The two most popular Medicare Supplement plans are Plan G and Plan N. They're both excellent. The marketing brochures make them sound interchangeable — they aren't. The right choice depends on a couple of specific questions about your situation, and getting it wrong can cost you several hundred dollars a year for the rest of your life. Here's how to think about it without the sales pitch.
What they have in common
Both Plan G and Plan N are standardized Medicare Supplement plans. Standardization means every Plan G is identical across every carrier, and every Plan N is identical across every carrier — the only differences are price and customer service. Both plans cover:
- Your 20% coinsurance after Original Medicare pays its 80%
- The Part A hospital deductible
- Skilled nursing facility coinsurance
- The first 3 pints of blood
- Hospice coinsurance
- Foreign travel emergency (80% after a $250 deductible, up to plan limits)
For most healthcare encounters — hospital stays, surgeries, specialist visits, ongoing chronic care management — you'll pay $0 on either plan. The places they differ are small, but they add up over time.
Where Plan N pulls back
Plan N has three specific situations where you pay something out of pocket that Plan G covers:
- Up to $20 copay for some office visits. Not every visit — only certain ones. It usually applies to specialist visits and some primary care appointments.
- Up to $50 copay for emergency room visits that don't lead to a hospital admission. If you're admitted, the copay is waived.
- Part B excess charges. Plan N does not cover these; Plan G does. Excess charges are when a doctor charges 15% more than the Medicare-approved amount. This is rare in most of the country — about 96% of doctors accept Medicare assignment and don't charge excess — but in a few states it can be an issue worth checking.
How the math works in practice
The decision between G and N comes down to how often you'd be hit by those office and ER copays compared to the premium difference. A representative example for a 65-year-old, female, non-tobacco user in a Midwest zip code:
- Plan G premium: $140/month → $1,680/year
- Plan N premium: $100/month → $1,200/year
- Annual premium savings on Plan N: $480
For Plan N to cost more than Plan G in a year, you'd need to absorb more than $480 in copays. At $20 per office visit, that's 24 office visits a year. Most people don't go that often. So if you're an average user of healthcare, Plan N usually saves money.
The flip happens for someone with chronic conditions seeing specialists monthly, getting infusions, or going to the ER more than once a year. For those people, Plan G's predictability is worth the premium difference.
Who picks Plan G
Plan G is the right call if:
- You see doctors and specialists often (more than once a month combined)
- You'd rather pay a higher premium and have zero copays at the office
- You're managing chronic conditions or expect to use a lot of care
- You travel domestically and want zero friction at out-of-state ERs
- You're in a state with higher rates of Medicare excess-billing (a few rural states)
Who picks Plan N
Plan N is the right call if:
- You're in generally good health and see doctors a few times a year
- You'd rather pay less per month and a small copay when you do visit
- You're confident your local doctors accept Medicare assignment (don't bill excess)
- You've done the math and the premium savings outweigh expected copays
What about High-Deductible Plan G?
Worth a mention: there's a third option called High-Deductible Plan G. Same coverage as Plan G but you pay a calendar-year deductible (around $2,870 in 2026) before benefits kick in. Premium is dramatically lower — often $40-$60/month. Right for healthy people who rarely use care and want catastrophic protection without paying a high premium. Worse for people who use care regularly.
The carrier matters as much as the plan letter
Because Medigap is standardized, choosing the right carrier is just as important as choosing the right plan letter. Carriers raise rates differently over time — some are aggressive, some are stable. A Plan G with Carrier A and a Plan G with Carrier B cover the same things, but over 10 years they can diverge in premium by thousands of dollars. We always look at rate history when recommending a carrier.
The simplest way to decide
For someone newly enrolling and trying to choose between G and N: estimate how many office and ER visits you'll have in a typical year, multiply that by $20-50, and compare to the annual premium difference. If your expected copays are less than the savings, Plan N wins. If they're more, Plan G wins.
If you want the lowest-effort decision: Plan G is the safer default. You pay slightly more but never have to think about it.