Medigap Plan G vs Plan N

The standardized chart has 9 benefits, and Plan G and Plan N answer 7 of them identically. Everything below is the whole of the difference:

• Part B coinsurance or copayment. Plan G: covered in full. Plan N: covered, apart from a copay of up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to admission.
• Part B excess charges. Plan G: covered in full. Plan N: not covered.

Both of those land at the point of care rather than on your statement, which is why two people with the same plan can have very different years. Nothing else on the chart separates them — not the Part A deductible, not skilled nursing coinsurance, not hospice, not foreign travel emergency. The full standardized chart shows every row for every letter.

Plan N leaves you two copays, both capped:

• up to $20 for some office visits;
• up to $50 for an emergency room visit — waived if you are admitted, because the stay then falls under Part A.

"Up to" is doing real work in both. The copay cannot exceed the Part B coinsurance you would otherwise owe, so a short, inexpensive visit can cost less than the ceiling. And not every encounter carries one: the copay attaches to office visits, not to lab work, imaging or the preventive services Medicare already covers in full.

The arithmetic most people want is simple. Take the monthly premium difference between the two quotes in front of you, multiply by twelve, and divide by $20. That is roughly how many office visits a year Plan N buys you before the saving is gone — and for most people it is a larger number than they expect.

A doctor who has not agreed to accept Medicare's approved amount as full payment — a non-participating provider — may bill you up to 15% above it. That extra is the Part B excess charge. Plan G covers it; Plan N does not.

Two things make this smaller than it sounds, and one makes it larger.

Smaller: the large majority of doctors accept assignment, so the charge never arises for most visits. And several states ban excess charges outright — in those states the row cannot cost you anything, whichever letter you hold, which makes Plan N's lower premium a straightforward saving on that count.

Larger: it follows the provider, not the illness, so it tends to appear exactly where you have least room to shop — a specialist you were referred to, or a surgeon you did not choose.

This is a question to answer for your own state and your own doctors before you compare premiums, because it changes what the premium difference is buying.

This page will not pick, and the reason is not caution: the answer is a quote comparison, and premiums for the same letter vary by carrier, state, age and tobacco use. Two people on the same street can get different answers. What this page can do is tell you what to weigh.

Plan N tends to suit someone who sees a doctor a handful of times a year, lives in a state that bans excess charges or uses providers who accept assignment, and would rather hold the monthly saving and pay at the desk.

Plan G tends to suit someone who sees specialists often, wants a bill they can predict to the dollar, or does not want to think about which providers accept assignment — particularly if they travel or expect a year with surgery in it.

One thing outranks both: when you buy. During your Medigap open enrollment period — six months from the month you are both 65 or older and enrolled in Part B — an insurer cannot refuse you or charge you more because of your health. Afterwards, in most states, it can. The enrollment windows page covers that timetable, and it matters more than the choice between these two letters.