Medicare Plan G vs Plan N Calculator — True Annual Cost Comparison (2026)

Whichever supplement you buy, you also keep paying Medicare itself. These are the CMS figures for 2026.

Plan N's lower premium is not free; it is the price of three specific gaps.

The office copay is up to $20 per visit, and "up to" matters — it is capped at the visit's cost-sharing amount, so a cheap visit costs less than $20. It applies to any office visit, primary or specialist.

The emergency room copay is up to $50, waived if you are admitted as an inpatient. Someone who ends up in an emergency department several times a year should count these.

Excess charges are the one genuinely open-ended item. A provider who has not accepted Medicare assignment may bill up to 15% above the Medicare-approved amount, and Plan N does not cover it. In practice the great majority of providers accept assignment and never generate one, and eight states — Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont — prohibit them outright for care received in-state. If you live in one of those, this exposure is simply not yours.

Accepts assignment —

the provider agrees to take Medicare's approved amount as full payment. No excess charge is possible.

Non-participating provider —

still treats Medicare patients but has not agreed to the approved amount, and may bill the 15% excess.

Opted out —

a small number of providers have left Medicare entirely. They can charge whatever they like, and neither Plan G nor Plan N helps — a private contract applies.

The most consequential feature of Medigap is not the cost sharing at all. It is medical underwriting.

You get a six-month open enrolment window beginning when you are 65 and enrolled in Part B. During it, any insurer must sell you any plan they offer at their standard rate, regardless of your health history. Guaranteed.

Once that window closes, in most states an insurer may ask health questions and decline you. Someone who chooses Plan N at 65 and later develops a condition that makes Plan G more attractive may find they cannot switch. The choice made in that window is, for practical purposes, often permanent.

That reframes the comparison. Plan G's premium difference is small — commonly $20 to $30 a month. What it buys is certainty: after the deductible, the exposure is zero, forever, regardless of what happens to your health. Someone with chronic conditions, or who simply prefers a fixed cost, is buying predictability rather than expected value.

Plan N suits the reverse case: healthy, few visits, comfortable with variable small costs, ideally in a state that bans excess charges. The saving is real, and for a light user it compounds over decades.

Both Plan G and Plan N are supplements to Original Medicare, and both leave the same things out.

Prescription drugs are not covered. You need a separate Part D plan, and delaying enrolment without other creditable coverage incurs a permanent late penalty added to your premium for as long as you have Part D.

Routine dental, vision and hearing are not covered by Original Medicare and so not by a supplement either.

Long-term custodial care is not covered. Medicare pays for skilled nursing after a qualifying hospital stay, for a limited period. It does not pay for someone to help you with daily living indefinitely, which is the cost most families are actually worried about.

Care outside the United States is largely excluded by Medicare, though both Plan G and Plan N include foreign travel emergency coverage at 80% after a $250 deductible, up to a $50,000 lifetime maximum.