Medigap Plan G vs. Plan N: Which Is Best?

Medigap Plan G is the most comprehensive Medicare Supplement Insurance plan that’s available for purchase by all Medicare members. Medigap Plan N covers a bit less, but its premiums are lower, too.

The biggest difference between Medigap Plan G and Medigap Plan N is that Plan N has copays for certain medical office and emergency department visits, whereas Plan G doesn’t. If you wouldn’t need to pay the copays often, Medigap Plan N could cost less overall.

Plan G also offers a high-deductible Medigap plan in some states.

Here’s what you need to know to determine whether Medigap Plan G or Medigap Plan N is the best for you.

Medigap Plan G and Plan N have mostly the same set of Medicare benefits, but there are a couple of key differences.

Benefits that are the same in both Plan G and Plan N

Here are the Medicare benefits that both Plan G and Plan N cover, according to Medicare.gov:

• Part A coinsurance and hospital stays up to an additional 365 days after Medicare benefits are used up.

• Part A deductible.

• Part A hospice care coinsurance or copayment.

• Skilled nursing facility care coinsurance.

• Blood transfusion (first three pints).

• Medically necessary emergency health care service for the first 60 days when traveling outside the U.S. Deductible and limitations apply.

Benefits that differ between Plan G and Plan N

Medigap Plan G and Plan N have two differences in coverage.

Part B excess charge coverage

Medigap Plan G covers Medicare Part B excess charges, while Plan N doesn’t. If a health care provider is legally permitted to charge more than Medicare’s approved amount and does so, what’s left over after Medicare’s approved amount is an excess charge.

Part B coinsurance coverage

Medigap Plan G and Plan N both include Medicare Part B coinsurance coverage, but the level of coverage differs between the two plans. Plan G covers all of your Part B coinsurance, but Plan N doesn’t.

Rather than covering your entire Part B coinsurance, Medigap Plan N requires you to pay out of pocket for these visits:

• Office visits: Copay is up to $20 for certain office visits.

• Emergency room visits: Copay is up to $50 if you’re not admitted to hospital inpatient care.

After those copays, Plan N covers any additional Part B coinsurance for the visit. Plan N also pays the full Part B coinsurance for other types of visits covered by Medicare Part B.

» MORE: Compare Medicare Supplement Insurance plans

Medigap Plan G covers more than most other Medigap plans, and its premiums tend to be higher, too. Premiums for Plan N are lower because of its copay requirements.

Here are the lowest prices for each plan for a 65-year-old nonsmoker in Atlanta, a metro area with average costs for Medigap policies:

• Medigap Plan G: $119.

• Medigap Plan N: $90.

Would you pay less with Medigap Plan N because of its lower premiums, or would the savings be outweighed by the copay requirements? That answer depends on two factors:

• What’s the difference in premiums?

• How often will you have office or emergency visits?

In the earlier example with Atlanta prices, the difference in premiums is $29 per month. If you had about one $20 office visit copay per month or about one $50 emergency visit every other month, you could come out ahead with Plan N’s less expensive premiums. But if you had to pay the copays significantly more often, Plan G could be the better deal.

Medigap Plan G vs. Plan N calculator

Consider Plan N if you have relatively few health care visits

If you don’t have many medical office or emergency visits, the premium savings from Plan N might be worthwhile.

For example, say Plan N costs $25 less per month than Plan G. That’s a difference of $300 for the whole year.

If you have four office visits with $20 copays and one emergency visit with a $50 copay over the course of the year, that’s $130 in out-of-pocket costs. You would end up saving $170 ($300 - $130 = $170) for the year as compared to Plan G.

Consider Plan G if you have frequent visits or prefer predictable costs

If you tend to have more frequent visits to your health care providers, Plan G might be the better deal.

For example, take the same $25 difference in monthly premiums between Plan G and Plan N — $300 for the year.

If you had one $20 office visit copay per month (so 12 per year) and one $50 emergency copay per year, that adds up to $290 in out-of-pocket costs. With a $300 annual difference in premiums, you would save $10 per year with Plan N ($300 - $290 = $10). If you had any more visits than that, the difference in premiums wouldn’t be enough to cover the out-of-pocket costs.

You might also want to opt for Plan G for the sake of predictability. It’s hard to guess how many office or emergency visits you might have, so there’s more uncertainty with what you’ll spend for Plan N. Plan G’s premiums may be higher, but you know in advance what you’ll have to pay each month.