Medicare Plan G vs Plan N 2026: Costs, Copays, Which Wins

Medicare Plan G vs Plan N is the choice most people face now that Plan F is closed to anyone newly eligible for Medicare since 2020. Both are Medigap (Medicare Supplement) policies sold alongside Original Medicare. G costs more and covers more; N costs less and adds small copays. With Medigap rates climbing fast in 2026, the gap matters more than ever.

This guide lays out the pros and cons of each plan: exactly what each pays, what you still owe under 2026 Medicare figures, how much insurers raised rates this year, and a simple break-even test you can run with your own quotes. It closes with the switching rules, because moving from G to N is easy in some states and nearly impossible in others.

Key Takeaways

• G and N pay identical hospital benefits. The only differences are on the Part B side: G covers excess charges and has no copays; N does not cover excess charges and charges up to $20 for some office visits and up to $50 for ER visits that do not lead to admission.
• Neither plan covers the Part B deductible, $283 in 2026, per the CMS premiums fact sheet published November 14, 2025.
• Insurers raised 2026 rates an average of 16.8% on Plan G and 15.0% on Plan N, Telos Actuarial reported on August 6, 2026.
• Break-even math: a $300-a-year premium gap covers 12 office visits plus one ER visit at Plan N’s maximum copays. Fewer visits than that, and N is cheaper.
• Switching from G to N usually means medical underwriting unless you live in one of the 12 birthday-rule states that allow moves to lesser benefits or a state with continuous guaranteed issue, such as Connecticut or New York.

What is the difference between Plan G and Plan N?

Medicare Plan G and Plan N are standardized Medigap policies that pay the hospital and doctor bills Original Medicare leaves behind. Both cover the Part A hospital deductible, hospital and skilled nursing coinsurance, and 80% of foreign travel emergencies. Neither covers the Part B deductible, which is $283 in 2026. The differences sit on the Part B side. Plan G pays your 20% coinsurance in full and covers Part B excess charges, the extra amount a non-participating doctor may bill. Plan N pays the coinsurance but charges up to $20 for some office visits and up to $50 for an emergency room visit that does not end in admission, and it leaves excess charges to you. In exchange, N carries a lower monthly premium. Insurers raised Plan G rates an average of 16.8% and Plan N rates 15.0% in 2026, so the premium gap, not the benefit chart, decides which plan saves you money.

Both letters are standardized under federal law, so G from one insurer pays exactly what G from another pays. Only the premium, the company’s rate history, and its customer service differ. The same is true of N. That is why this comparison spends as much time on price behavior as on benefits.

If you are still deciding between a Medigap policy and a Medicare Advantage plan, start with our Medicare Advantage vs Medigap comparison. This article assumes you have chosen Original Medicare plus a supplement.

Medigap Plan G vs Plan N side by side

The Medicare.gov coverage chart shows the two plans matching on every hospital line. Here is the full picture, with the 2026 dollar amounts from CMS attached to each benefit so you can see what is actually at stake.

Benefit (2026 amounts)	Plan G	Plan N
Part A hospital deductible ($1,736 per benefit period)	Covered 100%	Covered 100%
Part A coinsurance ($434 a day for days 61 to 90; $868 for lifetime reserve days)	Covered 100%	Covered 100%
Skilled nursing coinsurance ($217 a day for days 21 to 100)	Covered 100%	Covered 100%
Part B deductible ($283)	Not covered	Not covered
Part B coinsurance (20% of approved amount)	Covered 100%	Covered, except copays of up to $20 for some office visits and up to $50 for ER visits without admission
Part B excess charges (up to 15% above the approved amount)	Covered 100%	Not covered
Blood (first 3 pints), hospice coinsurance	Covered 100%	Covered 100%
Foreign travel emergency	80%, after a $250 deductible, to a $50,000 lifetime limit	80%, after a $250 deductible, to a $50,000 lifetime limit
High-deductible version ($2,950 in 2026)	Available	Not available
Federal guaranteed-issue rights	Yes (listed plan)	No (not on the federal list)

Two rows surprise people. The high-deductible option exists only for G. And when you lose coverage through no fault of your own, the federal guaranteed-issue list names Plans A, B, C, D, F, and G. It does not name N, so an insurer can require health questions before selling you N in those situations.

What does Medicare Plan N make you pay in 2026?

Three things, and they are smaller than most people fear. First, the Part B deductible of $283, which G enrollees pay too. Second, a copay of up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to an inpatient admission. Third, any Part B excess charge a non-participating doctor bills.

The copay wording matters. The CMS Medigap guide says “up to $20” because the NAIC standard sets the copay at the lesser of $20 or your Part B coinsurance for that visit, so it can be smaller.

Under CMS and NAIC guidance, the copay attaches only to the office-visit code, not to labs, x-rays, or equipment billed alongside the visit. CMS guidance also requires the $50 ER copay to be waived when the visit ends in an admission paid under Part A.

Excess charges only arise with doctors who do not accept assignment. Federal law caps the extra amount at 15% of the Medicare-approved amount, per Medicare.gov. On a $200 approved visit that is at most $30. The section on excess charges below shows how rare that situation is.

For the full list of what Original Medicare itself charges this year, see our Medicare deductibles for 2026 guide. The table below pulls out the numbers that matter for the G versus N decision.

2026 Original Medicare figure	Amount	Who pays it with Plan G	Who pays it with Plan N
Part B standard premium (monthly)	$202.90	You	You
Part B annual deductible	$283	You	You
Part B coinsurance after deductible	20% of approved amount	Insurer	Insurer, minus copays of up to $20 or $50
Part B excess charge	Up to 15% above approved amount	Insurer	You
Part A hospital deductible	$1,736	Insurer	Insurer
High-deductible Plan G deductible	$2,950	You, on the high-deductible version only	Not offered

What is the disadvantage of Plan G?

Premium. You pay more every month for coverage you may rarely use. G’s design is worth the money for someone who wants zero surprise bills, but for a person who sees a doctor three times a year, the extra premium buys protection against copays that would total $60.

The second downside is rate momentum. Telos Actuarial’s August 6, 2026 report, covering filings through July, puts the 2026 industry average increase for G at 16.8%, above N’s 15.0%. CSG Actuarial’s January 2026 analysis shows the trend: average Medicare Supplement increases of 7.8% in 2024, 10.6% in 2025, and 11.7% year to date in 2026. G leads that trend.

A third, quieter downside: G’s popularity. With roughly 6.3 million enrollees at the end of 2025 per Mark Farrah Associates, G’s 16.8% outpaced N’s 15.0% in 2026, and a large, aging pool of policyholders tends to keep drawing increases.

What are the disadvantages of Plan N?

Copays, excess charges, and weaker guaranteed-issue protection. The copays are capped and predictable. Excess charges are rare but uncapped in total, because they depend on how many non-participating doctors you see. The guaranteed-issue gap is the one people miss: lose your employer retiree plan or your Medicare Advantage plan leaves your area, and federal law guarantees you G, not N.

There is also a practical annoyance. N’s office-visit copay is collected by the doctor’s office, and billing errors happen. Keep your Medicare Summary Notices and your Medigap explanation of benefits together so you can check that the office charged no more than $20 for the visit itself.

None of these is a reason to avoid N. They are the price of the discount. The question is whether the discount is big enough, which is where the next two sections go.

How much cheaper is Plan N than Plan G?

Plan N is priced below Plan G by design, but there is no national dollar gap, because Medigap premiums vary by state, ZIP code, age, and carrier. The best public benchmark is KFF’s October 2024 analysis of insurer filings: the average Plan G premium was $164 a month in 2023, from about $140 in the cheapest markets to $236 in New York. KFF published no Plan N average.

What you can rely on is the direction. Because N excludes excess charges and shifts copays to you, insurers price it below G in the same market, though no public dataset reports the gap state by state. The 2026 rate round narrowed nothing: G rose faster (16.8%) than N (15.0%), so the dollar gap between them grew for most policyholders.

Your job is to get both quotes from the same insurer for your ZIP code and age, then subtract. The result, multiplied by 12, is the number you carry into the break-even test. Remember that the Part B premium of $202.90 sits on top of either plan, so it does not affect the comparison.

Which is better, Plan G or Plan N? The break-even test

N is better when your expected copays for the year are smaller than the premium you save. G is better when they are larger, or when you simply want no bills at the doctor. Here is the arithmetic using the maximum copays in the CMS guide, $20 per office visit and $50 per ER visit.

Suppose N saves you $25 a month, or $300 a year. One ER visit costs $50, leaving $250, which covers 12 office visits at $20 each. At 13 visits plus the ER trip, N costs $310 and G wins by $10. At $40 a month, or $480 a year, N stays ahead through 21 office visits plus an ER visit.

Run the test with your own numbers, and be honest about visits. Count specialist follow-ups and urgent care visits billed as office visits; physical therapy and telehealth usually carry no Plan N copay. Then add a margin for a bad year. If N still wins by a comfortable amount, it is the rational pick. If it wins by $40, the certainty of G is probably worth the price.

Are Part B excess charges a real risk with Plan N?

Rarely. KFF’s January 2025 analysis found that 98% of physicians and practitioners billing Medicare were participating providers in 2022, meaning they accept the approved amount as full payment. About 1% have opted out entirely, and opted-out doctors bill privately under contract, which no Medigap plan covers, G included. The small remaining group of non-participating doctors may bill up to the 15% limiting charge.

Several states restrict or prohibit excess charges for their residents. Minnesota, Ohio, Pennsylvania, and Massachusetts bar Medicare balance billing by statute or licensing rule. Vermont bars it too, but exempts higher-income beneficiaries whose Social Security benefits are taxable. New York caps physician charges at 105% of the approved amount, with an exception for office and home visits.

Rhode Island lets a doctor bill above the assignment amount only after posting the practice’s assignment policy. In these states, Plan G’s excess-charge benefit buys little, and N’s main weakness shrinks to the copays. Connecticut is not one of them: despite claims on some sites, its fact sheet says only QMB enrollees are protected there, as in every state.

Elsewhere, the risk is real but manageable. Ask each new doctor’s office one question, “Do you accept Medicare assignment?” A yes means no excess charge on that bill, whichever plan you hold.

Who picks Plan G and who picks Plan N: 2023 enrollment shares

Most people pick G. KFF’s analysis of 2023 insurer filings puts G at 39% of all Medigap enrollees, F at 36% (a closed block that shrinks every year), and N at 10%. Everything else, the other lettered plans, shares the remaining 15% (KFF folds high-deductible G into G’s 39%).

The gap is partly habit. Plan F was the default for two decades, and when it closed, agents steered new enrollees to G as the nearest thing. N’s 10% share understates its fit for healthy 65-year-olds, who would pass the break-even test easily. It also reflects the guaranteed-issue rule: people buying under a federal right cannot always choose N.

The market keeps growing regardless. Mark Farrah Associates counted more than 13.8 million Medigap enrollees at the end of 2025, with about 6.3 million in Plan G. That is the block absorbing the 16.8% increases described above.

Should I switch from Plan G to Plan N?

Switch if the break-even test says N wins by a clear margin and you can get the policy. The second condition is the hard one. Outside your six-month Medigap Open Enrollment Period, which begins the month you are 65 or older and enrolled in Part B, insurers in most states may ask health questions and decline you.

Four states, Connecticut, Massachusetts, Maine, and New York, require insurers to accept applicants without health questions either year-round or at least once a year, per KFF. Maine’s year-round right covers moves to equal or lesser benefits.

Fifteen other states have a birthday rule that lets you switch Medigap policies around your birthday each year without health questions, according to a July 2026 roundup by 24/7 Wall St. Twelve allow moves to equal or lesser benefits; Indiana, Kentucky, and Virginia allow same-letter moves only, so no G to N. Some guides count 16 by including Missouri’s anniversary rule, also same-letter only.

The 15 states in that roundup:

• California, Delaware, Idaho, Illinois, Indiana
• Kentucky, Louisiana, Maryland, Nevada, Oklahoma
• Oregon, Utah, Virginia, West Virginia, Wyoming

Windows and conditions differ, and some rules apply only within the same insurer, so confirm with your state insurance department before you count on one. New Mexico joins the list on January 1, 2027 with a 60-day window.

Minnesota added a new door on August 1, 2026, though not a Plan G to Plan N one (see the caution below). Under Minnesota Statutes 62A.31, residents aged 65 to 70 get one chance to use the fall window, October 15 to December 7, without underwriting. The statute sets a lifetime surcharge: 15% for the 2026 window, rising 5 points a year to 35% from 2030.

One caution: Massachusetts, Minnesota, and Wisconsin standardize Medigap differently and do not sell lettered Plan G (Minnesota sells its own version of Plan N). If you live in one of those states, use the state pages in the Medicare.gov Choosing a Medigap Policy guide to find the closest equivalent before applying the math here.

Situation	Can you move from G to N without health questions?	Deadline or window
Medigap Open Enrollment Period (age 65+ and new to Part B)	Yes, any plan sold in your state	6 months from your Part B start
Federal guaranteed-issue event (lost employer plan, Advantage plan left area)	No. Federal rights cover Plans A, B, C, D, F, and G, not N	Apply within 63 days of losing coverage
Trial right (joined Advantage at 65, leave within 12 months)	Yes, any Medigap policy sold in your state	Within the first year in the Advantage plan
Continuous guaranteed-issue states (CT, NY; ME for equal-or-lesser moves; MA uses its own plan designs)	Yes	Any time
Birthday-rule states (15 as of 2026; confirm yours)	Yes in 12 states, to equal or lesser benefits. No in Indiana, Kentucky, and Virginia, which allow same-letter moves only	Around your birthday; length varies by state
Minnesota annual window (from August 1, 2026)	Not a G-to-N path (Minnesota sells its own plan designs). Ages 65 to 70 can buy a Minnesota Medigap plan once without underwriting, with a mandatory surcharge	October 15 to December 7 each year
Everywhere else, any other time	Only if you pass medical underwriting	None

One more path: a trial right. If you joined a Medicare Advantage plan when you first became eligible at 65 and leave within the first year, federal law lets you buy any Medigap policy sold in your state, N included. Details are on pages 17 and 18 of the CMS Medigap guide.

Timing note: Medigap changes are not tied to fall Medicare Open Enrollment, which runs October 15 to December 7 for Advantage and Part D plans. You can apply for a Medigap policy any month; the question is only whether the insurer can underwrite you.

What about high-deductible Plan G?

High-deductible G is the same Plan G with a much lower premium and a $2,950 deductible in 2026, up from $2,870 in 2025 and $2,800 in 2024, per CMS. You pay Medicare’s cost sharing yourself until it reaches $2,950, then the plan pays 100% for the rest of the year. The Part B deductible counts toward it.

It is a different bet from Plan N. N keeps each copay small but has no annual cap and leaves excess charges open. High-deductible G caps your total exposure at $2,950 plus the premium but makes you pay the first hospital stay yourself. For someone with savings who rarely uses care, it can be the cheapest of the three.

If premiums are the problem, check whether you qualify for a Medicare Savings Program, which pays the Part B premium and, in the QMB tier, most cost sharing. Many people who qualify do not need a Medigap policy at all.

The bottom line on Medicare Plan G vs Plan N

Plan G and Plan N cover the same hospital bills. G adds excess-charge coverage and no copays; N trades those for a lower premium. Neither covers the $283 Part B deductible. In 2026, G’s rates rose 16.8% and N’s 15.0%, so the premium gap favors N for anyone who sees doctors a handful of times a year.

Get quotes for both from the same insurer, run the break-even test with your real visit count, and check whether your state lets you switch later without health questions.

If your state has year-round guaranteed issue, N is a choice you can undo. In most birthday-rule states you can step down from G to N later but not back up to G (Indiana, Kentucky, and Virginia allow same-letter moves only), so weigh G’s certainty against the savings. The plan you pick at 65 may be the one you keep.

Related reading on this site:

• Medicare program guide: eligibility, enrollment, and costs
• Medicare HMO vs PPO: how Advantage networks compare
• Medicare IRMAA 2026: the income surcharge on Part B and Part D