Quick answer

Plan G covers more, costs more monthly, and is the most popular Medigap plan in the country. Plan N covers slightly less (small office/ER copays + Part B excess charges), costs less monthly, and is a smart choice for healthy people who don't go to the doctor often. The premium gap is usually $20-$50/month.

What they both cover

Both Plan G and Plan N cover everything Original Medicare leaves on the table — except the small Part B annual deductible (~$240 in 2026). Specifically, both pay:

• Part A hospital coinsurance + 365 additional days after Medicare runs out
• Part B coinsurance (the 20% Original Medicare doesn't cover) — with a small office-visit copay on Plan N
• Part A hospital deductible (~$1,676/benefit period in 2026)
• Skilled nursing facility coinsurance
• Foreign travel emergency (up to plan limits — both plans 80% to a $50,000 lifetime max)
• First 3 pints of blood
• Hospice coinsurance

Where they differ

Three differences:

1. Office visit copay. Plan G: $0. Plan N: up to $20 per office visit (after the Part B deductible).
2. ER copay. Plan G: $0. Plan N: up to $50 per ER visit (waived if admitted).
3. Part B excess charges. Plan G: covered. Plan N: NOT covered. (See explanation below.)

The Part B excess charges thing — what it actually means

This trips people up. Most providers "accept assignment" — meaning they accept Medicare's approved payment as full payment. Some providers don't accept assignment and can charge up to 15% MORE than Medicare's approved amount. That extra amount is called a "Part B excess charge."

• Plan G covers excess charges. If your doctor charges 15% over Medicare's approved amount, Plan G pays the difference.
• Plan N does NOT cover excess charges. You pay the 15% out of pocket.

Practically, this matters less than people fear because:

• Most doctors accept assignment
• 8 states ban excess charges entirely (NY, MA, CT, OH, PA, MN, RI, VT) — Plan N has zero excess-charge exposure in those states
• In Texas (where most of our clients are), excess charges are legal but uncommon — most major hospital systems accept assignment

How to know: ask your doctor's billing office "do you accept Medicare assignment?" If yes, Plan N's excess-charge exclusion doesn't affect you for visits to that doctor.

Premium math: when does Plan N save money?

Sample monthly premium for a 65-year-old female non-smoker in Friendswood, TX (2026 quotes will vary):

• Plan G: ~$140-$170/month
• Plan N: ~$110-$135/month

Annual savings on Plan N: typically $360-$540.

Plan N's added costs (vs. G):

• $20 per office visit. If you go 12 times a year, that's $240/year.
• $50 per ER visit. If you go zero times, that's $0.
• Part B excess charges: depends on your providers, usually $0.

Net for a healthy 65-year-old: Plan N saves $200-$400/year vs. Plan G in most years.

Net for someone with frequent specialist visits or who goes to the ER occasionally: Plan G can come out ahead.

Who Plan G fits best

• You see doctors frequently (chronic condition management, multiple specialists)
• You go to the ER more than once a year
• Some of your providers don't accept Medicare assignment
• You strongly value cost predictability — you'd rather pay a slightly higher premium than face $20-$50 surprise charges per visit
• You live in a state where excess charges are legal AND common

Who Plan N fits best

• You're healthy and don't visit doctors often (1-3 times a year)
• Your doctors all accept Medicare assignment (verify with billing office)
• You live in a no-excess-charge state (NY, MA, CT, OH, PA, MN, RI, VT)
• You want to lock in lower premiums while you're young in Medicare years (premiums tend to grow with age — Plan N's lower starting point compounds)
• You don't mind a small per-visit copay in exchange for monthly savings

What about Plan F?

You may have heard about Plan F. It used to be the most popular Medigap plan because it covered everything including the Part B annual deductible. As of January 1, 2020, Plan F is no longer available to people newly eligible for Medicare. If you're already on Plan F, you can keep it. If you're newly eligible, your most-comprehensive option is Plan G.

What about High-Deductible Plan G?

Same coverage as standard Plan G but with an annual deductible of ~$2,800 (2026) before benefits start. Premium is dramatically lower — typically $40-$70/month. Good fit if:

• You're very healthy and don't expect to hit the deductible
• You have savings to cover the deductible if a major event happens
• You want catastrophic-only coverage with the lowest possible premium

Same plan, different prices — why a broker matters

Important reminder: Medigap plans are federally standardized. A "Plan G" from BCBS Texas covers the EXACT same things as a "Plan G" from Mutual of Omaha. The only difference is the price.

What this means: if you're picking Plan G or Plan N, the only real shopping question is "which carrier is cheapest in my zip code, age, and gender?" That's literally the comparison we do — pull every carrier's price for the same plan, side by side.

Some carriers also offer "household discounts" (5-15% off if your spouse also enrolls in any Medigap plan) which can change the math.

Bottom line

• Healthy 65-year-old who rarely sees doctors → consider Plan N for $360+/year savings
• Frequent doctor visits or chronic condition → Plan G usually wins
• Catastrophic-only with low premium → High-Deductible Plan G
• Either way: shop ALL carriers for the same plan — same coverage, different prices

Related: Full Medigap guide · Medicare Advantage vs Medigap · Medicare 101