Choosing the right Medicare plan can feel confusing, but many people narrow it down to Medicare Plan G vs Plan N. After a small Part B deductible, Plan G covers almost everything, even extra charges some doctors bill so you get peace of mind with very few surprises. Plan N usually costs less each month, but you’ll pay small copays for doctor or ER visits, and it doesn’t cover those extra charges. The tradeoff is simple: pay a bit more for broad coverage, or save on premiums and accept some out-of-pocket costs.
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Key Differences Between Medicare Plan G and Plan N
At first, Plan G and Plan N look a lot alike. Both of these Medigap plans give strong Medicare coverage. Private insurance companies make these Medigap plans to help with costs that Original Medicare does not pay for. This can be things like coinsurance and deductibles. But, how they help cover these extra costs is not the same and this can change what you pay.
The main difference is in how they split costs. Medigap Plan G gives you clear and steady costs, so what you pay is more predictable. Medigap Plan N comes with a lower monthly payment. In return, you pay more out of your pocket for some visits and services. To pick between Medigap Plan G and Medigap Plan N, you need to know what each one gives and which will work best for you.
Overview of Coverage Options
Both Plan G and Plan N are Medigap policies. These plans give you set benefits to help with your healthcare costs if you have Original Medicare. The main aim is to limit the money you have to spend out of your own pocket for things that Medicare Parts A and B do not pay for.
Medicare Plan G is seen by many people as the most complete or full coverage option for those who are new to Medicare. When you pay the yearly Part B deductible, Plan G covers all of your other approved Medicare costs. This is full coverage. Plan G covers things like Part B excess charges. These are extra fees that some doctors may charge for a visit or care. Many people find a lot of peace of mind with this level of protection.
Plan N is also a plan with good, comprehensive coverage. But, there is some cost-sharing. This means you may need to pay small amounts. For example, you may have to pay a small amount when you have doctor visits or trips to the emergency room. One of the biggest differences between Plan N and Plan G is about Part B excess charges. Plan N does not cover Part B excess charges. So that is a cost that you may need to pay, while Plan G covers this in full. Both plans work with Original Medicare coverage and help lower your healthcare costs if you get sick or hurt.
How Plan G and Plan N Handle Outpatient and Inpatient Services
When you get inpatient hospital care, both Plan G and Plan N give you the same, strong coverage. If you have to stay in a hospital, both plans pay for your Medicare Part A coinsurance and deductible. This also covers skilled nursing facility care and hospice care. You do not have to pay out of your own pocket for these big inpatient medical services.
There are some differences for outpatient services. Plan G covers everything for outpatient costs once your Part B deductible is paid, and you do not have to pay copays. With Plan N, you help pay some of the costs after you reach your deductible:
- You might need to pay up to a $20 copay for some office visits.
- There is a $50 copay for emergency room visits, but only if you are not admitted to the hospital.
Since both choices are a Medigap plan, they work with Original Medicare. This means you can see any doctor or go to any hospital in the U.S. that takes Medicare. You have freedom and choices, so you can get emergency room help in any state or go see a specialist far from home if you want.
Comparing Out-of-Pocket Costs for Plan G vs Plan N
Looking at your possible out-of-pocket costs is very important when you choose between Plan G and Plan N. There is more to this choice than just looking at the monthly premiums. You also need to think about deductibles, copayments, and other costs, like surprise fees and excess charges, that can add to your healthcare costs each year.
For some people, paying the higher monthly premiums with Plan G is a good idea because they want to know what their bills will be. For others, saving money each month with Plan N makes more sense, even if that means sometimes paying extra copays. Let’s break down these costs together to see how they could shape the way you handle your budget.
Premiums, Deductibles, and Coinsurance Explained
The most noticeable difference in cost between the two plans is their monthly premiums. Plan G consistently has higher premiums because it offers more first-dollar coverage after the deductible. Plan N’s lower premiums make it an attractive option for those looking to reduce their fixed monthly expenses.
Both plans require you to pay the annual Medicare Part B deductible ($257 in 2025, but this amount can change yearly). Once you have met this deductible, your coverage kicks in. For coinsurance, Plan G covers it entirely. Plan N also covers most coinsurance, but its copayment structure for office and ER visits is a form of cost-sharing that you must factor in.
This table provides a quick comparison of the key cost-sharing features for each plan.
| Feature | Plan G | Plan N |
| Part B Deductible | You Pay | You Pay |
| Part B Excess Charges | Covered | Not Covered |
| Office Visit Copays | None | Up to $20 |
| ER Visit Copays | None | $50 (unless admitted) |
| Monthly Premium | Higher | Lower |
Copayments and Potential Excess Charges
The cost-sharing of Plan N is set by its copayments. You will pay up to $20 for some office visits. For emergency room visits, the copay is $50 if you are not admitted to the hospital. Keep in mind that telehealth appointments, which got popular during the pandemic, are now often billed the same way as in-person office visits. So, a copay may apply for these as well.
Another thing to think about is Part B excess charges. These are extra fees, up to 15% above the Medicare-approved amount, that some doctors can charge. Are these additional fees common? No. More than 98% of doctors take Medicare assignment and will not bill for Part B excess charges, according to KFF.
But, the way the plans handle Part B excess charges is not the same:
- Plan G covers Part B excess charges completely.
- Plan N does not cover these, so you have to pay out of pocket.
- You can stay away from paying these additional fees by making sure your doctors accept Medicare assignment.
Which Plan Offers Better Value Based on Your Healthcare Usage?
Deciding if Medigap Plan G or Medigap Plan N gives you better value depends on your own healthcare needs. You need to think about how often you need medical services. There is not one “best” Medigap plan that fits everyone. The plan that works for you should match the amount you want to pay for premiums and what you expect to pay out-of-pocket.
Ask yourself if you go to the doctor a lot or if you think you will not use many medical services. This simple question helps you find out which Medigap plan, Plan G or Plan N will give you the best value for your own needs. This way, you can get the best out of your Medigap plan.
Suitability for Frequent Doctor Visits or Specialist Care
If you think you will see the doctor a lot or you need to visit a specialist often, Medicare Plan G is usually the best option. This Medicare plan is good for people who want peace of mind and don’t want to worry about surprise bills. After you pay the yearly Part B deductible, you don’t have to pay copays when you go to your doctor or to a specialist.
This setup gives you stable and clear healthcare costs. You only need to pay the Part B deductible for the whole year, no matter how many doctor visits or appointments you have. This is really helpful if you have a long-term health problem and want to get rid of guessing about your healthcare bills. With Plan G:
- There are no copays for doctor visits.
- You can expect steady and clear healthcare costs.
- It covers Part B excess charges, so you do not need to worry about which doctor you choose.
On the other hand, Plan N makes you pay up to $20 for each doctor visit. This may not seem bad at first, but if you go to the doctor many times, these copays add up. You can figure out when Plan G saves you more money by dividing the price difference in the yearly premium between Plan G and Plan N by $20. This shows how many doctor visits it takes for Medicare Plan G to be the better value.
Best Scenarios for Low or Moderate Healthcare Utilization
For people who are new to Medicare, are healthy, and do not see the doctor a lot, Plan N can often be a better deal. The big reason is that it gives you lower monthly premiums right away. You could save hundreds of dollars each year, and that helps a lot if you have a set budget to work with.
With Plan N, you pay small copays when you do see the doctor. For those who need only a few doctor visits or some Part B services, the total you pay in premiums plus copays is often still less than what you would pay in total monthly premiums with Plan G. So you are choosing to pay less every month, and only be paying a little extra when you use medical care.
Plan N also gives you good medical coverage in case something major happens, like needing a hospital stay. This plan lets you save money in the years when you do not need much Part B care. It is a good pick for healthy people who want safe and strong coverage for any big problems, but who do not want to pay for extra coverage for things they do not need or use.
Major Advantages and Drawbacks of Plan N Over Plan G
Choosing Plan N instead of Plan G has both good and bad sides. The main good thing is about money. You pay a lower premium. You may see smaller rate increases as time goes on. This is good for people who want to save money and still get good coverage.
The downside is in cost-sharing and not having full coverage. With Plan N, you need to pay copayments for some services. The plan will not protect you from Part B excess charges. Think about what you want and look at the pros and cons before you choose your healthcare plan for the future. This is important for your long term strategy. Plan N and Plan G both have options, but Part B excess and rate increases matter a lot.
Lower Premiums and Rate Stability
The biggest benefit of Plan N is that you pay less each month. With this plan, you can save between $40 and $80 every month compared to Plan G, depending on your age and where you live. Over a year, this adds up to a lot of savings. You can use this extra money on other things you need. Private insurance companies are able to give these lower monthly rates because you share in the costs, and that helps lower the risk for the companies.
On top of those first savings, Plan N can also keep your rates more steady as time goes on. Rate increases for Plan G are often higher, partly because this plan is a “guaranteed issue.” That means people who are leaving other coverage can still join. Usually, these people have bigger health needs. This makes claims go up. Then, everyone on the plan ends up paying higher future costs.
Because Plan N has you pay more of the costs when you use the plan, it usually attracts people who are healthier. This helps keep rate increases lower and more stable over time. Many people like this for their retirement plans. That makes Plan N a more popular choice for those who want to plan future spending.
Important Limitations and Considerations When Choosing Plan N
Plan N can save you some money, but there are a few big things to think about. The biggest difference is that Plan N does not help with Part B excess charges. If you go to the doctor or use another provider who does not take Medicare assignment, you will have to pay any extra fees they charge. These fees can be up to 15% more than what Medicare agrees to pay.
When you look at Plan N policies, there are a few things you will need to watch for:
- Copayments: You might have to pay up to $20 when you go for office visits and $50 when you go to the ER.
- Excess Charges: There is no help for you on these extra bills.
- Provider Choice: You must make sure your doctors take Medicare assignment. This can help you avoid extra charges known as Part B excess.
Because of these limits, Plan N asks you to be more involved with your healthcare, compared to the better coverage from Plan G. If you don’t mind double checking your provider’s status, and you are OK with paying some copays now and then, what you save on your premiums can make Plan N a good choice.
Conclusion
At the end of the day, picking between Medicare Plan G and Plan N is about what you need from your healthcare plan and what you can spend. You need to know the important differences when it comes to how each plan covers you, how much you will pay out of your own pocket, and what both good and bad things you get with each one. Plan N might have lower monthly costs and give you some benefits. But, it also has limits that could change the way you get healthcare. Take time to think about everything, including how often you use medical services, so you can pick the plan, either Plan N or Plan G that fits your life best.
Not sure which plan is right for you? The Medicare Family is here to make it simple. With 40+ years of experience and access to 30+ top insurance companies, we’ll walk you through your options in an easy way and give you expert advice at no cost. Schedule your FREE call today and discover the plan that fits your life with lifetime support you can count on.
