Medigap Plan G vs Plan N 2026: Which Medicare Supplement Is Right for You?

Original Medicare pays 80% of outpatient costs — with no out-of-pocket cap. A two-week hospital stay or a complex surgery can expose you to tens of thousands of dollars in 20% coinsurance. Medigap fills that gap. But the two most popular plans — Plan G and Plan N — are priced differently and cover different things. This page explains exactly what each covers in 2026, when Plan N's lower premiums are actually the better deal, and when Plan G's broader coverage is worth the extra cost.

What Medigap does (and what it doesn't)

Medicare Supplement Insurance — called Medigap — is sold by private insurers to wrap around Original Medicare (Parts A and B). It covers some or all of the cost-sharing that Medicare leaves on you: the Part A hospital deductible, the Part B 20% coinsurance, skilled nursing coinsurance, and more.

Medigap does not cover:

• Prescription drugs — you still need a standalone Part D plan
• Dental, vision, or hearing
• Long-term care or custodial care
• Care outside the U.S. (some plans cover emergency foreign travel, but not Plan G or Plan N)

For a full explanation of enrollment windows, Part B penalties, and the Original Medicare vs. Medicare Advantage choice, see our Medicare enrollment guide.

2026 plan comparison: G, N, and High-Deductible G

*Plan N pays 100% Part B coinsurance except for office and ER copays listed above.
Premiums vary significantly by state, ZIP code, gender, tobacco use, and insurer. Get quotes for your area — benefits are standardized by law; only price varies.

Interactive annual cost calculator: Plan G vs Plan N

Enter your estimated annual usage and the premiums available in your area to see which plan is cheaper for your situation.

Plan G: the comprehensive standard

Plan G is the most popular Medigap plan sold to new Medicare enrollees. After you pay the annual Part B deductible ($283 in 2026), Plan G covers 100% of what Medicare approves for the rest of the year — including the Part A hospital deductible, skilled nursing coinsurance, and Part B excess charges. There are no copays, no coinsurance on Medicare-covered services, and no annual out-of-pocket cap to worry about.

The key benefit of Plan G: predictability. Your annual out-of-pocket cost exposure is capped at $283 (the Part B deductible) after you've paid your monthly premiums. For a retiree who values financial certainty or has chronic conditions requiring frequent care, this matters enormously.

Part B excess charges — what Plan G protects against

When a doctor doesn't accept Medicare "assignment" — meaning they don't agree to accept Medicare's approved payment rate as full payment — they can charge up to 15% above the Medicare-approved amount. Plan G pays that 15% overage. Plan N does not.

In practice, roughly 97% of physicians accept Medicare assignment, so excess charges are uncommon. But they're more prevalent in certain areas (notably some parts of New York, Massachusetts, and large urban specialty centers) and among certain specialist types. If you see a lot of specialists or travel frequently, Plan G's excess-charge protection is worth more to you.

Plan N: lower premiums with defined copays

Plan N offers nearly the same coverage as Plan G but with two cost-sharing differences:

1. Office visit copay: Up to $20 per visit (applies to physician and specialist office visits). The $20 is a cap — the actual copay may be less for some visit types.
2. Emergency room copay: Up to $50 per ER visit. This copay is waived entirely if you're admitted to the hospital from the ER.
3. No excess charge coverage. If your doctor charges above the Medicare-approved amount, you owe the difference.

In exchange for these cost-sharing elements, Plan N premiums are typically 20–30% lower than Plan G. For a 65-year-old in 2026, that's often $40–$60/month in premium savings — or $480–$720/year.

When Plan N makes sense

• You're healthy and have few office visits (the math usually favors N at fewer than 20–25 visits/year)
• All your doctors accept Medicare assignment (eliminating the excess-charge risk)
• You're price-sensitive and want to reduce fixed monthly costs
• You have a financial cushion to absorb the occasional $20 copay without stress

The underwriting risk of Plan N

The most underappreciated risk of Plan N is the difficulty of switching later. During your Medigap Open Enrollment Period (OEP) — the 6 months starting when you first enroll in Part B at age 65 — you can buy any Medigap plan with no medical underwriting. Insurers must accept you regardless of pre-existing conditions during OEP.

After OEP, most states allow insurers to medically underwrite Medigap applicants. If your health has deteriorated since you first enrolled, an insurer can charge higher premiums or deny your application for Plan G entirely. Starting with Plan N and wanting to upgrade to Plan G later may not be possible at an affordable price — or at all.

High-Deductible Plan G: ultra-low premiums for the healthy

High-Deductible Plan G (HDG) offers the same coverage as Plan G once you've met an annual deductible: $2,950 in 2026 (indexed annually to inflation).¹ Until you hit that threshold, you pay cost-sharing as if you had no Medigap plan at all.

In exchange, monthly premiums are very low — typically $40–$80/month for a 65-year-old, or roughly one-quarter of Plan G's cost. The math is essentially self-insuring for routine costs while protecting against catastrophic bills.

At the numbers above, Plan G's worst case ($2,503) is actually lower than HD Plan G's worst case ($3,610) — but HD Plan G's best case ($660) is far lower than Plan G's ($2,220). HD Plan G is a bet on good health. It works best for healthy 65-year-olds who want to keep monthly costs very low and have a cash reserve to cover the deductible if needed.

What about Plan F?

Plan F is the only Medigap plan that also covers the Part B deductible ($283), giving it a true $0-after-deductible structure. However, Plan F is only available to people who were eligible for Medicare before January 1, 2020 — generally, those born before January 2, 1955. If you turned 65 after 2019, Plan F is not an option for you.²

If you enrolled before 2020 and are on Plan F, check whether Plan G would be cheaper: Plan F covers the $283 deductible, but the premium difference between F and G often exceeds $283, making Plan G the better value. Run the math for your specific premiums.

The guaranteed-issue window: your most important Medigap timing decision

Your Medigap Open Enrollment Period runs for 6 months starting from the month you are first enrolled in Medicare Part B — typically the month you turn 65. During this window, every insurer must sell you any Medigap plan at the standard rate for your age, with no medical questions asked.

Outside this window, insurers in most states can:

• Ask about pre-existing conditions and medical history
• Charge higher premiums based on health status
• Decline to cover you entirely

A small number of states (New York, Connecticut, Massachusetts, Maine) have continuous guaranteed-issue rules that prevent underwriting regardless of when you apply. In all other states, your OEP is the single best opportunity to get the Medigap coverage you actually want.

Who should choose Plan G vs Plan N?

Choose Plan G if:

• You have chronic conditions requiring frequent specialist or hospital care
• You're risk-averse and want to know your maximum out-of-pocket exposure is just the Part B deductible
• Some of your doctors don't accept Medicare assignment (especially relevant for certain specialists)
• You travel frequently within the U.S. and may see providers in areas with higher non-participating rates
• You want flexibility to switch insurers for price in the future without worrying about plan type

Choose Plan N if:

• You're healthy, with few anticipated office visits (fewer than 20/year) and no chronic conditions
• All your primary doctors and specialists accept Medicare assignment
• You live in a state with continuous guaranteed-issue (NY, CT, MA, ME) — switching later is still an option
• Lower fixed monthly premiums meaningfully improve your retirement cash flow

Consider HD Plan G if:

• You're healthy and want the absolute lowest monthly cost
• You have sufficient liquid savings ($3,000–$5,000) to cover the deductible without stress
• You're comfortable with self-insuring routine costs in exchange for catastrophic coverage

How to shop for Medigap

Because Medigap benefits are standardized by law, your only comparison criteria are:

1. Price. Get at least 3–4 quotes for the same plan letter in your ZIP code. Tools like Medicare.gov's Medigap finder show participating insurers and pricing.
2. Pricing method. Insurers use one of three rating methods: community-rated (same price regardless of age), issue-age-rated (locked at the price for your age at enrollment), or attained-age-rated (increases as you age). Attained-age plans look cheapest at 65 but become the most expensive over time. Issue-age and community-rated plans offer more pricing stability.
3. Financial stability. Check AM Best ratings — look for A or higher.
4. Claims reputation. Standardized coverage means if Medicare approves a claim, the Medigap insurer must pay. Disputes are rare, but read reviews.

Working with a fee-only advisor on your Medicare decision

The Medigap plan choice is one piece of a larger Medicare puzzle: which plan letter, which Part D drug plan, IRMAA planning (making sure your Roth conversions don't inadvertently spike your Medicare premiums), and how Medicare interacts with your HSA, your retirement account drawdown sequence, and your long-term care plan.

A fee-only financial advisor who specializes in retirement planning — someone without a financial incentive to sell you a particular insurance product — can help you model the full picture.

Sources

1. CMS Medigap — Medicare Supplement Insurance: 2026 plan benefits, standardization rules, and High-Deductible Plan G deductible of $2,950. Values verified May 2026.
2. Medicare.gov — Compare Medigap Plan Benefits: Official standardized benefit comparison chart for all plan letters, including Plan F eligibility restriction for post-2019 enrollees.
3. Medicare.gov — Part B Costs 2026: Part B deductible $283, standard premium $202.90. Source for baseline cost-sharing Plan G and Plan N users both face.
4. CMS — 2026 Medicare Part B Premiums and Deductibles: Confirms Part B deductible $283 and Part A inpatient hospital deductible $1,736 in 2026.

Premium ranges shown are illustrative national estimates for a 65-year-old nonsmoker in 2026. Actual premiums vary by state, county, gender, tobacco use, and insurer — obtain quotes for your area. Benefits are standardized; coverage described reflects federally-defined plan letter requirements.

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