Medigap Plan N vs Plan G: The Real Difference

What They Have in Common

Both Plan G and Plan N are Medigap (Medicare Supplement) policies. They work alongside Original Medicare to cover cost-sharing gaps — the deductibles, copayments, and coinsurance that Original Medicare leaves to the beneficiary. Both plans are standardized by the federal government, meaning the benefits are identical regardless of which insurance company sells the policy. The difference between insurers is the premium, not the coverage.

Both plans cover: Medicare Part A coinsurance and hospital costs, Part B coinsurance or copayment, blood (first three pints), Part A hospice care coinsurance, skilled nursing facility coinsurance, and Part A deductible. Both also include a foreign travel emergency benefit.

Where They Differ

The core difference comes down to two cost-sharing elements:

Part B Excess Charges Explained

When a doctor does not "accept assignment" — meaning they do not agree to Medicare's approved amount as full payment — they may charge up to 15% above the Medicare-approved amount. This additional charge is called a Part B excess charge. Plan G covers it. Plan N does not.

In practice, the vast majority of doctors accept Medicare assignment. According to Medicare data, over 97% of providers accept assignment. Some states (Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont) have laws limiting or prohibiting excess charges. If you live in one of these states or primarily use providers who accept assignment, this difference may not materially affect you.

The Copay Trade-Off

Plan N requires a copayment of up to $20 for some office visits and up to $50 for emergency room visits that do not result in an inpatient admission. Plan G has no such copays.

For someone who visits the doctor frequently — say, six to eight office visits per year — these copays add up to roughly $120 to $160 annually. Whether that exceeds the premium savings of Plan N compared to Plan G depends on the specific premium difference in your area and for your age and health profile.

Which Plan May Fit Better

Plan G may suit you if: You value maximum predictability, prefer zero copays at the point of service, or want coverage against the (small) possibility of excess charges.

Plan N may suit you if: You are comfortable with small copays at office visits, your providers accept Medicare assignment, and the premium savings meaningfully improve your monthly budget.

Neither plan is universally better. The best choice depends on your healthcare usage patterns, your provider relationships, your state regulations, and the specific premiums available to you.

"The gap between Plan G and Plan N is often smaller than people expect — both in benefits and in premium. Run the numbers for your situation."