Medicare Supplement (Medigap) Plan G and Plan N are standardized policies sold by private insurance companies to people with Original Medicare. Because benefits are standardized by federal law, a Plan G from one company covers the same benefits as a Plan G from another; what differs between companies is mainly price, rate history and service.
Plan G and Plan N cover most of the same costs. This page explains where they differ and the questions worth asking before choosing between them. New to Medigap? Start with Medigap Basics.
What both plans cover
- Part A coinsurance and hospital costs, up to an additional 365 days after Medicare benefits are used up
- Part A deductible
- Part A hospice care coinsurance or copayment
- Skilled nursing facility care coinsurance
- First 3 pints of blood
- Foreign travel emergency care (80%, up to plan limits)
Neither plan covers the Part B deductible, which is $283 in 2026. With either plan, you pay that amount first each calendar year.
The three differences
| Plan G | Plan N | |
|---|---|---|
| Doctor office visits | No copay after the Part B deductible | Copay of up to $20 for some office visits |
| Emergency room visits | No copay after the Part B deductible | Copay of up to $50 if you are not admitted as an inpatient |
| Part B excess charges | Covered | Not covered |
Everything else on the standardized benefit chart is the same. In exchange for these differences, Plan N premiums are usually lower than Plan G premiums from the same company, though the gap varies by company, age, ZIP code and other factors.
This page compares standard Plan G. Some companies also sell a high-deductible version of Plan G. It has the same benefits, but you pay Medicare-covered costs up to a yearly deductible ($2,950 in 2026, which includes the Part B deductible) before the policy pays anything. It usually costs less per month and works differently from both plans compared here.
Excess charges: the difference people overlook
Most doctors accept Medicare “assignment,” meaning they accept the Medicare-approved amount as full payment. Doctors who don’t accept assignment work from a lower Medicare-approved amount (95% of the standard rate). In most cases, they can charge you up to 15% above that lower amount. The extra amount above what Medicare approves is called a Part B excess charge.
For example, suppose Medicare’s standard approved amount for a service is $100. For a doctor who doesn’t accept assignment, the approved amount is $95, and the doctor can bill up to $109.25. The extra $14.25 is the excess charge. Plan G pays it. With Plan N, you pay it. That’s about 9% above the standard rate: small for a single office visit, but it can add up on costly outpatient care such as surgery, imaging or ongoing treatment.
A few states prohibit or limit excess charges. Texas is not one of them, so the difference matters more here than in those states. How much it matters depends on whether the doctors you use accept assignment. You can ask your doctors directly, or check with Medicare’s Care Compare tool.
How to think through the trade-off
The basic math compares the yearly premium difference with the copays you expect to pay. Here’s a hypothetical example (not an actual quote): if Plan N cost $30 a month less than Plan G, you would save $360 a year in premiums. That covers 18 office copays at $20 each, before counting any ER visits or excess charges.
The math is only part of the decision. Other questions worth asking:
- How often do you see doctors or specialists? Frequent visits add up under Plan N.
- Do your doctors accept Medicare assignment? If they all do, excess charges are less of a concern today, though doctors and needs can change.
- Do you prefer predictable costs or a lower premium? Plan G gives more predictable costs after the deductible. Plan N trades some predictability for a lower premium.
- Could you switch later if your needs change? See the next section. This is often the most important question.
Switching later isn’t guaranteed
Many people assume they can start with a lower-premium plan and move to a more comprehensive one later. Outside your six-month Medigap Open Enrollment Period and certain guaranteed-issue situations, insurance companies in most cases can use medical underwriting. They can ask health questions and may charge more or decline the application. Someone who starts on Plan N and later develops health conditions may not be able to qualify for Plan G.
State rules can add protections beyond federal law. For example, Texas recently added Medigap enrollment protections for some people under 65 who have Medicare because of end-stage renal disease (ESRD) or ALS. Before relying on any switching or enrollment right, check current Texas rules with the Texas Department of Insurance.
What about Plan F?
Plan F also covers the Part B deductible. Under federal law, Plan F (and Plan C) can be sold only to people who became eligible for Medicare before January 1, 2020. For people who became eligible after that date, Plan G is the most comprehensive option apart from that deductible.
Before comparing policies
- Confirm that you have, or will have, both Part A and Part B.
- Know when your Medigap Open Enrollment Period starts and ends.
- Compare the same plan letter across companies, and ask how each company prices its policies as you age.
- Read the actual policy documents and the official benefit chart. Don’t rely only on summaries, including this one.
Official sources
- Compare Medigap plan benefits (Medicare.gov)
- Medigap basics (Medicare.gov)
- Care Compare: find doctors who accept Medicare (Medicare.gov)
- TDI Bulletin B-0010-25: Texas Medigap protections for people under 65 with ESRD or ALS
- Texas Department of Insurance — Consumer Help Line: 1-800-252-3439
Sources reviewed November 9, 2026. 2026 amounts shown; Medicare typically announces next year’s Part B deductible in the fall. Medicare rules and plan information may change; check the official source for updates.
