Medigap Plan G vs. Plan N: Which One Leaves You With More Bills?

Plan N usually leaves you with more small bills than Plan G. With both plans you pay the Part B deductible ($283 in 2026), but Plan N can also charge copays of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to an inpatient admission. Plan N also doesn't cover Part B "excess charges," while Plan G does.

What do Plan G and Plan N both cover?

Medicare.gov's Medigap comparison chart shows that both plans pay:

• Part A coinsurance and hospital costs, up to an extra 365 days after Medicare benefits are used.
• Part B coinsurance (with Plan N's copays, below).
• The first 3 pints of blood.
• Part A hospice coinsurance or copays.
• Skilled nursing facility coinsurance.
• The Part A deductible.
• Foreign travel emergency care, at 80% up to plan limits.

Neither plan pays the Part B deductible. CMS lists that deductible at $283 for 2026. For a refresher on all the letters, see Medigap plans: what they pay.

Where do Plan G and Plan N differ?

There are two differences that show up on your bills.

1. Plan N copays. Medicare.gov says that with Plan N, you pay a copay of up to $20 for some office visits and up to $50 for emergency room visits when you aren't admitted as an inpatient. Plan G doesn't have these copays.

2. Excess charges. Plan G covers Part B excess charges. Plan N doesn't.

What is an excess charge?

Many doctors accept Medicare "assignment," which means they take the Medicare-approved amount as full payment. Medicare.gov explains that doctors who don't accept assignment can charge more than the approved amount, up to a limit called the limiting charge. That extra amount is the excess charge.

With Plan N, you'd pay that extra amount yourself. With Plan G, the plan pays it. If your doctors all accept assignment, excess charges may never come up. See Medicare balance billing and the maximum you may be billed.

What to ask a new doctor's office:

"Do you accept Medicare assignment for all your services?"

What bills should I expect with Plan G?

With Plan G, the main bill you'll see each year is the Part B deductible. Once you've paid $283 in 2026 for Part B-covered services, Plan G pays your Part B coinsurance for covered services for the rest of the year.

That's why a January doctor or lab bill can catch you off guard. Check your Medicare Summary Notice. If it shows the deductible was applied, the bill may be correct. See the Part B deductible and 20% coinsurance.

What bills should I expect with Plan N?

Plan N members can see:

• The Part B deductible early in the year.
• Office visit copays of up to $20 for some visits, often paid at the front desk.
• ER copays of up to $50 when you go home without being admitted.
• Excess charges, if a doctor doesn't accept assignment.

Each of these can be correct. Check the amount against the rules. An ER copay of $75 on a Plan N bill, for example, is worth a call.

Which plan costs less overall?

That depends on premiums where you live and how often you see doctors. Plan N premiums may be lower in some places, but prices vary by insurer and state, so compare real quotes. Add up a year of premiums plus the copays you'd likely pay. If you see doctors often, Plan G's higher premium may even out. If you rarely go, Plan N may cost less over the year.

Your State Health Insurance Assistance Program (SHIP) can walk through the numbers with you for free. Find yours at shiphelp.org. See SHIP counselors: free Medicare help.

Can I switch from Plan N to Plan G later?

Maybe. Medicare.gov says the best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period, which starts when you're 65 or older and have Part B. After that, insurance companies in most states don't have to sell you a policy unless you have a guaranteed issue right, and they may look at your health. Medigap Open Enrollment is a separate window from the fall Medicare Open Enrollment.

Guaranteed issue rights don't all cover Plan N. Medicare's Medigap booklet says that in the most common situations, like a Medicare Advantage Plan leaving your area, you can buy Plan A, B, D, or G (or C or F if you were eligible for Medicare before 2020). One exception: if you joined a Medicare Advantage Plan when you were first eligible at 65 and switch to Original Medicare within the first year (a "trial right"), the booklet says you can buy any Medigap policy sold in your state, including Plan N. See leaving Medicare Advantage: can you get Medigap? Some states have their own rules, so check with your SHIP or state insurance department before you drop a plan.

How do I check a bill if I have Plan G or Plan N?

1. Find the Medicare Summary Notice for the same date.
2. Look at "maximum you may be billed."
3. Check whether the bill was sent to your Medigap plan.
4. Compare what's left with your plan's rules above.

What to say when you call the billing office:

"I have Original Medicare and a Medigap Plan [G or N] through [insurer]. Has this claim been sent to my Medigap plan? My Medicare notice shows the most I may be billed is $[amount]. Can you tell me how you got to the balance on this bill?"

If something still seems off, see why Medigap still leaves a bill.

Frequently asked questions

Does Plan G or Plan N pay the Part B deductible?

Neither. You pay the Part B deductible, $283 in 2026, with both plans.

What are the Plan N copays?

Medicare.gov says up to $20 for some office visits and up to $50 for ER visits when you aren't admitted as an inpatient.

Does Plan N cover excess charges?

No. Plan G covers Part B excess charges, and Plan N doesn't.

Can I change from Plan N to Plan G anytime?

Not always. Outside your Medigap Open Enrollment Period, insurers in most states can decline or price based on your health unless you have a guaranteed issue right.

Not sure a Medigap bill is right?

Bill Review Coach is a monthly medical bill review service for seniors and their families. Upload your first bill free, no card needed. Snap a photo of the bill and your Medicare notice, and you'll get back a plain-English summary of what your Medigap plan should have paid and what to ask. Refer a friend and you both get a free month once they join the paid plan. You make the calls and write the emails; we help you know what to say.