increase on a cheaper Plan N policy. Over time, the dollar gap between Plan G and Plan N tends to widen, making Plan N's savings even more pronounced as you age into your 70s and 80s.

It is also important to know how your specific policy is priced. Insurance companies use three different pricing methods: Attained-age, Issue-age, and Community-rated. Attained-age policies automatically increase in price every year just because you get older. Issue-age policies base your premium on the age you were when you bought the policy, meaning they don't increase just because of your birthday (though they still increase due to inflation). Community-rated policies charge everyone in a specific area the exact same price, regardless of age. When comparing Plan G vs Plan N, make sure you are comparing policies with the same pricing structure so you get an accurate picture of future costs.

Finally, be aware of demographic factors. Tobacco users generally pay roughly 12% to 15% more for both Plan G and Plan N. Additionally, in states where it is legally permitted, men generally pay higher baseline rates than women due to actuarial data showing men tend to have higher healthcare costs later in life.

The Underwriting Trap: Why Upgrading Later Can Be Difficult

One of the most dangerous mistakes seniors make is assuming they can simply buy the cheaper Plan N today and upgrade to the more robust Plan G later if they get sick. While you are legally allowed to apply for a plan change at any time, doing so outside of your initial Medigap Open Enrollment Period comes with a massive catch: medical underwriting.

Your Medigap Open Enrollment Period (OEP) is a golden, one-time-only 6-month window that begins the first month you have Medicare Part B and are 65 or older. During this window, you have a "guaranteed issue" right. Insurance companies cannot ask you any health questions, they cannot deny you coverage, and they cannot charge you a higher premium because of pre-existing conditions. You could have a severe heart condition or a cancer diagnosis, and they must sell you the policy at the best available rate.

However, once those 6 months are over, your guaranteed issue right vanishes in most states. If you bought Plan N to save money and five years later you develop a chronic illness that requires frequent doctor visits, you might decide you want the $0 copays of Plan G. But when you apply for Plan G, the insurance company will put you through medical underwriting. They will review your medical records, look at your prescriptions, and assess your health risk. Because you now have a chronic illness, they will likely deny your application entirely. You will be "trapped" in Plan N.

There are some exceptions to this rule. If you live in a state like New York, Connecticut, Massachusetts, or Maine, state law mandates continuous open enrollment or community rating, meaning you can switch plans without underwriting. Other states, like California, Oregon, Idaho, and Nevada, have "Birthday Rules" that allow you a brief window around your birthday each year to switch to a plan of equal or lesser benefit without underwriting. But for the majority of Americans, the plan you choose at age 65 might be the plan you are stuck with for the rest of your life. Always factor your long-term health history into your decision.

If you are currently on a Medicare Advantage plan and are considering switching from Medicare Advantage to Medigap, you will almost certainly have to pass medical underwriting unless you qualify for a special enrollment period.

Factoring in Your Total Healthcare Budget for 2027

When choosing between Plan G and Plan N, you cannot look at Medigap premiums in a vacuum. You must consider your entire healthcare budget, which includes your prescription drug costs under Medicare Part D. This is especially important as we look ahead to massive changes coming in 2027.

In 2026, the maximum Part D deductible is $615, and the out-of-pocket cap is $2,100. But official numbers from CMS show that in 2027, the Part D maximum deductible will jump to $700, and the Medicare Part D out-of-pocket cap will increase to $2,400. This means you will likely be spending more of your own money at the pharmacy counter next year.

This is where the Plan N strategy becomes brilliant for many seniors. By choosing Plan N instead of Plan G, you might save $500 or more a year in Medigap premiums. You can then take those exact premium savings and set them aside to help pay for your higher 2027 Part D deductible. You are essentially moving money from an insurance company's pocket into your own pharmacy budget. For seniors who take expensive brand-name medications, sacrificing the $0 doctor copay of Plan G in order to free up cash for prescription drugs is a highly effective financial strategy.

Another option to consider is High-Deductible Plan G (HD-G). This plan offers the exact same coverage as standard Plan G, but before the plan pays anything, you must meet a massive deductible. In 2026, the HD-G deductible is $2,950, and CMS projections show it rising to $3,050 in 2027. The trade-off is that HD-G premiums are incredibly low, often under $50 a month. This is a great choice for seniors who have a lot of savings and want catastrophic protection, but it requires you to be comfortable paying out of pocket for routine care.

Checklist: How to Decide Between Plan G and Plan N for Next Year

Making your final decision doesn't have to be overwhelming. Use this simple step-by-step checklist to guide your choice:

• Review your doctor visits: Look at your calendar from the past year. Count exactly how many times you saw a doctor or specialist. Multiply that number by $20 to estimate your Plan N copay risk.
• Check your budget: Compare the annual premium of Plan G versus Plan N in your specific zip code. Does the premium savings of Plan N outweigh your estimated copays?
• Ask your doctors about excess charges: Call your primary care doctor and your most visited specialists. Ask them, "Do you accept Medicare assignment?" If they say yes, you don't need to worry about Plan N's lack of excess charge coverage.
• Consider your future health: Look at your family health history. If you anticipate developing conditions that require high-frequency doctor visits, Plan G might be safer, as upgrading later could be blocked by medical underwriting.
• Factor in Part D costs: Ensure you have enough room in your overall budget to handle the 2027 Part D deductible increase to $700. If money is tight, Plan N's lower premium can help balance the scales.

Compare Medigap Rates in 30 Seconds

The math between Plan G and Plan N is completely dependent on the actual prices in your local area. A $40 monthly savings might make Plan N a no-brainer, but a $10 monthly savings might make Plan G the safer bet. You cannot make an informed decision without seeing real numbers.

At Genie Medicare, we believe you shouldn't have to jump through hoops just to see a price. You can compare real-time Medigap rates in your exact zip code in about 30 seconds. We show you the prices first, with absolutely no name, phone number, or email address required to look. If you see a plan you like, our licensed agents are ready to grant your Medicare rate wish and help you enroll smoothly. Take control of your healthcare costs today and find the plan that fits you perfectly.