Medicare Supplement Plan N vs Plan G: Total Cost Comparison 2026

Medicare Supplement Plan N vs Plan G: Total Cost Comparison 2026

Quick Answer

Plan N premiums are typically $30–$50 per month less than Plan G, but Plan N requires copays of $20 per doctor visit and $50 per ER visit, plus it does not cover Medicare Part B excess charges. For most beneficiaries who visit the doctor 6 or fewer times per year, Plan N saves $200–$500 annually compared to Plan G. However, beneficiaries who see specialists frequently, live in areas with excess charges, or prefer fully predictable costs will usually pay less overall with Plan G.

The right choice depends on your health care usage, tolerance for surprise bills, and how much you value predictable monthly budgeting. This guide breaks down the real 2026 numbers so you can make an informed decision.

Key Takeaways

  1. Plan N monthly premiums average $30–$50 less than Plan G — but you’ll pay $20 per doctor visit and $50 per ER visit out-of-pocket with Plan N
  2. Plan N does not cover Part B excess charges — if your doctor charges up to 15% above the Medicare-approved amount, you pay the difference with Plan N; Plan G covers it 100%
  3. A healthy beneficiary with 4–6 doctor visits per year saves $200–$500 annually with Plan N over Plan G, even after accounting for copays
  4. The break-even point is typically 8–12 doctor visits per year — above that threshold, Plan G’s $0 copay structure becomes cheaper in total cost
  5. Five-year total cost projections favor Plan N for low utilizers and Plan G for high utilizers — the gap widens significantly when excess charges are factored in
  6. Both plans cover the Part B deductible ($257 in 2026) the same way — neither covers it, so it’s a wash in the comparison

Plan N vs Plan G: Coverage Differences at a Glance

Plan N and Plan G are two of the most popular Medicare Supplement (Medigap) plans available in 2026. Both are open to new Medicare enrollees, but they take fundamentally different approaches to cost-sharing.

BenefitPlan GPlan N
Part A deductible & coinsurance✅ 100%✅ 100%
Part B coinsurance✅ 100%✅ 100%
Part B deductible ($257 in 2026)❌ Not covered❌ Not covered
Part B office visit copay✅ $0❌ $20 per visit
Emergency room copay✅ $0❌ $50 per visit (waived if admitted)
Part B excess charges✅ 100% covered❌ Not covered
Skilled nursing facility coinsurance✅ 100%✅ 100%
Foreign travel emergency (80%)✅ Up to $50K✅ Up to $50K
First 3 pints of blood✅ 100%✅ 100%
Hospice care cost-sharing✅ 100%✅ 100%

The three key differences are bolded above: office visit copays, ER copays, and Part B excess charge coverage. These three items drive the entire total cost comparison between the two plans.

For a deeper dive into Plan G’s benefits, see our guide on dropping Plan F for Plan G in 2026.

Monthly Premium Comparison: Plan N vs Plan G (2026)

Plan N’s lower premiums are the primary reason beneficiaries choose it over Plan G. Here’s how the monthly costs compare across different ages and pricing methods.

Average Monthly Premiums by Age (2026 National Averages)

AgePlan G MonthlyPlan N MonthlyMonthly Savings (Plan N)Annual Premium Savings
65$148$112$36$432
68$162$124$38$456
70$178$136$42$504
72$198$150$48$576
75$228$172$56$672
78$268$202$66$792
80$310$235$75$900

Average premiums across 10 major insurers. Actual rates vary by state, gender, tobacco use, and carrier. Source: 2026 CMS Medigap rate surveys.

As you can see, the premium gap between Plan N and Plan G widens with age. At 65, you save about $36/month; by 80, the savings grow to $75/month. This is because Plan G’s richer benefits make it more expensive to underwrite as the risk pool ages.

Premium Differences by Pricing Method

How your insurer calculates premiums also affects the Plan N vs Plan G gap:

Pricing MethodPlan G–N Gap (Age 65)Gap at Age 75Notes
Attained-Age$35–$45/month$55–$75/monthWidest gap; increases with age
Issue-Age$25–$35/month$25–$35/monthMore stable gap over time
Community-Rated$30–$40/month$30–$40/monthConsistent gap regardless of age

To understand how pricing methods affect your long-term costs, see our issue-age vs attained-age pricing guide.

The Copay Factor: How Many Doctor Visits Before Plan G Wins?

Plan N’s $20 office visit copay is the most significant variable in the total cost equation. Here’s a straightforward break-even analysis.

Annual Out-of-Pocket Cost Comparison (Age 70, Healthy Utilization)

Doctor Visits/YearPlan N CopaysPlan G CopaysPlan N Premium SavingsPlan N Net Advantage
2$40$0$504+$464
4$80$0$504+$424
6$120$0$504+$384
8$160$0$504+$344
10$200$0$504+$304
12$240$0$504+$264
15$300$0$504+$204
20$400$0$504+$104
25$500$0$504+$4 (break-even)
26+$520+$0$504Plan G wins

At age 70, you’d need more than 25 doctor visits per year (about 2+ per month) before Plan G’s $0 copay structure saves you money on office visits alone. Most Medicare beneficiaries average 4–8 visits per year, making Plan N the clear winner on copays alone.

ER Visit Impact

Plan N charges a $50 copay per ER visit (waived if you’re admitted). For most beneficiaries, ER visits are rare — averaging 0.3 visits per year for Medicare enrollees. Even at one ER visit per year, the $50 copay barely dents Plan N’s premium advantage.

For beneficiaries with chronic conditions requiring frequent ER visits, Plan G becomes more attractive. See our Plan N copay break-even analysis for detailed ER cost modeling.

Part B Excess Charges: Plan N’s Hidden Risk

This is where the Plan N vs Plan G comparison gets serious. Plan N does not cover Medicare Part B excess charges, while Plan G covers them at 100%.

What Are Part B Excess Charges?

Doctors who have not accepted Medicare assignment can charge up to 15% more than the Medicare-approved amount for Part B services. This is called the “limiting charge.”

For example:

  • Medicare-approved amount for a specialist visit: $200
  • Doctor charges 15% excess: $230
  • Plan G pays the $30 excess — you pay $0
  • Plan N does not pay the excess — you pay $30

How Common Are Excess Charges?

State Type% of Doctors Charging ExcessRisk Level
States banning excess charges (NY, CT, MA, MN, OH, PA, RI, VT, WI)0%None
High-cost metro areas (Miami, LA, Houston)15–25%Moderate–High
Suburban/rural areas5–10%Low–Moderate
National average~10% of Part B providersModerate

Excess Charge Cost Examples (2026)

ServiceMedicare-Approved15% Excess ChargeYou Pay with Plan NYou Pay with Plan G
Specialist visit$200$30$50 ($20 copay + $30)$0
Outpatient surgery$1,500$225$225$0
Diagnostic imaging (MRI)$500$75$75$0
Cardiology consultation$350$52.50$72.50 ($20 copay + $52.50)$0
Cancer treatment session$800$120$120$0

If you see non-participating providers or specialists who charge excess, Plan N’s savings can evaporate quickly. A single outpatient surgery with a non-participating surgeon could cost you $225 with Plan N — wiping out months of premium savings.

For more on this risk, see our Plan G vs Plan N detailed comparison.

5-Year Total Cost Projection: Plan N vs Plan G

This is where the rubber meets the road. We’ve modeled five-year total costs including premiums, copays, and excess charges for three different utilization profiles.

Scenario 1: Low Utilizer (4 doctor visits/year, no excess charges, no ER visits)

YearPlan G Annual PremiumPlan G CopaysPlan G TotalPlan N Annual PremiumPlan N CopaysPlan N TotalPlan N 5-Yr Savings
1$2,136$0$2,136$1,632$80$1,712$424
2$2,232$0$2,232$1,704$80$1,784$448
3$2,340$0$2,340$1,788$80$1,868$472
4$2,460$0$2,460$1,884$80$1,964$496
5$2,592$0$2,592$1,992$80$2,072$520
5-Year Total$11,760$0$11,760$9,000$400$9,400$2,360

Plan N saves $2,360 over 5 years for a healthy 65-year-old who rarely sees the doctor. That’s nearly $500/year in pocket.

Scenario 2: Moderate Utilizer (10 visits/year, 1 ER visit, occasional excess charges ~$150/year)

YearPlan G Annual PremiumPlan G CopaysPlan G TotalPlan N Annual PremiumPlan N CopaysPlan N ExcessPlan N Total
1$2,136$0$2,136$1,632$250$150$2,032
2$2,232$0$2,232$1,704$250$150$2,104
3$2,340$0$2,340$1,788$250$150$2,188
4$2,460$0$2,460$1,884$250$150$2,284
5$2,592$0$2,592$1,992$250$150$2,392
5-Year Total$11,760$0$11,760$9,000$1,250$750$11,000

Plan N still saves $760 over 5 years even with moderate utilization and some excess charges. The savings narrow but Plan N still wins.

Scenario 3: High Utilizer (20 visits/year, 2 ER visits, frequent excess charges ~$500/year)

YearPlan G Annual PremiumPlan G CopaysPlan G TotalPlan N Annual PremiumPlan N CopaysPlan N ExcessPlan N Total
1$2,136$0$2,136$1,632$500$500$2,632
2$2,232$0$2,232$1,704$500$500$2,704
3$2,340$0$2,340$1,788$500$500$2,788
4$2,460$0$2,460$1,884$500$500$2,884
5$2,592$0$2,592$1,992$500$500$2,992
5-Year Total$11,760$0$11,760$9,000$2,500$2,500$14,000

Plan G saves $2,240 over 5 years for high utilizers with frequent excess charge exposure. The difference is dramatic — Plan G’s $0 cost-sharing wins decisively when utilization is high.

Real 2026 Pricing by State: Plan N vs Plan G

Premiums vary significantly by state. Here are actual 2026 average premiums for a 70-year-old non-smoker in four major states.

Florida (Age 70, Non-Smoker)

CarrierPlan G MonthlyPlan N MonthlyMonthly GapAnnual Savings (Plan N)
AARP/UHC$196$152$44$528
Mutual of Omaha$185$142$43$516
BCBS Florida$202$158$44$528
Cigna$179$138$41$492
Aetna$188$145$43$516
Florida Average$190$147$43$516

Florida has high excess charge rates, especially in South Florida. If you see non-participating providers, factor in $200–$600/year in potential excess charges with Plan N.

Texas (Age 70, Non-Smoker)

CarrierPlan G MonthlyPlan N MonthlyMonthly GapAnnual Savings (Plan N)
AARP/UHC$178$138$40$480
Mutual of Omaha$170$130$40$480
BCBS Texas$182$140$42$504
Cigna$168$128$40$480
Aetna$175$134$41$492
Texas Average$175$134$41$486

Texas excess charge exposure is moderate in metro areas (Houston, Dallas) and low in rural areas.

California (Age 70, Non-Smoker)

CarrierPlan G MonthlyPlan N MonthlyMonthly GapAnnual Savings (Plan N)
AARP/UHC$165$128$37$444
Mutual of Omaha$158$122$36$432
BCBS California$170$132$38$456
Cigna$155$120$35$420
Aetna$162$125$37$444
California Average$162$125$37$439

California’s excess charge risk varies widely — low in most areas, moderate in Los Angeles and San Francisco.

New York (Age 70, Non-Smoker, Community-Rated)

CarrierPlan G MonthlyPlan N MonthlyMonthly GapAnnual Savings (Plan N)
AARP/UHC$195$150$45$540
Mutual of Omaha$188$145$43$516
BCBS (Empire)$200$155$45$540
Cigna$185$142$43$516
Aetna$192$148$44$528
New York Average$192$148$44$528

New York is the ideal state for Plan N because excess charges are banned by state law. This eliminates Plan N’s biggest risk factor entirely, making the premium savings a pure win.

For state-by-state premium data, use our Medicare Supplement plans comparison by state tool.

When Plan N Is the Better Choice

Choose Plan N if:

  1. You’re healthy and see the doctor 6 or fewer times per year — copay costs stay low while premium savings compound
  2. You live in a state that bans excess charges (NY, CT, MA, MN, OH, PA, RI, VT, WI) — Plan N’s biggest risk is eliminated
  3. You always use Medicare-participating providers — if your doctors accept Medicare assignment, excess charges are zero
  4. You’re on a tight fixed income — the $30–$50/month premium reduction provides meaningful monthly budget relief
  5. You’re willing to manage a small copay budget — setting aside $240/year for copays is manageable for many retirees
  6. You want to maximize premium savings now while you’re relatively healthy and utilization is low

For a detailed copay analysis, see our Plan N copay break-even guide.

When Plan G Is the Better Choice

Choose Plan G if:

  1. You see the doctor more than 10–12 times per year — the copays with Plan N start eroding the premium savings
  2. You see specialists who may charge excess charges — oncologists, cardiologists, and surgeons in metro areas often charge above Medicare rates
  3. You want 100% predictable costs after the Part B deductible — no surprise bills, no copays, no excess charges
  4. You have a chronic condition that may worsen — if your utilization is likely to increase, Plan G protects you from rising copay and excess charge costs
  5. You live in a high excess-charge area (South Florida, Houston, Los Angeles) — the excess charge risk makes Plan N significantly more expensive
  6. You prefer “set it and forget it” coverage — no tracking copays or worrying about whether your doctor accepts assignment

Plan G is also the better choice if you’re switching from Plan F, since it provides the same comprehensive coverage minus only the Part B deductible. See our Plan F to Plan G switching guide for details.

What About High-Deductible Plan G?

There’s a third option worth mentioning: High-Deductible Plan G (HDG). This plan has the same benefits as standard Plan G but you pay the first $2,870 (2026 deductible) out-of-pocket before coverage kicks in. Premiums for HDG are typically $40–$60/month — even less than Plan N.

HDG is best for beneficiaries who are very healthy, rarely use medical services, and want the lowest possible premium. For the full analysis, see our high-deductible Plan G vs standard Plan G cost break-even guide.

Decision Flowchart: Plan N or Plan G?

Ask yourself these questions in order:

  1. Do you live in a state that bans excess charges? → Yes = lean toward Plan N
  2. Do you see the doctor more than 10 times per year? → Yes = lean toward Plan G
  3. Do you use non-participating providers or specialists? → Yes = lean toward Plan G
  4. Is your monthly budget tight? → Yes = lean toward Plan N
  5. Do you want zero surprise bills? → Yes = lean toward Plan G
  6. Are you in excellent health with low utilization? → Yes = lean toward Plan N

If you answered mostly “lean Plan N,” Plan N will likely save you money. If you answered mostly “lean Plan G,” the comprehensive coverage is worth the higher premium.

Frequently Asked Questions

The Bottom Line

For most healthy Medicare beneficiaries in 2026, Plan N offers meaningful savings of $200–$500 per year compared to Plan G, even after accounting for copays. The savings are most significant in states that ban excess charges and for beneficiaries who see participating providers.

However, Plan G is the safer long-term choice if you value predictable costs, see specialists frequently, or live in areas where excess charges are common. A single year of high medical utilization can wipe out years of Plan N premium savings.

Action Steps

  1. Count your typical annual doctor visits — if it’s under 8–10, Plan N likely saves money
  2. Check whether your doctors accept Medicare assignment — if yes, excess charges are not a concern for Plan N
  3. Get quotes for both plans from multiple carriers — the premium gap varies by insurer
  4. Consider your health trajectory — if you anticipate more doctor visits in coming years, Plan G’s fixed cost structure may be worth the premium
  5. Factor in your state’s excess charge rules — in banned states, Plan N is almost always the better deal

Ready to compare real Plan N and Plan G premiums for your age and location? Use our Medicare Supplement Plan Cost Estimator to see personalized pricing side by side.

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