The Two Most Popular Medigap Plans
Since Medicare Plan F became unavailable to new enrollees in 2020, Plan G and Plan N have emerged as the most popular Medigap choices. Together, they account for the majority of new Medigap enrollments nationwide. Both provide strong protection against Original Medicare's cost-sharing, but they differ in important ways that affect your out-of-pocket costs and monthly premium.
Coverage Comparison
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A hospital coinsurance + 365 extra days | 100% | 100% |
| Part A hospice coinsurance/copay | 100% | 100% |
| Part A deductible ($1,724 in 2026) | 100% | 100% |
| Part B coinsurance (normally 20%) | 100% | 100% (with copays noted below) |
| Part B deductible ($264 in 2026) | Not covered | Not covered |
| Part B excess charges | 100% | Not covered |
| Skilled nursing facility coinsurance | 100% | 100% |
| Foreign travel emergency (80%) | Covered | Covered |
| Blood (first 3 pints) | 100% | 100% |
| Office visit copay | $0 | Up to $20 |
| ER visit copay (no admission) | $0 | Up to $50 |
Understanding the Key Differences
Difference 1: Office visit and ER copays
Plan N applies a copay of up to $20 per office visit and up to $50 per emergency room visit that does not result in an inpatient admission. Plan G has no copays at all. For someone who visits a doctor 6 times a year, that is potentially $120 in extra costs with Plan N. For someone who visits 2 times, it is only $40.
Difference 2: Part B excess charges
Plan G covers Part B excess charges — the amount a non-participating provider can charge above the Medicare-approved amount (up to 15% more). Plan N does not cover these charges. In practice, this matters less than it sounds: the vast majority of doctors (96%+) accept Medicare assignment and do not bill excess charges. However, if you see specialists who do not accept assignment, Plan G protects you while Plan N does not.
Difference 3: Premium savings
The primary reason to choose Plan N over Plan G is the lower monthly premium. Nationally, Plan N premiums average $30–$80 less per month than Plan G — savings of $360–$960 per year. For a healthy beneficiary with few doctor visits, the premium savings almost always exceed the occasional copays.
Cost Analysis: Plan G vs. Plan N
| Scenario | Plan G Annual Cost | Plan N Annual Cost |
|---|---|---|
| Healthy (3 doctor visits, no ER) | $2,520 premium only | $1,920 premium + $60 copays = $1,980 |
| Moderate (8 visits, 1 ER no admission) | $2,520 premium only | $1,920 premium + $210 copays = $2,130 |
| High use (15 visits, 2 ER no admission) | $2,520 premium only | $1,920 premium + $400 copays = $2,320 |
Example based on Plan G at $210/mo and Plan N at $160/mo. Actual premiums vary by age, state, and insurer.
Who Should Choose Plan G?
- Beneficiaries with chronic conditions requiring frequent specialist visits
- Those who see providers that do not accept Medicare assignment
- People who value maximum predictability and simplicity — after the $264 Part B deductible, there are truly $0 out-of-pocket costs
- Beneficiaries who prefer to never think about copays at the point of service
Who Should Choose Plan N?
- Relatively healthy beneficiaries with few doctor visits per year
- Those who see only Medicare-participating providers (no excess charges)
- Budget-conscious enrollees who want strong protection at lower monthly cost
- People comfortable with small, predictable copays at the point of service
High-Deductible Plan G: A Third Option
For beneficiaries willing to accept more risk in exchange for very low premiums, the High-Deductible Plan G requires you to pay the first $2,870 (2026) of Medicare cost-sharing out of pocket before coverage kicks in. After meeting this deductible, it covers everything Plan G covers. Monthly premiums are often $30–$80/month — a fraction of standard Plan G. This option works well for very healthy beneficiaries who want catastrophic protection at minimal cost.
Shopping and Switching Tips
Because Medigap plans are standardized, the coverage for any Plan G is identical across all insurers. Shop purely on premium, financial stability of the insurer, and customer service reputation. Use your state insurance department rate comparison tools. If you currently have Plan G and want to switch to Plan N (or vice versa), be aware that outside your initial open enrollment period, you may face medical underwriting in most states.