Medigap Plan G vs. Medigap Plan N

Because Medigap letters are federally standardized, G and N differ in exactly three ways: Plan N doesn't cover Part B excess charges, Plan N has copays of up to $20 for some office visits and up to $50 for ER visits that don't end in admission, and the premium spread between them is the price of those two exposures. Everything else is identical.

Medigap Plan G

The federally standardized Medigap plan that covers essentially every gap in Original Medicare except the Part B deductible.

Medigap Plan N

A federally standardized Medigap plan with nearly the same coverage as Plan G, minus excess-charge protection and with small fixed copays for some office and ER visits.

What's identical

Federal standardization is the headline: every Plan G has identical benefits no matter which company sells it, and the same is true of every Plan N — by law, price is the only difference between two policies with the same letter.
Both cover the Part A hospital coinsurance and add up to 365 extra hospital days after Medicare benefits are used up.
Both cover the Part A deductible in full.
Both cover skilled nursing facility coinsurance, the Part A hospice coinsurance or copayment, and the first three pints of blood.
Both cover 80% of foreign-travel emergency care, up to plan limits.
Neither covers the Part B deductible — identical treatment, and worth stating because shoppers often assume this is a difference; since January 1, 2020, no Medigap plan sold to newly eligible people covers it.
Both work identically at the point of care: any provider in the U.S. that accepts Medicare, no networks, no referrals, no prior authorization — those properties come from Original Medicare, not from the plan letter.
Both are guaranteed renewable — the insurer can't cancel the policy as long as premiums are paid.

The actual differences

	Medigap Plan G	Medigap Plan N
Part B excess charges This is a bounded exposure: it only arises with providers who don't accept Medicare assignment, and some states prohibit excess charges entirely — your state insurance department or SHIP can confirm the rule where you live.	Covered — if a non-participating provider charges above the Medicare-approved amount, Plan G pays the difference.	Not covered — the excess charge, federally capped in most cases at 15% above the Medicare-approved amount, is yours to pay.
Office visit cost The math is knowable in advance: multiply your realistic annual visit count by up to $20 and compare it against the premium spread.	Nothing beyond the Part B deductible — Plan G pays the 20% coinsurance in full.	A copayment of up to $20 for some office visits, after which the plan pays the rest of the coinsurance.
Emergency room cost A capped, occasional cost — meaningful only if ER-without-admission visits are a regular pattern.	Nothing beyond the Part B deductible.	A copayment of up to $50 for emergency room visits that don't result in an inpatient admission (waived if you're admitted).
Premium level The spread varies widely by company and ZIP code even though benefits don't, so the same comparison can favor a different letter in a different county.	Typically priced higher, because the insurer absorbs the copays and excess-charge risk.	Typically priced lower — the copays and excess-charge exposure you retain are what the discount is paying for.
High-deductible version High-deductible G is effectively a third structure — catastrophic-only Medigap — that exists on the G side of the ledger only.	Plan G is offered in a high-deductible form in some states, where you pay Medicare cost-sharing up to a deductible of $2,950 in 2026 before the policy pays.	Plan N has no high-deductible version.
Sensitivity to state rules The same two plans can be a materially different trade in different states — this is a where-you-live variable, not just a which-letter variable.	Excess-charge coverage is worth the most where excess charges are legal and non-participating providers are common.	In states that ban excess charges, Plan N's biggest coverage gap is closed by law rather than by premium.

The deciding variables

The premium spread in your ZIP code versus your realistic exposure: annual office visits times up to $20, occasional ER copays of up to $50, and any excess-charge risk — when the spread exceeds the exposure, the trade leans one way; when it doesn't, the other.
Whether your providers accept Medicare assignment: excess charges only exist at non-participating providers, and most providers accept assignment — a fact you can check per provider at medicare.gov.
Your state's excess-charge rule: in states that prohibit excess charges, the largest coverage difference between the letters is neutralized by law.
How often you actually see doctors: high-frequency care compounds Plan N's per-visit copays; low-frequency care makes them nearly theoretical.

Medigap plans are federally standardized by letter, which makes this one of the few insurance comparisons that can be answered exactly. Every Plan G sold anywhere in the country (outside the three states that standardize differently — Massachusetts, Minnesota, and Wisconsin) carries identical benefits regardless of which company issues it, and the same holds for Plan N. Medicare.gov states the consequence plainly: the price is the only difference between policies with the same letter sold by different companies. So comparing G and N is not like comparing two carriers' products — it's comparing two fixed benefit schedules, and the entire difference between them fits in three lines.

First, context for why these two letters dominate the conversation: Plan F, which historically covered everything including the Part B deductible, closed to newly eligible people — anyone new to Medicare on or after January 1, 2020, can't buy Plan F (or Plan C). That made Plan G the most comprehensive letter available to new enrollees, with Plan N as its closest sibling. And on the deductible question shoppers most often get wrong: G and N are identical — neither covers the Part B deductible. You pay it out of pocket under either plan before the coverage picture diverges at all.

The three actual differences: one, Part B excess charges — Plan G covers them, Plan N doesn't. Two, Plan N charges a copayment of up to $20 for some office visits. Three, Plan N charges a copayment of up to $50 for emergency room visits that don't result in an inpatient admission — admitted visits waive it. That's the complete list. Every other benefit line on the federal chart — Part A coinsurance and the extra 365 hospital days, the Part A deductible, skilled nursing coinsurance, hospice cost-sharing, blood, 80% foreign-travel emergency coverage — reads identically for both letters.

Excess charges deserve a plain-English unpacking, because the term does more work in Medigap marketing than in most people's actual claims history. When a doctor 'accepts assignment,' they agree to the Medicare-approved amount as full payment. A non-participating provider can charge more — but federal law caps the markup in most cases at 15% above the approved amount (the 'limiting charge'). So Plan N's excess-charge exposure is doubly bounded: it applies only at non-participating providers, and it's capped by law when it does. Most providers accept assignment, and you can check any specific doctor's status through medicare.gov. On top of that, some states prohibit excess charges outright — in those states, the single largest coverage difference between G and N is erased by statute. Your State Health Insurance Assistance Program (SHIP) or state insurance department can tell you your state's rule, which is genuinely one of the first facts worth establishing in this comparison.

That leaves the premium spread as the real decision surface. Plan N is generally priced below Plan G precisely because the policyholder retains the copays and the excess-charge exposure; the spread is what the insurer pays you to keep those risks. The arithmetic is unusually honest for insurance: estimate your annual office visits, multiply by up to $20, add a realistic allowance for ER visits and any excess-charge risk given your providers and state, and compare that number to twelve months of premium difference in your ZIP code. Because companies price the same letters very differently in the same market, the spread itself varies — which means neither letter wins in the abstract. One more structural note: Plan G (like Plan F before it) also comes in a high-deductible version in some states, with a $2,950 deductible in 2026 before the policy pays — a catastrophic-only structure with no Plan N equivalent.

Two practical anchors as you compare. Whichever letter you weigh, the point-of-care experience is the same — any provider that takes Medicare, no networks, no referrals, no prior authorization — because those properties come from Original Medicare itself. And the timing rules are the same too: guaranteed-issue access without medical underwriting is generally limited to your 6-month Medigap Open Enrollment Period and specific guaranteed-issue situations, and that applies to switching between letters later just as it applies to first purchase. Compare actual quotes for both letters in your area through the Medigap policy finder at medicare.gov, call 1-800-MEDICARE, or sit down with a SHIP counselor, who can run your state's excess-charge rule and your visit patterns against live local premiums for free.

Situations where each tends to fit

Medigap Plan G

A person managing chronic conditions with frequent specialist visits, for whom per-visit copays would accumulate and first-dollar predictability is the point of buying Medigap.
Someone who sees, or expects to see, providers that don't accept Medicare assignment — or who lives in a state where excess charges are permitted and wants that exposure closed.
A person who wants their out-of-pocket exposure limited to the Part B deductible and nothing else, at any provider that takes Medicare.

Medigap Plan N

A generally healthy person who visits doctors a few times a year, in a market where the premium spread between the letters is larger than their realistic copay total.
Someone whose providers all accept Medicare assignment, or who lives in a state that bans excess charges — making Plan N's excess-charge gap moot in practice.
A person who wants Medigap's any-provider, no-network structure but is optimizing the premium line, and is comfortable with small, capped per-visit costs.

Common questions

Does either Plan G or Plan N cover the Part B deductible?

No — and they're identical on this point, which surprises many shoppers. Neither Plan G nor Plan N covers the annual Part B deductible; you pay it out of pocket under both before either plan's coverage differences matter. Plans that covered the Part B deductible (F and C) closed to people newly eligible for Medicare on or after January 1, 2020, which is precisely why the G-versus-N comparison became the default one.

What exactly are Part B excess charges, and how likely am I to face one?

If a provider doesn't 'accept assignment' — Medicare's approved amount as full payment — they can charge more, but federal law caps the markup in most cases at 15% above the approved amount, called the limiting charge. Plan G pays that difference; Plan N leaves it to you. In practice the exposure is bounded: most providers accept assignment (you can check any provider's status at medicare.gov), and some states prohibit excess charges entirely, which eliminates the difference by law. Your SHIP office can confirm your state's rule.

Are Plan G and Plan N benefits really identical from every insurance company?

Yes — Medigap plans are standardized under federal law, so every Plan G carries the same benefits as every other Plan G, and likewise for Plan N, in every state except Massachusetts, Minnesota, and Wisconsin, which standardize their plans differently. Medicare.gov states it directly: price is the only difference between policies with the same letter from different companies. That's why comparing quotes across companies for the same letter is purely a price exercise.

Can I switch between Plan G and Plan N later if I change my mind?

Not always freely — the honest answer is that switching Medigap policies outside your original 6-month Medigap Open Enrollment Period generally allows the insurer to medically underwrite you in most states, meaning the application can be denied or priced up based on health, unless you qualify for a guaranteed-issue right or your state provides broader switching protections. Verify your options with your State Health Insurance Assistance Program or 1-800-MEDICARE before counting on a future switch.

What are Plan N's copays, exactly?

Plan N pays 100% of the Part B coinsurance except in two situations: a copayment of up to $20 for some office visits, and a copayment of up to $50 for emergency room visits that don't result in an inpatient admission — if you're admitted, that ER copay doesn't apply. These are federally defined caps on the copay amounts, the same under every company's Plan N, per the CMS Medigap guide's 2026 benefit chart.

What is high-deductible Plan G?

In some states, Plan G is also sold in a high-deductible version: you pay Medicare-covered costs — coinsurance, copayments, deductibles — up to $2,950 in 2026 before the policy pays anything, in exchange for a much lower premium. It's effectively a catastrophic-coverage variant of G, useful to know about as a third structure in this comparison; Plan N has no high-deductible counterpart.

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Sources

Verified 2026-08-12

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