Medicare Supplement Plan G vs Plan N: Which Costs Less in 2026 Based on Your Health

2026 Medigap Plan G vs Plan N Premium Costs by Age and Region

Premium differences between Plan G and Plan N vary substantially by age, gender, tobacco use, and rating method — community-rated, issue-age-rated, or attained-age-rated. The figures below reflect sample monthly premiums for a non-tobacco-using female at three age benchmarks in three geographic markets, drawn from publicly available carrier rate filings and comparison tools current as of early 2026. Always request a personalized quote from a licensed broker, as your specific county can shift rates significantly.

Sample premium ranges compiled from carrier rate comparison tools. Verify current rates with a licensed Medigap broker or at medicare.gov (verify at medicare.gov). Premiums vary by carrier, zip code, rating method, and underwriting.

The typical premium gap in most U.S. markets runs $30–$50/month, or $360–$600/year. That annual premium savings is the benchmark Plan N must beat through lower out-of-pocket utilization costs. In high-cost states like Florida and New York, the gap can widen to $55–$70/month — making Plan N’s math harder to justify for frequent users.

What the Coverage Difference Actually Means in Dollar Terms

Both Plan G and Plan N cover Medicare Part A coinsurance and hospital costs, Part B coinsurance, the Part A deductible ($1,676 in 2026), skilled nursing facility coinsurance, and foreign travel emergency care (at 80%, up to plan limits). The divergence lives in three specific cost items that Plan N does not cover but Plan G does.

Part B copays under Plan N: Plan N requires up to a $20 copay per office visit and up to a $50 copay per emergency room visit (waived if admitted). Plan G has no copays for these visits. CMS publishes the Part B cost-sharing structure at cms.gov (verify at cms.gov).

Part B excess charges: When a provider does not accept Medicare assignment, they may bill up to 15% above the Medicare-approved amount. Plan G covers this. Plan N does not. Twenty-seven states and Washington D.C. have banned excess charges through state law — including Ohio, New York, Connecticut, Massachusetts, and Pennsylvania — effectively eliminating this risk for Plan N holders in those states. In states like Texas, Florida, Georgia, and Arizona, excess charges remain a live financial exposure. The American Association for Medicare Supplement Insurance (AAAMSI) maintains a current state-by-state excess charge map (verify at medicaresupp.org).

The Part B deductible: Neither Plan G nor Plan N covers the 2026 Part B deductible of $257. Both plans are equal here. This is a frequent point of confusion — some beneficiaries compare Plan G to legacy Plan F, which did cover the deductible. Plan F is no longer available to beneficiaries who turned 65 after January 1, 2020.

Coverage structure per CMS standardized Medigap benefit chart. Verify at CMS Medigap Overview.

Plan G vs Plan N: Which Is Better for Your Health Profile?

The core break-even calculation is straightforward. Take the annual premium difference between Plan G and Plan N quotes from the same carrier. Then estimate your expected annual copay and excess charge exposure under Plan N. When your expected Plan N costs equal the premium savings, you’ve hit the break-even point.

Break-even model — moderate market ($40/month premium gap):

Annual premium savings with Plan N: $480. At $20 per office visit copay, you’d need 24 covered office visits to exhaust the savings — an unusually high number for most beneficiaries. But that math assumes every visit triggers a $20 copay. In practice, many visits — including lab-only encounters, preventive-care appointments, and some primary care visits — may not trigger the full copay, depending on how the visit is coded. Specialist visits at large academic medical centers or surgery centers are the most consistent copay triggers.

Scenario A — Healthy 65-year-old: 8 primary care visits/year, no specialist visits, no ER use, no excess charge risk. Estimated Plan N annual copay exposure: $80–$120. Net Plan N annual savings vs Plan G: $360–$400. Plan N wins clearly.

Scenario B — Active chronic condition: 4 primary care visits + 8 specialist visits + 1 ER visit/year. Estimated Plan N copay exposure: $170–$290 (mix of $20 office + $50 ER copays). Net Plan N savings: $190–$310. Plan N still saves money — but by a narrower margin that erodes further if any provider bills excess charges.

Scenario C — Complex health needs: 6 primary care + 14 specialist + 2 ER visits/year, providers in a non-assignment state. Estimated Plan N exposure: $380–$540 in copays alone, plus potential excess charge exposure. Net savings under Plan N: near zero or negative. Plan G wins.

What Most People Get Wrong When Comparing Plan G and Plan N

Medigap shoppers make predictable, costly errors when evaluating these two plans. Each mistake below has a direct dollar consequence.

Mistake 1 — Comparing premiums across different carriers. A Plan G quote from Mutual of Omaha and a Plan N quote from Cigna tell you almost nothing useful. Benefit standardization means Plan G coverage is identical regardless of carrier. But premiums, rate increase history, and underwriting practices vary widely. Always compare G vs N quotes from the same carrier to isolate the true coverage cost differential. Failing to do this can make Plan N appear cheaper than it actually is relative to the Plan G you’d realistically buy.

Mistake 2 — Ignoring the rating method. Attained-age-rated plans start with lower premiums but increase every year as you age. Issue-age-rated plans lock pricing to your age at enrollment. Community-rated plans charge everyone the same regardless of age. A Plan N that looks $45/month cheaper at 65 on an attained-age policy may become more expensive than Plan G by age 75 if rate increases outpace the G plan’s trajectory. The Kaiser Family Foundation (KFF) has documented the long-term cost implications of rating methodology in its Medigap research (verify at kff.org).

Mistake 3 — Forgetting that Plan N requires underwriting after the initial open enrollment window. If you enroll in Plan N at 65 during your guaranteed-issue window and later want to switch to Plan G, you will almost certainly face medical underwriting — and could be denied or surcharged based on conditions you’ve developed. This asymmetry of switching rights means Plan N isn’t just a premium decision; it’s a long-term health bet.

Mistake 4 — Assuming excess charges are rare. In states without excess charge bans, the Medicare Payment Advisory Commission (MedPAC) has documented that a meaningful share of physicians do not accept Medicare assignment, particularly in high-demand specialties like orthopedics, dermatology, and ophthalmology. For a Plan N holder in Texas needing orthopedic surgery, a single procedure could generate hundreds of dollars in excess charges not covered by the plan.

Mistake 5 — Treating the Part B deductible as a Plan G advantage. Neither plan covers the $257 Part B deductible in 2026. Beneficiaries who recently held Plan F sometimes assume Plan G maintains that benefit. It does not. Both plans treat this cost identically.

Is Plan G or Plan N Worth It? Who Should Choose Each

The value of either plan depends on three intersecting factors: your current health utilization pattern, your state’s regulatory environment for excess charges, and your personal tolerance for variable annual out-of-pocket exposure.

Choose Plan G if:

You have one or more chronic conditions requiring regular specialist management — diabetes, heart disease, COPD, rheumatoid arthritis, or cancer history. You see more than one specialist regularly. You live in a state that permits Part B excess charges (Texas, Florida, Georgia, Arizona, and others). You value predictable annual costs and find the administrative friction of copays at each visit genuinely burdensome. You are 70 or older and anticipate increasing utilization over the next five years. Your premium gap between G and N is less than $30/month — at that spread, the break-even requires so few visits that G is almost always preferable.

Choose Plan N if:

You are newly enrolled at 65, in excellent health, and have a documented pattern of low healthcare utilization. You live in a state that bans Part B excess charges, eliminating one of Plan N’s two primary financial exposures. The premium savings represent a meaningful amount for your budget — $480–$720/year is real money, especially for beneficiaries on fixed Social Security income. You are willing to track and manage your copay exposure annually and switch plans if your health status changes — understanding that switching will require underwriting.

Special consideration — Medicaid and dual eligibility: Beneficiaries who qualify for both Medicare and Medicaid (dual eligibles) typically have Medicaid covering their cost-sharing, making a Medigap supplement largely redundant. CMS maintains guidance on dual eligibility coordination at cms.gov (verify at cms.gov). For beneficiaries approaching Medicaid spend-down thresholds due to long-term care costs, the cost-sharing protection of Plan G may be less critical than other financial and legal planning steps.

What’s changed in 2026: The Part A deductible increased to $1,676 (from $1,632 in 2025) and the Part B deductible rose to $257 (from $240 in 2025). Both plans cover the Part A deductible equally, so this change does not alter the G vs N comparison. The Part B deductible increase of $17 affects both plans identically. Premium trends for 2026 showed modest increases of 3–6% for most carriers in most markets, consistent with recent years — the premium gap between G and N remained relatively stable.

How We Researched This Article

This analysis was developed using primary data from federal government sources, peer-reviewed insurance research organizations, and publicly available carrier rate filings. Research was last conducted in May 2026.

Medicare cost-sharing figures — including the 2026 Part A deductible ($1,676), Part B deductible ($257), and Plan N copay structures — were sourced directly from the Centers for Medicare and Medicaid Services Medigap overview page and the Medicare.gov Medigap explainer. The standardized benefit structure for Plan G and Plan N is mandated by federal law and does not vary by carrier — only premiums, rate history, and underwriting practices differ.

Premium ranges were compiled from publicly accessible Medigap comparison tools and reflect rates quoted for a non-tobacco female in three geographic markets (Dallas TX, Columbus OH, Miami FL) at ages 65, 70, and 75. These represent illustrative ranges, not guarantees. Individual premiums depend on carrier, rating method, zip code, and — outside of guaranteed-issue windows — health history.

State-level excess charge regulations were verified using guidance from the Kaiser Family Foundation’s Medigap enrollment and consumer protections analysis. Provider assignment data and excess charge prevalence were informed by Medicare Payment Advisory Commission (MedPAC) reports on physician billing practices.

Break-even scenarios are modeled calculations based on the cost-sharing structures above and representative premium gaps observed in the market. They are not actuarial projections and will vary based on individual circumstances. Readers should run personalized calculations using actual quotes from a licensed Medigap broker and their own visit utilization history. The Social Security Administration’s Medicare enrollment resources provide additional context on eligibility and enrollment periods.

This article does not model Medicare Advantage as an alternative, as that comparison involves substantially different cost structures and network considerations outside the scope of this analysis. Limitations: premium data reflects point-in-time rate filings and may not reflect carrier-specific increases applied mid-year. Copay triggers under Plan N vary by how individual visits are coded by providers and may not apply uniformly to all office visits.

All figures were verified against named primary sources before publication.