Plan G Versus Plan N: What Differs in Cost Sharing

Plan G and Plan N are the two Medicare Supplement plans most people weigh against each other. They look alike on a chart. Both are sold by private firms with the same standard benefits for each letter, set by federal rules. The plans split on a short list of cost-sharing points. This guide names each point, so you can match the plans to the way you use care.

One idea first. A Medigap plan pays toward what Original Medicare owes. It does not cover a service on its own. Medicare decides if a service is covered, and then the Medigap plan pays its set share of the cost that is left. Our Medicare Supplement hub gives the wider picture, and our guide to when you can buy a Medigap policy covers the best times to buy.

What both plans pay

For most bills, the two plans act the same.

• Part A hospital coinsurance and the Part A deductible: both plans pay.
• Skilled nursing facility coinsurance: both plans pay.
• Hospice care coinsurance: both plans pay.
• Part B coinsurance: for most Part B care, you would owe 20% of the Medicare-approved amount. Both plans pay that 20% in full.
• Part B deductible: neither plan pays it. For 2026, the Part B deductible is $283. You pay that sum first each year under both plans.
• Part B premium: this is not a Medigap cost at all. You pay the Part B premium to Medicare either way. For 2026, the standard premium is $202.90 per month. The Medigap firm's price is on top of it.

Where the plans split

Three points split Plan G from Plan N.

First, excess charges. Most doctors who take Medicare accept the Medicare-approved amount as full pay. This is called accepting assignment. A doctor who does not accept assignment can charge more than the approved amount, within a federal limit. That extra sum is an excess charge. Plan G pays excess charges in full. Plan N pays none of them. If your doctors do not accept assignment, Plan N can leave you with bills that Plan G would have paid.

Second, office visit copays. Plan N can charge you up to $20 for some office visits. The copay applies to visits where you would have owed the 20% coinsurance. Plan G has no such copay.

Third, emergency room copays. Plan N can charge up to $50 for a visit to the emergency room that does not lead to being admitted to a hospital. If you are admitted, the copay does not apply. Plan G has no such copay.

These copay caps and the excess charge rule are benefit design rules from Medicare.gov. They are the same for a given plan letter no matter which firm sells the plan.

How to weigh the two plans

Think about how you use care, and who your doctors are.

Price matters too, but get prices from firms for both letters before you judge. The same plan letter can cost far more at one firm than at the next, and the firm's price, not the letter, is what you will pay each month. Some people also weigh a Medicare Advantage plan against both. Our Medicare Advantage hub shows how that path works. It is a fork in the road, not a mix: you pick one path or the other.

• If you see doctors often, Plan N's copays can add up across a year. A low monthly price can lose its edge fast.
• If your key doctors do not accept assignment, the excess charge gap is the one that matters most. Ask your doctors' offices if they accept assignment before you choose.
• If you are in good health, see doctors a few times a year, and your doctors accept assignment, Plan N's lower monthly price may leave you ahead.
• If you want the fewest bills to think about, Plan G is the calmer plan. With G, after the $283 Part B deductible, most covered care costs you nothing at the time of care.

Sample situation

Tom is turning 65 and must pick a plan. He sees a heart doctor four times a year and a foot doctor twice a year. He asks both offices if they accept assignment. The heart doctor does. The foot doctor does not, and charges a small sum above the approved amount on each visit.

Tom prices both plans. He knows he will pay the $283 Part B deductible himself under either plan. Under Plan N, he would also pay the foot doctor's excess charges out of his own pocket, plus copays of up to $20 on some visits. Under Plan G, the excess charges are paid in full and there are no visit copays.

He adds up a year of the foot doctor's extra sums and his visit copays. The total comes close to what he would save on Plan N's lower monthly price, and one bad year at the foot doctor could pass it. He picks Plan G for the calm of it. A friend of his, who sees one doctor twice a year and whose doctor accepts assignment, runs the same math and picks Plan N.

Steps to choose with care

• List your doctors and ask each office if it accepts Medicare assignment.
• Count your office visits in a normal year.
• Get written prices for both Plan G and Plan N from more than one firm.
• Add your likely copays and any excess charges to the Plan N price before you compare it with Plan G.
• Buy in your open enrollment window if you can, when firms must take you and cannot charge more for health issues.

Sources

• https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits