Here's the short answer. Plan G and Plan N are both standardized Medigap policies that pay most of what Original Medicare doesn't. The difference comes down to three things: Plan N charges a small copay for some office and ER visits, Plan N doesn't cover Part B excess charges, and Plan G's broader coverage usually means a higher premium. Neither plan covers the Part A or Part B deductible.
Side-by-side: what each plan covers
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A coinsurance and hospital costs | Covered in full | Covered in full |
| Part A hospice coinsurance | Covered in full | Not covered |
| Skilled nursing facility coinsurance | Covered in full | Not covered |
| Part B coinsurance | Covered in full | Covered, but with a copay up to $20 for some office visits and up to $50 for an ER visit that doesn't lead to admission |
| Part B excess charges | Covered in full | Not covered |
| Part A deductible | Not covered | Not covered |
| Part B deductible | Not covered | Not covered |
| Blood (first 3 pints) | Covered in full | Covered in full |
| Foreign travel emergency | 80% up to plan limits | 80% up to plan limits |
Understanding Part B excess charges
Some doctors don't agree to accept Medicare's approved amount as full payment. Those providers can charge up to 15% more than the Medicare-approved amount for a service — that extra amount is an "excess charge," and it's your bill to pay unless your Medigap plan covers it. Plan G pays excess charges in full. Plan N does not, so if you see providers who charge excess fees, that cost falls on you under Plan N. Before choosing Plan N, ask your doctors' offices whether they charge above the Medicare-approved amount, or check whether excess charges are even allowed in your state — some states ban them outright.
The office-visit and ER copays under Plan N
Plan N's trade-off for a lower premium is a small copay you pay directly to the provider: up to $20 for some office visits, and up to $50 for an emergency room visit that doesn't result in an inpatient admission. These are capped amounts, not percentages, so they're predictable — but if you visit doctors often, they add up faster than Plan G's zero-copay design.
How to think about the trade-off
- Choose Plan G if you want the fewest surprises at the doctor's office and full protection from excess charges, and you're comfortable paying a higher monthly premium for that certainty.
- Choose Plan N if you want a lower monthly premium, don't mind small per-visit copays, and you've confirmed your providers don't charge (or rarely charge) excess fees.
Premiums for both plans vary by insurer, state, and your age, so get quotes for both before deciding — a large premium gap can outweigh the copay difference, or vice versa. Understanding Your Costs and Choosing Coverage walk through comparing total costs, not just the sticker premium.
Common questions
What's the single biggest difference between Plan G and Plan N?
Plan G pays Part B excess charges in full and has no office-visit or ER copays. Plan N doesn't cover excess charges and adds a copay of up to $20 for some office visits and up to $50 for ER visits that don't lead to admission.
What are Part B excess charges, and do I need to worry about them?
Some doctors who don't accept Medicare's approved amount can charge up to 15% more than that amount. Plan G covers that extra cost; Plan N doesn't. Whether this matters depends on whether providers in your area charge excess fees — ask before you decide.
Do both plans cover the Part A deductible?
No. Neither Plan G nor Plan N covers the Part A deductible or the Part B deductible. Both pay the Part A coinsurance/hospital costs and the Part B coinsurance (minus Plan N's small copays) at 100%.
Is Plan N always cheaper than Plan G?
Plan N's premiums are typically lower, since insurers price it below Plan G to reflect its copays and lack of excess-charge coverage. But exact prices vary by insurer, so compare quotes for both in your area before deciding.
Can I switch from Plan N to Plan G later, or the other way around?
You can ask to switch, but after your Medigap Open Enrollment Period ends, the insurer can use medical underwriting and may deny you or charge more based on your health. See Medigap Plans for how switching and guaranteed-issue rights work.
Official sources
- Medicare.gov: Compare Medigap plan benefits (full benefit table, all plan letters)
- Medicare.gov: Get Medigap costs