Medigap Plan G vs Plan N

Say you compare the two on premium and take the cheaper letter. What you saved on the monthly bill comes back at the point of care instead. The letters are identical by law except in where they put the small costs.

What is the difference between Medigap Plan G and Plan N?

Medigap Plan G and Plan N cover the same benefits except in two places. Plan G covers Part B excess charges and Plan N does not. Plan N charges copayments for some office visits and some emergency room visits, and Plan G charges none. Neither covers the Part B deductible.

Both are Medigap policies, which means both are extra insurance bought from a private insurance company to help pay your share of out-of-pocket costs in Original Medicare, like copayments, coinsurance and deductibles. You generally need Part A and Part B in place before you can buy either one.

Everything else on the chart matches. Both cover Part A coinsurance and hospital costs for up to an additional 365 days after Medicare benefits are used. Both cover the first 3 pints of blood, Part A hospice care coinsurance or copayment, skilled nursing facility care coinsurance, and the Part A deductible, each at 100 percent.

Both also cover foreign travel emergency care at 80 percent, up to plan limits, which is one of the few things Medigap covers that Original Medicare does not.

So the whole comparison is two rows out of the chart's ten. One is a copayment attached to visits. The other is a charge you may never meet at all, depending on the providers you use.

What copays does Plan N have?

Plan N pays 100 percent of the costs of Part B services, except for copayments for some office visits and some emergency room visits. Medicare.gov does not state which visits carry a copayment, or how much it is, so that answer sits with the individual policy rather than with any national page.

The word doing the work is some. The chart's footnote does not say all office visits, and it does not name a dollar amount anywhere.

The two plans are identical on almost everything, so the differences fit in one small table.

	Plan G	Plan N
Office visit copay	None	Up to a set amount per visit
Emergency room copay	None	Up to a set amount, waived if admitted
Part B excess charges	Covered	Not covered

Three rows is the whole difference. Everything else about a lettered Medigap plan is set by law and is the same wherever you buy it.

That makes the Plan N copayment a question to ask the insurance company before buying, not one to look up. What the copayment does structurally is move part of the cost from the premium to the visit, which is a different shape of cost rather than proof of a smaller one.

What is a Part B excess charge?

Plan G covers the Part B excess charge and Plan N does not. The charge sits with a provider who does not accept assignment: such a provider can bill more than the Medicare-approved amount, in many cases no more than 15 percent above it, which Medicare.gov calls the limiting charge.

Accepting assignment means a provider takes the Medicare-approved amount as payment in full for a covered service, and agrees to charge you only the Medicare deductible and coinsurance amount. A provider who does not is called non-participating.

One honest note about the term itself. Medicare.gov's benefits chart names a Part B excess charge row without defining the phrase on that page, and the assignment page describes the mechanism above without using it. The two facts are stated here separately, exactly as the government states them.

How much this row matters is a question about your own doctors, because most doctors, providers and suppliers accept assignment, and Medicare.gov's instruction is to check that yours do.

That is what makes this difference unusual among the ones on the chart. A copayment on an office visit is a cost you will meet if you see a doctor. An excess charge is a cost that only exists if a particular provider is non-participating, so two people holding the same Plan N can have entirely different experiences of the same missing row.

What does Medigap not cover?

Medigap generally does not cover long-term care such as nursing home care, vision or dental care, hearing aids, glasses, or private-duty nursing. Policies sold after 2005 do not include prescription drug coverage either, so drug coverage means joining a separate Medicare drug plan.

That list is the same for Plan G and Plan N, and for every other letter. Standardization cuts both ways: it fixes what a letter covers, and it fixes what no letter covers.

Two letters are also missing from the market for most people. Plan C and Plan F are not available if you turned 65 on or after January 1, 2020, and to some people under 65, though someone eligible for Medicare before that date but not yet enrolled may still be able to get them.

Plans F and G also come in a high deductible version in some states, where you pay Medicare-covered costs up to a deductible amount before the policy pays anything.

How do Medigap premiums compare?

Medigap premiums vary widely by insurance company, plan and location, and each company decides how it sets its price. A policy is rated in one of three ways: community-rated, issue-age-rated, or attained-age-rated. Only the third raises your premium because you got older.

Community-rated, also called no-age-rated, generally charges everyone the same premium regardless of age or sex. Issue-age-rated, also called entry-age-rated, sets the premium by the age you are when you buy, and it does not change as you age. Both can still rise with inflation and other factors.

Attained-age-rated is the one that changes shape over time. It is based on your current age, so it may be the least expensive at first and can eventually become the most expensive.

Other things move the price too: discounts, whether the company uses medical underwriting when you have no guaranteed issue right and are outside your open enrollment period, whether it sells Medicare SELECT policies, and whether it offers a high deductible option.

Two structural facts sit under all of it. The Medigap premium is paid to the insurance company on top of your monthly Part B premium, Medicare pays none of it, and premium amounts typically increase each year.

Are Plan G and Plan N the same at every company?

Plan G and Plan N carry the same basic benefits at every company. All Medigap policies are standardized, so a lettered policy offers the same benefits no matter where you live or who sells it. Call it the Letter Settles It: price is the only difference left.

All Medigap policies are standardized, so a lettered policy offers the same benefits no matter where you live or who sells it.

The Letter Settles It is our naming for what two published rules do when put together. Medicare.gov states that same-letter policies offer the same basic benefits, and that price is the only difference between same-letter policies from different companies. The rules are the government's. Naming what they leave a shopper to compare is ours.

That is why Medicare.gov's own instruction is to compare like with like: Plan G from one company against Plan G from another, because there can be big differences in what companies charge for identical coverage.

Three states sit outside this. In Massachusetts, Minnesota and Wisconsin, Medigap policies are standardized in a different way.

One more variant exists. In some states you can buy a Medicare SELECT policy, which may require using certain hospitals and, in some cases, certain doctors for full benefits. Its premium may be lower for that reason. Buying one carries a right to change your mind within 12 months and switch to a standard Medigap policy.

What this means for you

The Plan G and Plan N decision is narrower than the letters suggest. Two rows differ: the Part B excess charge, which Plan G covers, and the office and emergency room copayments, which Plan N carries. Everything else on the benefits chart is identical.

Because the letters are standardized, the second half of the work is not about benefits at all. It is about price, and about which of the three rating methods a company uses, since only one of them raises your premium as you age.

Prices shown in a comparison are estimates, and Medicare.gov says to contact the insurance company for an accurate one.

For when you are allowed to buy any of this without a health question, read the open enrollment article in this cluster. For changing a policy after you already have one, read the switching article beside it.

FAQ

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

Neither does. On Medicare.gov's benefits chart the Part B deductible row is covered only by Plan C and Plan F, and both of those are closed to most new buyers.

They are not available if you turned 65 on or after January 1, 2020, or to some people under 65. Someone who was eligible for Medicare before that date but had not yet enrolled may still be able to get them.

For everyone else, the Part B deductible is a cost you meet yourself before a Plan G or Plan N policy starts paying its share of Part B coinsurance. The chart states the rule directly: a Medigap policy only pays your coinsurance after you have paid the deductible, unless the policy also covers that deductible.

Is Plan N always cheaper than Plan G?

Medicare.gov does not say so, and the structure of Medigap pricing is the reason it cannot. Premiums vary widely by insurance company, by plan and by where you live, each company decides how it sets its price, and the same lettered plan can carry very different premiums from different companies.

What is true structurally is that Plan N covers less than Plan G in two places, the Part B excess charge and the office and emergency room copayments, and those uncovered costs sit with you instead.

Comparing the two honestly means comparing a specific Plan G quote against a specific Plan N quote from companies selling in your area, and asking each how it rates its policies.

What is the high deductible version of Plan G?

Plans F and G are also offered as high deductible plans in some states. With one of those, you pay Medicare-covered costs, meaning coinsurance, copayments and deductibles, up to a deductible amount before your Medigap policy pays anything.

Medicare.gov publishes that deductible figure with its plan year attached, and this article deliberately carries no plan-year dollar amount, so check the current figure on the source page before relying on it.

The structural point is that a high deductible policy puts a block of Medicare-covered costs in front of the policy paying anything, and it is offered only in some states. It is a different product from standard Plan G, sold under the same letter.

What does foreign travel emergency coverage include on these plans?

Both Plan G and Plan N cover foreign travel emergency care at 80 percent, up to plan limits.

That figure is one of the few places on the benefits chart where neither plan covers 100 percent, and the phrase up to plan limits is doing real work: the ceiling is set by the individual policy rather than by any national rule.

This benefit matters because it is one of the few things Medigap covers that Original Medicare does not. Medicare.gov lists emergency medical care while traveling outside the United States as an example of coverage some Medigap policies add. Anyone planning time abroad should ask the insurance company for the specific limits in the policy they are considering.

Do I still need a drug plan if I buy Plan G or Plan N?

Yes, if you want prescription drug coverage. Medigap policies sold after 2005 do not include prescription drug coverage, and Medicare.gov's own note is that you can enroll in a separate Medicare drug plan if you want it.

With Medigap you are assembling coverage from parts: Original Medicare, a Medigap policy for your share of the costs, and a separate Medicare drug plan. Each carries its own premium, and the Medigap premium sits on top of the monthly Part B premium rather than replacing it.

Yes, and the reason is structural. Medigap policies sold after 2005 do not include prescription drug coverage (K15), so neither Plan G nor Plan N carries any. Drug coverage is a separate Medicare drug plan alongside it.

Are Medigap benefits different in some states?

Yes, in three of them. Medicare.gov states that in Massachusetts, Minnesota and Wisconsin, Medigap policies are standardized in a different way, and it publishes separate benefit comparisons for each. Everywhere else the ten lettered plans work the same way, which is what makes cross-company comparison possible at all.

There is also a separate product to know about: in some states you may be able to buy a Medicare SELECT policy, a type of Medigap that may require you to use particular hospitals and, in some cases, particular doctors to get full benefits.

Its premium may be lower, and buying one carries a right to change your mind within 12 months and switch to a standard Medigap policy.