Medigap Plan G vs. Plan N: Which Medicare Supplement Saves More in 2025?
If you're shopping for a Medicare Supplement (Medigap) policy, Plan G and Plan N are the two most popular options for people new to Medicare today. Both cover significant out-of-pocket costs that Original Medicare leaves behind — but they work differently, and the "better deal" depends entirely on how you use healthcare.
Here's a clear breakdown of what each plan covers, where they differ, and the factors that determine which one actually costs less over time.
What Both Plans Have in Common
Plan G and Plan N share a strong coverage foundation. Both cover:
- Medicare Part A coinsurance and hospital costs (up to an additional 365 days after Medicare benefits are used)
- Medicare Part B coinsurance or copayment (with one key exception in Plan N — more on that below)
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- Part A deductible
- Foreign travel emergency care (up to plan limits)
Neither plan covers the Part B deductible — that's a fixed annual amount set by Medicare each year. You pay it out of pocket before either plan kicks in for most outpatient services.
Where Plan G and Plan N Differ 🔍
This is where the real comparison lives. Two differences separate these plans:
1. Excess Charges
Plan G covers Medicare Part B excess charges. Plan N does not.
An excess charge occurs when a doctor doesn't accept Medicare assignment — meaning they're allowed to bill up to 15% more than Medicare's approved amount. Plan G absorbs that extra cost. With Plan N, you pay it yourself.
This matters more in some states and regions than others. In a handful of states, excess charges are prohibited by law, making this distinction irrelevant. In most states, the risk is real but varies widely depending on which providers you use.
2. Copayments at the Doctor and Emergency Room
Plan N requires small copayments for certain visits. Plan G does not.
With Plan N, you may owe:
- Up to $20 per office visit for covered Part B services
- Up to $50 per emergency room visit (waived if you're admitted)
Plan G has no such copayments — once your Part B deductible is met, it pays 100% of covered costs.
The Core Trade-Off: Lower Premium vs. Lower Out-of-Pocket
| Feature | Plan G | Plan N |
|---|---|---|
| Part A deductible | ✅ Covered | ✅ Covered |
| Part B deductible | ❌ Not covered | ❌ Not covered |
| Part B coinsurance | ✅ Covered | ✅ Covered (with copays) |
| Excess charges | ✅ Covered | ❌ Not covered |
| Office visit copay | None | Up to $20 |
| ER copay | None | Up to $50 |
| Typical monthly premium | Higher | Lower |
Plan N's lower monthly premium is its main selling point. The trade-off is accepting some cost-sharing when you actually use care.
Which Plan Saves More? It Depends on Your Usage ���
There's no universal answer — but here's how to think through it:
Plan N may come out ahead if you:
- Visit the doctor infrequently (a handful of times per year)
- Rarely or never go to the emergency room
- Live in a state that bans excess charges, or primarily use doctors who accept Medicare assignment
- Are in relatively good health and want to lower your fixed monthly costs
Plan G may come out ahead if you:
- See specialists or primary care doctors regularly
- Live in an area where many providers don't accept Medicare assignment
- Prefer the simplicity of zero cost-sharing after your deductible
- Have a condition that involves frequent medical visits
The Math That Matters
The key calculation is straightforward in concept: compare the annual premium difference against the likely copayments and any excess charges you'd face.
If Plan G costs meaningfully more per month than Plan N in your area, you'd need to accumulate enough office visit copays and excess charges to close that gap before Plan G "wins." If your visit frequency is low, Plan N's savings may never be offset. If you're a frequent user of medical services, Plan G's predictability can be worth the premium.
The problem is that neither you nor anyone else knows in advance exactly how much healthcare you'll use in a given year.
Don't Overlook These Important Variables
Pricing Varies by Location and Insurer
Medigap premiums aren't set nationally — they vary by state, ZIP code, insurance company, age, gender, and sometimes tobacco use. The premium gap between Plan G and Plan N can be wide in some markets and narrow in others. A difference of $10/month creates a very different calculation than a difference of $40/month.
How Insurers Price Over Time
Medigap plans are standardized by coverage, but not by pricing methodology. Insurers use different rating structures — community-rated, issue-age-rated, or attained-age-rated — which affect how premiums change as you age. This long-term pricing behavior is worth understanding when comparing policies, not just the current premium.
Underwriting Windows
Most people have a one-time guaranteed issue window when they first enroll in Medicare Part B. During this period, insurers cannot deny coverage or charge more based on health status. Outside this window, switching plans typically requires medical underwriting in most states — meaning your health history could affect your eligibility or pricing.
This makes the initial plan choice more consequential than it might appear. Choosing Plan N to save money now could be harder to undo later if your health changes. 🎯
A Note on Plan G High-Deductible Version
There's also a High-Deductible Plan G that some insurers offer. It carries an even lower premium but requires you to meet a higher deductible before coverage kicks in. This is a separate product worth understanding if you're comfortable with more cost-sharing in exchange for lower fixed costs — but it's a distinct tier from standard Plan G.
What You'd Need to Know to Decide
Before comparing these plans in your specific situation, the most useful information to gather includes:
- The actual premium quotes for both plans from carriers in your ZIP code
- Whether your preferred doctors accept Medicare assignment (you can check this on Medicare.gov)
- Whether your state prohibits excess charges (a licensed insurance counselor or your State Health Insurance Assistance Program — SHIP — can confirm this)
- Your typical annual healthcare usage — honestly assessed, not optimistically projected
- Your financial comfort with variable costs versus fixed, predictable premiums
Neither Plan G nor Plan N is objectively superior. They represent different bets on how much healthcare you'll use — and different preferences for certainty versus flexibility. The right choice is the one that fits your actual circumstances, not a general ranking.
