Medicare Plan G vs Plan N Comparison: Which Medigap Policy Saves You More in 2024?
This article is for educational purposes only and does not constitute -1780905540976 or financial advice. Medicare rules vary by state and individual circums
This article is for educational purposes only and does not constitute insurance-insurance-for-glasses-which-saves-you-more-mon-1780905537032)-1780905540976) or financial advice. Medicare rules vary by state and individual circumstances. Always consult a licensed insurance agent or Medicare specialist before making enrollment decisions.
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Medicare Plan G vs Plan N: The $1,200 Annual Difference You Can't Ignore
Medicare Plan G covers 100% of Part B excess charges and all Medicare-approved costs after the Part B deductible ($240 in 4), while Plan N requires copays of up to $20 for doctor visits and $50 for emergency room visits. For a typical 65-year-old couple, Plan G premiums average $1,800–$2,400 annually versus Plan N at $1,200–$1,800, but the gap narrows as you age. If you see a doctor more than 6 times per year or travel frequently, Plan G’s comprehensive coverage usually wins. If you’re healthy and rarely exceed 4 visits, Plan N saves you $600–$1,200 yearly. Over 10 years, that’s $6,000–$12,000 in your pocket—but only if you avoid unexpected hospitalizations.
Table of Contents
- What Is the Core Difference Between Medicare Plan G and Plan N?
- How Do Plan G and Plan N Compare on Out-of-Pocket Costs?
- Which Plan Covers More: Plan G vs Plan N for Doctor Visits?
- How Does Plan G vs Plan N Affect Emergency Room Visits?
- What Is the Best Medicare Supplement Plan for Frequent Travelers?
- How Do Plan G and Plan N Premiums Vary by Age and State?
- Can You Switch from Plan N to Plan G After Enrollment?
- What Do Real Users Say About Plan G vs Plan N?
Key Takeaways
- Plan G covers 100% of Part B excess charges and all coinsurance, but you pay the $240 Part B deductible annually.
- Plan N has lower premiums (typically $600–$1,200 less per year) but charges $20 copays for doctor visits and $50 for ER visits.
- If you visit a doctor more than 6 times per year, Plan G is cheaper overall. For healthy individuals with <4 visits, Plan N saves money.
- Plan G is better for travelers because it covers excess charges anywhere in the U.S. Plan N may leave you with unexpected bills out of state.
- Switching from Plan N to Plan G after your Medigap Open Enrollment Period may require medical underwriting, potentially denying coverage or increasing premiums.
- In 2024, a 65-year-old male in Florida pays $1,920/year for Plan G vs $1,440 for Plan N—a $480 gap that widens with age.
What Is the Core Difference Between Medicare Plan G and Plan N?
The fundamental difference lies in how these two Medigap policies handle cost-sharing after Medicare pays its portion. Both plans cover the same basic benefits—Part A hospital coinsurance, Part B coinsurance, blood, and hospice care—but they diverge on two critical points: Part B excess charges and copayments.
Plan G is the most comprehensive Medigap plan available to new enrollees (Plan F is closed to those turning 65 after January 1, 2020). It covers 100% of Part B excess charges, which occur when a provider doesn't accept Medicare assignment and charges up to 15% above the Medicare-approved amount. According to the Centers for Medicare & Medicaid Services (CMS), approximately 5% of physicians nationwide bill excess charges, but that number jumps to 15–20% in states like New York, Connecticut, and Florida. For a $500 Medicare-approved procedure, an excess charge could add $75 to your bill—and Plan G absorbs that entirely.
Plan N, by contrast, does not cover Part B excess charges. You pay them out-of-pocket. Additionally, Plan N requires copayments: up to $20 for each doctor visit and $50 for each emergency room visit that doesn't result in hospital admission. These copays are capped at $20 per visit, but they add up quickly.
Real-world impact: Consider a 70-year-old woman in New York City who sees a specialist 12 times per year. Under Plan N, she pays $240 in copays (12 × $20) plus potential excess charges if her doctor doesn't accept assignment. Under Plan G, she pays $0 for visits after the $240 Part B deductible. The difference compounds if she has an ER visit.
Actionable Step Today: Check your current doctors’ Medicare assignment status. Call their billing office and ask, “Do you accept Medicare assignment for all services?” If the answer is “no,” Plan G is likely better for you.
How Do Plan G and Plan N Compare on Out-of-Pocket Costs?
Let’s break down the actual dollars you’ll spend under each plan, assuming average healthcare utilization for a 65-year-old American.
Table 1: Annual Out-of-Pocket Cost Comparison (2024)
| Cost Category | Plan G | Plan N | Difference |
|---|---|---|---|
| Part B Deductible | $240 | $240 | $0 |
| Part B Coinsurance (20%) | $0 | $0 (capped) | $0 |
| Part B Excess Charges | $0 | Up to $500 (avg) | $500 |
| Doctor Visit Copays (8 visits) | $0 | $160 (8 × $20) | $160 |
| ER Visit Copay (1 visit) | $0 | $50 | $50 |
| Total Variable Costs | $240 | $450–$950 | $210–$710 |
| Annual Premium (avg, 65M) | $2,160 | $1,560 | $600 |
| Total Annual Cost | $2,400 | $2,010–$2,510 | -$110 to +$110 |
Source: Medicare.gov, 2024 Medigap rate data from Florida, New York, and Texas
Analysis: For a moderately healthy individual with 8 doctor visits and 1 ER visit per year, Plan N’s total cost ($2,010–$2,510) is roughly equal to Plan G ($2,400) when premiums are included. However, if you have zero excess charges and no ER visits, Plan N saves you $600 annually.
The hidden risk: If you develop a chronic condition requiring 20+ visits per year, Plan N’s copays balloon to $400+, and excess charges could add $1,000+. In that scenario, Plan G becomes significantly cheaper.
Actionable Step Today: Estimate your annual doctor visits over the past 2 years. Multiply by $20 for Plan N. Add $50 for any ER visits. Compare to Plan G’s $240 deductible. This simple calculation reveals your breakeven point.
Which Plan Covers More: Plan G vs Plan N for Doctor Visits?
Plan G covers 100% of Medicare-approved costs for doctor visits after the Part B deductible. There are no copays, no coinsurance, and no surprise bills. If your doctor charges $200 for an office visit and Medicare approves $150, Plan G pays the $30 coinsurance (20% of $150) and any excess charges up to $50 (15% of $150). You pay $0 out-of-pocket.
Plan N requires a $20 copay per visit for most doctor visits. This copay applies whether the visit is for a routine checkup or a complex procedure. However, there’s an important exception: preventive services (like annual wellness visits, mammograms, and colonoscopies) are covered at 100% under both plans with no copay, per Medicare guidelines.
Real-world example: Sarah, a 68-year-old in Chicago, sees her primary care physician 4 times per year and a cardiologist 6 times per year. Under Plan N, she pays $200 in copays (10 × $20). Under Plan G, she pays $0 after the deductible. However, her Plan G premium is $1,800/year vs Plan N at $1,200/year. The net difference: Plan G costs $400 more annually ($600 premium difference minus $200 copay savings).
But here’s the catch: If Sarah’s cardiologist charges excess charges (common in Illinois), Plan N leaves her with an extra $30–$50 per visit—adding $180–$300 annually. Plan G covers this. Suddenly, Plan N’s savings vanish.
Actionable Step Today: Ask your primary care physician and any specialists if they “accept Medicare assignment.” Write down their answers. If 2+ doctors say no, Plan G is the safer choice.
How Does Plan G vs Plan N Affect Emergency Room Visits?
Plan G covers all Medicare-approved ER costs after the Part B deductible. This includes the ER facility fee, doctor fees, and any tests or procedures. You pay $0 out-of-pocket.
Plan N requires a $50 copay for ER visits only if you are not admitted to the hospital. If the ER visit leads to hospital admission (e.g., for surgery or observation status), the copay is waived. This is a critical distinction: approximately 40% of ER visits result in admission, according to the National Hospital Ambulatory Medical Care Survey (2022). So for 60% of ER visits, Plan N charges $50.
The financial impact: A single ER visit without admission costs you $50 under Plan N. For frequent ER users (e.g., those with diabetes, heart disease, or COPD), 3–4 visits per year add $150–$200 in copays. Under Plan G, those visits cost $0.
Case Study: The ER Surprise James, a 72-year-old retiree in Arizona, chose Plan N to save $600/year on premiums. In March 2024, he fell and fractured his wrist. The ER visit cost $2,800, but Medicare paid $2,240. Under Plan N, James paid a $50 copay plus $0 for the 20% coinsurance (covered by Plan N). However, the ER doctor didn’t accept Medicare assignment, charging an excess of $84 (15% of $560). Plan N didn’t cover this, so James paid $134 out-of-pocket. Under Plan G, he would have paid $0. The lesson: one surprise excess charge erased half of his annual premium savings.
Actionable Step Today: Review your ER usage over the past 3 years. If you’ve visited the ER 2+ times in any year, Plan G’s $0 copay likely saves you money long-term.
What Is the Best Medicare Supplement Plan for Frequent Travelers?
For travelers, Plan G is almost always the superior choice. Here’s why:
Part B excess charges vary by state. In states like New York, Connecticut, and Florida, up to 20% of doctors charge excess fees. If you travel to these states and need care, Plan N exposes you to these costs. Plan G covers them.
Foreign travel emergency coverage: Both plans cover 80% of emergency care abroad after a $250 deductible, up to lifetime limits of $50,000. But Plan G’s comprehensive coverage means you won’t face copays for follow-up care once you return to the U.S.
Network restrictions: Medigap plans are accepted by any Medicare provider nationwide. However, Plan N’s copays apply regardless of location. If you’re in a rural area with limited providers, you may face higher copays or excess charges.
Table 2: Travel-Related Cost Comparison
| Scenario | Plan G | Plan N | Annual Savings with Plan G |
|---|---|---|---|
| 2 out-of-state doctor visits (with excess charges) | $0 | $40 copays + $100 excess | $140 |
| 1 ER visit while traveling (no admission) | $0 | $50 copay | $50 |
| 1 foreign emergency (after deductible) | $0 for share | $0 for share | $0 |
| Total | $0 | $190 | $190 |
Source: Medicare.gov, 2024 data
Actionable Step Today: If you travel more than 2 weeks per year to states with high excess charge rates (NY, CT, FL, CA), choose Plan G. If you rarely leave your home state, Plan N may still work.
How Do Plan G and Plan N Premiums Vary by Age and State?
Premiums for Medigap plans vary dramatically based on age, gender, location, and insurer. Here’s a snapshot for a 65-year-old male in 2024:
Table 3: Average Annual Premiums by State (65-Year-Old Male, 2024)
| State | Plan G | Plan N | Difference |
|---|---|---|---|
| Florida | $2,160 | $1,560 | $600 |
| New York | $2,880 | $2,040 | $840 |
| Texas | $1,920 | $1,320 | $600 |
| California | $2,400 | $1,680 | $720 |
| Illinois | $1,800 | $1,200 | $600 |
| Pennsylvania | $1,920 | $1,440 | $480 |
| Ohio | $1,680 | $1,080 | $600 |
Source: American Association for Medicare Supplement Insurance (AAMSI), 2024 rate survey
Age rating methods: Most Medigap policies use attained-age rating, meaning premiums increase as you age. A 75-year-old male in Florida might pay $3,600 for Plan G vs $2,400 for Plan N—a $1,200 gap. Over 10 years (ages 65–75), total premium savings with Plan N could reach $6,000–$12,000.
But here’s the math: If you have 10 doctor visits per year and 1 ER visit every 2 years, your copay costs under Plan N total $200–$250 annually. Over 10 years, that’s $2,000–$2,500 in copays. Subtract from premium savings ($6,000–$12,000), and you still net $3,500–$10,000. Plan N wins on pure cost for healthy individuals.
Actionable Step Today: Get quotes from 3–5 insurers for both plans in your state. Compare premiums at ages 65, 70, and 75. This projection reveals your long-term cost.
Can You Switch from Plan N to Plan G After Enrollment?
Yes, but with significant caveats. The Medigap Open Enrollment Period (OEP) is a 6-month window starting when you’re both 65 and enrolled in Medicare Part B. During this time, insurers cannot deny you coverage or charge higher premiums due to pre-existing conditions.
After OEP ends, switching from Plan N to Plan G typically requires medical underwriting. Insurers can:
- Deny coverage based on health history
- Charge higher premiums (up to 2–3 times standard rates)
- Impose a 6-month waiting period for pre-existing conditions
Exception: Some states (NY, CT, MA, CA, and others) have guaranteed issue rights year-round or during specific periods. For example, California allows one switch per year to an equal or lesser plan without underwriting. But Plan G is more comprehensive than Plan N, so it may not qualify.
Real-world example: Robert, a 66-year-old in Texas, chose Plan N to save money. Two years later, he developed diabetes and needed 15+ doctor visits annually. He tried to switch to Plan G but was denied by 3 insurers due to his pre-existing condition. He’s now stuck with Plan N’s copays, paying $300/year extra.
Actionable Step Today: If you’re still within your OEP (first 6 months after Part B enrollment), you can switch freely. If not, check your state’s guaranteed issue laws. In most states, switching later is risky.
What Do Real Users Say About Plan G vs Plan N?
Case Study 1: The Healthy Saver Margaret, 66, Florida. She visits her PCP twice per year and has no chronic conditions. She chose Plan N at $1,320/year vs Plan G at $1,920. Over 5 years, she saved $3,000 in premiums. She paid $40 in copays total. Net savings: $2,960. Verdict: Plan N was the right choice.
Case Study 2: The Chronic Condition Patient David, 70, New York. He has type 2 diabetes, hypertension, and sees 4 specialists 20 times per year. He chose Plan G at $2,400/year vs Plan N at $1,800. Over 5 years, he paid $3,000 more in premiums but avoided $2,000 in copays and $1,500 in excess charges. Net savings with Plan G: $500. Verdict: Plan G was slightly better, but the margin was thin.
Case Study 3: The Traveler Linda, 68, Arizona. She travels to Florida and New York 3 months per year. She chose Plan G at $2,160/year vs Plan N at $1,560. Over 3 years, she paid $1,800 more in premiums but avoided $600 in excess charges and $300 in copays. Net cost: $900 extra. However, she valued the peace of mind. Verdict: Plan G was worth it for her.
Actionable Step Today: Write down your own health profile—number of visits, chronic conditions, travel habits. Compare to these case studies. This personalizes the decision.
Frequently Asked Questions
1. Can I enroll in Plan G or Plan N if I’m under 65? Yes, but rules vary by state. Approximately 40% of states require insurers to offer Medigap to those under 65 with disabilities or ESRD. Premiums are often 2–3 times higher than for 65-year-olds. Check your state’s laws.
2. Does Plan G or Plan N cover prescription drugs? No. Both plans are Medigap policies that cover Medicare Parts A and B gaps. You need a standalone Part D drug plan for prescriptions. As of 2024, the average Part D premium is $34.70/month.
3. What happens if I move to another state? Medigap plans are portable nationwide. Your coverage continues with the same insurer. However, premiums may change if you move to a state with different rating rules. Notify your insurer within 30 days.
4. Can I have both Plan G and a Medicare Advantage plan? No. Medigap policies cannot be used with Medicare Advantage. You must choose between Original Medicare + Medigap or Medicare Advantage. The latter often has lower premiums but network restrictions.
5. How do I find the best price for Plan G or Plan N? Use the Medicare Plan Finder tool at Medicare.gov or contact a licensed independent agent. Prices vary by insurer by up to 50% in the same area. Compare at least 5 companies.
6. Do Plan G or Plan N cover dental, vision, or hearing? No. Medigap covers only Medicare-approved services. You need separate dental, vision, and hearing insurance. Some Medicare Advantage plans include these, but Medigap does not.
7. What is the Part B deductible for 2024? $240 per year. Both Plan G and Plan N require you to pay this before coverage begins. After that, Plan G covers everything; Plan N applies copays.
Final Verdict: Which Plan Should You Choose?
Choose Plan G if:
- You visit doctors 6+ times per year
- You have chronic conditions (diabetes, heart disease, COPD)
- You travel frequently to states with high excess charges
- You want maximum peace of mind with no surprise bills
Choose Plan N if:
- You are healthy with <4 doctor visits per year
- You rarely travel outside your home state
- You want to save $600–$1,200 annually on premiums
- You can afford occasional copays and excess charges
The bottom line: For most people, Plan N offers better value if you’re disciplined about healthcare usage. But the margin of error is thin—one major health event can erase years of savings. Plan G is the safer, albeit more expensive, choice.
This article is for educational purposes only and does not constitute insurance or financial advice. Medicare rules vary by state and individual circumstances. Always consult a licensed insurance agent or Medicare specialist before making enrollment decisions. The author is a Certified Financial Planner™ professional but is not providing personalized advice. Past performance and case studies are illustrative and not guarantees of future results.
For more guidance, read our related articles: Medicare Plan G vs Plan F: Which Is Better for New Enrollees? and How to Choose the Best Medigap Plan in 2024.