What are the key differences between Medigap Plan G and Plan N?

Plan G covers 100% of all Medicare gap expenses after you pay the annual Part B deductible. Plan N has lower monthly premiums (typically $30-$50/month less) but requires up to a $20 copay for doctor visits, up to $50 for ER visits, and does not cover Part B excess charges.

What are Part B excess charges on Plan N?

If a doctor does not accept Medicare assignment, they can legally bill up to 15% above the Medicare-approved amount. Plan G covers these excess charges, while Plan N leaves you responsible. However, 8 states ban excess charges by law (CT, MA, MN, NY, OH, PA, RI, VT), and over 98% of doctors nationwide accept Medicare assignment.

Medigap Plan G vs. Plan N Breakeven Calculator

Medicare Benefit	Medigap Plan G	Medigap Plan N
Part A Hospital Coinsurance & Deductible	100% Covered ($0 Out-of-Pocket)	100% Covered ($0 Out-of-Pocket)
Part B Medical Coinsurance (20%)	100% Covered (Zero copays)	100% Covered EXCEPT up to $20 office copay / $50 ER
Part B Annual Deductible	Not Covered (Paid by beneficiary)	Not Covered (Paid by beneficiary)
Part B Excess Charges	100% Covered	Not Covered (Rare, <2% of US doctors)
Historical Annual Rate Inflation	Higher (5%–9%/yr due to heavy utilization)	Lower & Stable (2%–5%/yr due to copay deterrent)

Medicare Benefit

Medigap Plan G

Medigap Plan N

Part A Hospital Coinsurance & Deductible

100% Covered ($0 Out-of-Pocket)

Part B Medical Coinsurance (20%)

100% Covered (Zero copays)

100% Covered EXCEPT up to $20 office copay / $50 ER

Part B Annual Deductible

Not Covered (Paid by beneficiary)

Part B Excess Charges

100% Covered

Not Covered (Rare, <2% of US doctors)

Historical Annual Rate Inflation

Higher (5%–9%/yr due to heavy utilization)

Lower & Stable (2%–5%/yr due to copay deterrent)

The Actuarial Math: Why Plan N Often Beats Plan G Over Time

When seniors age into Medicare at 65, Plan G is frequently pitched as the default choice because it offers "zero copays" after the annual Part B deductible. However, financial planners and Medicare actuaries frequently favor Plan N for healthy to moderately active retirees.

1. The Rate Inflation Disparity

Because Plan G has zero cost-sharing, policyholders utilize medical services at higher rates. This causes insurance carriers to increase Plan G premiums by 6% to 10% annually. In contrast, the modest $20 copay on Plan N deters frivolous claims, keeping the Plan N risk pool healthier and annual rate increases significantly lower (2% to 4%).

2. The Truth About Part B Excess Charges

Insurance agents often use Part B excess charges as a scare tactic against Plan N. In reality, over 98% of doctors nationwide accept Medicare Assignment (agreeing to statutory fee rates). Furthermore, 8 states ban excess charges outright (MOM states: CT, MA, MN, NY, OH, PA, RI, VT). If you live in or travel primarily within these states, you have zero excess charge exposure.

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Frequently Asked Questions

Do telehealth doctor visits require a $20 copay on Plan N?

Generally no. Telehealth visits, annual Medicare wellness visits, and preventive screenings (mammograms, colonoscopies) have a $0 copay on Plan N.

Are my Medicare quote inputs or health estimates saved?

Never. All calculations execute 100% locally in your device's browser memory (RAM).

Medigap Plan G vs. Plan N Breakeven Simulator

Detailed Medigap Plan G vs. Plan N Coverage Matrix