Medicare Plan G vs N: coverage, costs, and confidence

If you're stuck choosing between Medicare Plan G vs N, take a breathyou're not alone. I've walked so many folks through this exact decision, and once you see the differences laid out simply, it's like someone finally turned the lights on. Here's the quick scoop: Plan G usually costs more each month but removes office and ER copays and covers Part B excess charges. Plan N has lower premiums, but you'll pay small copays, and it won't cover excess charges if a provider bills above Medicare's approved amount.

Most people get tripped up by one thing: comparing premiums only. The smarter move? Estimate how often you'll see your doctor, whether you might hit the ER once or twice, and confirm if your providers accept Medicare assignment (that's the key to avoiding excess charges). Do that, and the "best" plan for your health, peace of mind, and wallet suddenly becomes crystal clear.

Quick takeaway

Let's boil down the core difference between Plan G and Plan Nno jargon, no fluff.

The difference

Plan G = higher premium, fewer surprises. Plan N = lower premium, pay small copays; no Part B excess charge coverage.

Plan G = higher premium, fewer surprises

Plan G is the "predictable costs" plan. After you meet the Medicare Part B deductible, you've basically covered the rest of your Medicare-approved outpatient costs, and you don't have office or ER copays. It also covers Part B excess charges in states where they're allowed.

Plan N = lower premium, some copays

Plan N is more budget-friendly month to month. You'll pay up to $20 for certain office visits and up to $50 for ER visits if you're not admitted. It doesn't cover Part B excess chargesmore on that shortly.

Who picks what

Prefer predictable costs or have frequent visits? Consider G

If you see specialists, travel often, or just don't like surprise bills, Plan G's steadiness is reassuring. Many people choose it for the peace of mind alone.

Few visits and watching monthly costs? Consider N

If you typically see the doctor a handful of times a year, and your providers accept Medicare assignment, Plan N can save you on premiums without sacrificing hospital-level coverage.

Plan G benefits

What Plan G covers

Medigap plans are standardized. That means Plan G covers the same core benefits no matter which insurer you choose (pricing can vary by company). Here's what you get with Plan G:

• Part A coinsurance and hospital costs
• Part A deductible
• Skilled nursing facility coinsurance
• Hospice care coinsurance or copayment
• First three pints of blood
• Foreign travel emergency (80% up to plan limits)
• Part B coinsurance (generally 100% after you meet the Part B deductible)
• Part B excess charges

Yes, you'll still pay the Medicare Part B deductible each year. After that, Plan G picks up the rest of Part B coinsurance and also covers excess charges if a provider bills above Medicare's approved amount (where allowed).

High-deductible Plan G option

There's also a high-deductible Plan G in many states. It has a much lower monthly premium, but you pay a larger deductible out of pocket before the plan's benefits kick in. It can make sense if you're comfortable with risk, rarely visit doctors, and want the safety net for big events.

Note on certain states

Medigap plans in Massachusetts, Minnesota, and Wisconsin are standardized differently. You can often mimic Plan G-like coverage through their state-specific structures, but the names and benefits aren't identical.

Plan G pros and cons

Pros

• No office or ER copays
• Covers Part B excess charges
• Predictable budgeting after the Part B deductible

Cons

• Higher monthly premiums than Plan N
• You still pay the Part B deductible
• No dental, vision, or hearing coverage (that's separate)

Plan N benefits

What Plan N covers

Plan N covers nearly everything Plan G does on the hospital side. It includes:

• Part A coinsurance and hospital costs
• Part A deductible
• Skilled nursing facility coinsurance
• Hospice care coinsurance or copayment
• First three pints of blood
• Foreign travel emergency (80% up to plan limits)
• Part B coinsurance with small copays

Copays explained

With Plan N, you'll typically pay up to $20 for certain office visits and up to $50 for ER visits if you're not admitted. These amounts are set by Medicare rules, not your insurer. And remember: Plan N does not cover Part B excess charges.

Plan N pros and cons

Pros

• Lower monthly premiums
• Similar hospital coverage to Plan G
• Great fit if you have infrequent office visits

Cons

• Office and ER copays
• No coverage for Part B excess charges
• Less predictable yearly costs if visit frequency rises

Coverage differences

Excess charges

Part B excess charges happen when a provider who doesn't accept Medicare assignment bills up to 15% above Medicare's approved amount. Plan G covers these excess charges. Plan N does not. The good news: many providers accept assignment, so you may never encounter them.

How to check assignment

Ask your providers directly, or look them up on Medicare's Care Compare tool. If your doctors accept assignment, they agree to Medicare's approved amountno excess charges. According to CMS's own explanations in its Medigap benefit charts, Plan N's trade-off is those office and ER copays and no excess charge coverage, while Plan G fills that gap (Medigap overview).

States limiting excess charges

Some states restrict or prohibit excess charges altogether. If you live in one of those statesor never see doctors who bill above Medicare's approved amountthe risk of excess charges may be very low, which makes Plan N more attractive.

Copays and coinsurance

When Plan N copays apply

Plan N's up-to-$20 copay applies for certain office visits; the up-to-$50 copay applies to ER visits if you're not admitted. Preventive visits and some services may not trigger copays, but it depends on how the visit is coded and what's covered under Part B preventive care.

How visit frequency tilts the math

If you see several specialists regularly, those small copays can stack up. For some folks, the total copays over a year can exceed the savings from Plan N's lower premiumat which point Plan G ends up cheaper overall.

High-deductible G vs N

Trade-offs to weigh

High-deductible Plan G can be much cheaper per month than standard Plan N, but you're on the hook for a larger deductible before benefits kick in. If you're healthy, rarely visit doctors, and can handle a "what if" year with higher out-of-pocket costs, it's worth a look. If that kind of risk makes you uneasy, Plan N or standard Plan G may be better.

Costs and examples

Typical premiums

Premiums vary by location, age, tobacco status, and insurer pricing. Insurers also use different rating methodscommunity-rated, issue-age-rated, or attained-age-ratedwhich can affect how your premiums change over time. Discounts (like household) and enrollment timing also influence your price.

What drives price

• ZIP code and state rules
• Age and rating method (community vs attained-age)
• Tobacco use
• Household or spousal discounts
• When you enroll (open enrollment vs later)

When Plan N really saves

Let's run some simple, real-world math. Suppose Plan G is $40/month more than Plan N in your area ($480/year difference). If you expect four office visits and one ER visit (not admitted) in a year, your Plan N copays could be roughly $204 + $50 = $130. Since $130 < $480, Plan N would likely save you money that yearassuming no excess charges and no unusual service volume.

Break-even thinking

Break-even happens when your annual premium savings on Plan N roughly equals the copays you expect to pay (plus any potential excess charges). If you expect many more visits, Plan G may win. If you expect only a couple, Plan N probably wins.

Simple worksheet

• Step 1: Annual premium difference (Plan G Plan N) = A
• Step 2: Expected office visits $20 (max) = B
• Step 3: Expected non-admitted ER visits $50 (max) = C
• Step 4: Excess charge risk (likely $0 if providers accept assignment) = D
• If A > (B + C + D), Plan N likely cheaper. If A (B + C + D), Plan G may be better.

Sample prices

Market prices shift, but media outlets and consumer finance sites often publish ranges. For example, consumer-focused comparisons sometimes show Plan G averaging higher monthly premiums than Plan N in the same city, with ranges varying widely by age and ZIP. According to reporting from comparison guides and cost examples, Plan N often undercuts Plan G but adds those small copays and the excess charge gap (NerdWallet's Plan G guide; Healthline's Plan N overview). For your exact price, use your ZIP, age, and tobacco status on trusted tools.

Pro tip: You can compare standardized benefits and see plan types across carriers using Medicare's official tools; then get quotes to see real premiums for your situation (Medigap plan comparison).

How to choose

Checklist

1) List your doctors and ask about assignment

Call each office. "Do you accept Medicare assignment?" If yes, excess charges are off the table.

2) Estimate office and ER visits

Look back at the past year or two. If you're seeing more specialists now, bump up your estimate.

3) Compare premiums for G and N

Get quotes from several carriers. Same Plan letter = same standardized benefits, but prices vary.

4) Run the copay math

Use the worksheet above. Plug in your likely visits, premium gap, and any excess charge risk.

5) Consider predictability vs flexibility

If surprise bills stress you out, Plan G's predictability may be worth it. If you're comfortable trading small copays for lower monthly costs, Plan N could fit like a glove.

When Plan G wins

• You see multiple specialists or have ongoing treatments
• You travel or see new providers and want excess charge protection
• You value predictable monthly costs and minimal per-visit billing

When Plan N wins

• You have few office visits and providers that accept assignment
• You want the lowest monthly premium with strong hospital coverage
• You're okay with small, occasional copays

Red flags

Rate increases and rating method

Ask how the plan is rated: community-rated (age doesn't affect the price), issue-age-rated (based on the age when you buy), or attained-age-rated (price increases as you age). Understanding this upfront helps you avoid future sticker shock.

Switching later may require underwriting

Outside protected periods, switching from Plan N to Plan G (or vice versa) might require health questions, and you could be denied or rated up. Make your initial choice carefully.

Enrollment basics

Medigap open enrollment

You get a six-month Medigap Open Enrollment Period starting the month your Part B coverage begins. During this time, you have guaranteed issue rightsno medical underwriting. It's the best time to buy.

Switching plans later

You can apply to switch anytime, but underwriting may apply unless you qualify for state-specific guaranteed issue rights or certain "trial rights." Some states also have unique switching windows. Check your state's rules.

Coordinating coverage

You can't have a Medigap plan and Medicare Advantage at the same time. If you need drug coverage, remember Part D is separate. Many people pair Original Medicare + Medigap + Part D.

Tools and tips

Calculator idea

Here's a quick way to pressure-test your choice: jot down the monthly premium difference, your expected office visits, ER visits, and whether your providers accept assignment. Multiply visits by the copay amounts for Plan N, then compare with Plan G's higher premium. If the math tilts clearly one waythere's your answer.

Where to compare

Use official sources to compare benefits and verify providers. For benefits and plan letters, the Medigap comparison on Medicare.gov is straightforward. To check assignment and star ratings, the Care Compare tool is your friend. It's always wise to cross-check with at least two reputable consumer guides to see real-world examples and decision logic (Medigap comparison; Care Compare).

Smart questions for agents

• Which rating method does this plan use?
• What discounts are available (household, autopay)?
• What's the carrier's five-year rate increase history?
• How easy is it to switch later in my state?
• Are there customer service differences between carriers?

Stories that help

Martha, 72: frequent visits

Martha sees a cardiologist and an endocrinologist every few months. She likes budgeting with few surprises. Even though Plan G costs her $35 more per month than Plan N, she avoids a dozen copays and doesn't worry about excess charges when she travels to see her grandkids. For her, predictability wins.

Luis, 66: light usage

Luis has one annual wellness visit and a couple of check-ins for seasonal allergies. All his doctors accept assignment. He picked Plan N, saving nearly $500 a year compared with Plan G and paying only a couple of small copays. For him, lower monthly costs make perfect sense.

Why this works

Expert-backed clarity

Medigap plans are standardized by federal rules, which means the lettered benefits are consistent across insurers. That's why the focus is on coverage differences (like excess charges and copays) and your usage patternsthis is where the real decision lives. Authoritative sources publish the same core distinctions, and consumer guides echo this logic because it's what matters in practice (Medicare's plan benefits; NerdWallet's Plan N explainer).

Balanced and practical

No plan is "best" for everyone, and anyone promising guaranteed savings is oversimplifying. Your real-world visits, state rules, and comfort with risk matter far more than a catchy headline. You deserve a clear side-by-side and the confidence to say, "Yes, this fits my life."

Conclusion

Choosing between Medicare Plan G vs N really comes down to two things: how often you'll see doctors and whether your providers accept Medicare assignment. Plan G typically costs more but removes office and ER copays and covers Part B excess chargesgreat for predictability and travelers. Plan N trims your monthly premium, but you'll pay small copays and won't be covered for excess charges if a provider bills above Medicare's approved amount.

Here's your next step: write down your likely office and ER visits, confirm assignment with your providers, and compare quotes from a few carriers. Run the simple math using the worksheet above. If you're still unsure, ask a licensed agent about rate history and underwriting rules in your stateno pressure, just clarity. Most of all, choose the plan that lowers your total costs and your stress, not just your monthly premium. What does peace of mind look like for you this year? If you want a second opinion, share your situationI'm happy to help you think it through.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.