Medicare Plan G vs. Plan N
Plan G covers everything except the Part B deductible (~$257 in 2026). Plan N has lower premiums but charges $20 office-visit and $50 ER copays. Plan N wins when you rarely see doctors; Plan G wins when you have frequent visits or want full predictability.
The short answer
Plan G, unless you are a genuinely light user of care and expect to stay that way.
On pure arithmetic the two land close together for someone with average utilisation, and Plan N wins for anyone who rarely sees a doctor. If cost were the only consideration, Plan N would be the default.
The tie-breaker is not cost. It is that you may not be able to switch later. Outside your six-month open enrolment window, most states let insurers medically underwrite and decline you — so the choice made at 65 is frequently permanent.
That makes Plan G the safer default for anyone with a chronic condition or a preference for a fixed, known cost. Plan N rewards people who are genuinely light users and are comfortable with variable small charges.
What it actually costs
A 65-year-old in Texas. Plan G quoted at $130/month, Plan N at about $107. Twelve primary care visits, four specialist visits, no ER trips, no excess charges. Part B deductible $283 for 2026.
| Plan G | $1,843/year | $1,560 of premium plus the $283 deductible. Nothing else. |
|---|---|---|
| Plan N | $1,882/year | $1,279 of premium, the $283 deductible, and $320 of office copays. |
A $39 difference — effectively a tie. The break-even is 15 office visits a year: below that Plan N wins, above it Plan G does.
Where people go wrong
- Treating the $50 emergency-room copay as a specialist copay. Specialist office visits carry the same $20 as any other office visit.
- Forgetting that the Part B premium is paid on top of the Medigap premium, not instead of it.
- Missing the six-month open enrolment window, which is the only time any insurer must sell you any plan.
- Comparing quotes without asking whether they are attained-age, issue-age or community-rated.
Common questions
Can I switch from Plan N to Plan G later?
Sometimes. Outside open enrolment, insurers in most states can ask health questions and decline you. A few states — Connecticut, Massachusetts, New York and Maine among them — provide continuous or annual guaranteed-issue rights. Check your own state before assuming a switch will be available.
Do the two plans cover different doctors?
No. Neither has a network. Any provider who accepts Medicare accepts either plan, anywhere in the country. That portability is the main structural difference from Medicare Advantage.
What about Part B excess charges?
Plan G covers them and Plan N does not. In practice most providers accept assignment and never generate one, and eight states prohibit them outright for in-state care: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island and Vermont.
| Medicare Plan G | Plan N | |
|---|---|---|
| Monthly premium (age 65) | $120-$180 | $95-$140 |
| Part A deductible | Covered | Covered |
| Part B deductible | You pay (~$257) | You pay (~$257) |
| Office visit copay | None | $20 per visit |
| ER copay | None | $50 per visit (waived if admitted) |
| Part B excess charges | Covered | NOT covered — you pay 15% extra |
| Foreign travel emergency | Covered | Covered |
| Best for | Frequent doctor visits, full predictability | Lower premiums, infrequent visits |
Choose Medicare Plan G if
- You see doctors 6+ times per year.
- You want zero copays at the point of service.
- You live in an area with many "excess charge" doctors.
- Your budget can absorb $50/month higher premiums.
Choose Plan N if
- You rarely see doctors (1-3 times/year).
- You can absorb $20/visit and $50/ER copays.
- Your doctors accept Medicare assignment (no excess charges).
- You want to bank the premium savings each month.
Run the numbers yourself
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