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Plan G and Plan N are the two Medigap plans most people actually buy, and the choice between them comes down to a simple tradeoff: Plan G costs more each month and covers nearly everything, while Plan N costs less each month and asks you to pay small copays when you use care. Run the numbers for your situation and the answer usually becomes obvious.
What each plan covers
Both plans cover the Part A deductible, Part A coinsurance, skilled nursing coinsurance, hospice coinsurance, blood, and foreign travel emergencies. Both leave you paying the Part B deductible yourself, which is $283 in 2026.
The differences are two. First, Plan G covers Part B excess charges and Plan N does not. Excess charges happen when a doctor does not accept Medicare assignment and bills up to 15 percent above the Medicare-approved amount. If every doctor you see accepts assignment, this difference never costs you anything. You can check by asking your doctors directly.
Second, Plan N has copays: up to $20 for office visits and up to $50 for emergency room visits that do not result in admission. Plan G has no copays. Preventive visits that Medicare covers at 100 percent do not trigger the copay.
The math that decides
Take the annual premium difference between Plan G and Plan N from the same insurer, then estimate your copays under Plan N. If you see a doctor six times a year, that is up to $120 in copays. If Plan N saves you $40 a month in premiums, that is $480 a year, and Plan N wins by $360 even with the copays. If you see specialists monthly and visit urgent care a few times, the copays add up, and the premium gap has to be bigger to justify Plan N.
Premiums vary by insurer, age, and zip code, so use real quotes for your area rather than national averages. Get both letters quoted from the same company to keep the comparison clean.
When Plan G is the safer pick
If any of your regular doctors do not accept Medicare assignment, Plan G’s excess charge coverage is worth real money and peace of mind. It is also the better pick if you travel frequently within the US and see out-of-area providers, or if you simply want medical bills to be as close to zero-surprise as possible. People with chronic conditions who see doctors often tend to prefer it, because the copays under Plan N stop feeling small around the tenth visit of the year.
When Plan N makes more sense
If you are healthy, see a doctor a few times a year, and all your providers accept assignment, Plan N’s lower premium usually wins. The copays are small enough that you barely notice them, and the yearly savings compound. Over a decade, the premium difference between the two plans can add up to thousands, which matters on a fixed income.
One thing to check before you decide
Make sure you are comparing current prices, not what a neighbor pays. Medigap premiums are priced by attained age, issue age, or community rating depending on the insurer and state, so two 70-year-olds in the same town can pay different amounts for the same letter. And if you are switching from one to the other after your open enrollment period, remember that most states allow underwriting, so lock in the new plan before dropping the old one.
For the full landscape of every standardized plan, see Medicare Advantage vs Medigap: the real tradeoff, which covers when the supplement route beats the Advantage route entirely.
