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Medicare supplements, plain EnglishMedigap Plan G vs Plan N: Which One Is Better for You? Pros, Cons, and the New York Twist

By Dick Tracy · Published August 29, 2026

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Medigap Plan G vs Plan N comes down to two differences. Plan N asks you to pay a copay of up to $20 at the doctor's office and up to $50 at the emergency room (waived if they admit you), and it does not cover Part B excess charges, the extra a doctor who does not take Medicare assignment can bill. Plan G covers all of that in full. Everything else, the hospital deductible, the coinsurance, skilled nursing, hospice, blood, foreign travel emergencies, is identical. In exchange for those two gaps, Plan N charges a lower monthly premium. So the question is really: do you want to prepay for zero bills, or keep the difference and pay small copays when you go in? I educate, you decide.

I'm Dick Tracy, an independent health insurance broker in Buffalo, licensed in 25 states with 80+ carriers. On the Medicare side of the desk I write Medicare supplements, the letter plans, and only those. I do not sell Medicare Advantage. Not because Advantage is evil, but because a supplement is the product where I can promise you that the doctor you want is the doctor you get, and where the math is simple enough that I can show it to you on one page. This is that page.

Enrollment share and state rules: KFF, Medigap Enrollment and Consumer Protections Vary Across States. Benefit chart: Medicare.gov, Compare Medigap plan benefits.

Plan G vs Plan N side by side

Medigap plans are standardized by federal law. A Plan G from one carrier pays exactly what a Plan G from another carrier pays; only the premium and the customer service differ. That is what makes this comparison clean. Here is the whole chart, and you will notice the two plans agree on almost everything.

That is the entire difference. Not the network (there is none; any doctor who takes Medicare takes either plan). Not prior authorizations (there are none). Not the drug plan (you buy a Part D plan separately with both). Two lines on a chart.

What those two differences cost you in real life

The copays. Up to $20 per office visit. "Up to" matters: the copay is the smaller of $20 or the 20% coinsurance Medicare would have left, so on a cheap visit it can be less. If you see a doctor once a month, that is roughly $240 a year on the high side. If you see one four times a year, $80. Write your own number down, because the whole decision hangs on it. The ER copay is up to $50 and disappears entirely if the ER visit turns into an admission, which is exactly when you would least want a bill.

The excess charges. This one gets oversold by people who want to scare you into Plan G. A doctor who does not "accept assignment" can bill up to 15% more than Medicare's approved amount, and Plan N leaves that to you. The vast majority of doctors accept assignment. And here in New York, state law caps what a non-participating doctor can charge a Medicare patient above the approved amount at 5%, so the exposure is small to begin with. Where it becomes real again is if you winter in a state that allows the full 15% and you see specialists there. That is a legitimate reason to lean Plan G. "A doctor somewhere might not take assignment" is not.

The math: take the premium difference and divide by $20

Here is how I run it with people at the kitchen table. I do not quote premiums on this page because they change every year and vary by carrier and zip code, but the method does not change. Take the Plan G premium and the Plan N premium from the same carrier. Subtract. Multiply by 12. That is what Plan N hands you back every year for accepting the copays. Now divide by $20. That is how many office visits it would take before Plan N stopped being the better deal. For most of the healthy retirees I sit with, the number of visits comes out somewhere north of what they actually use, and Plan N wins by a comfortable margin. For someone managing a chronic condition with a specialist every few weeks, plus physical therapy, Plan G wins. Either way the math maths. It just needs your visit count, not a stranger's.

One more thing about premiums that nobody says out loud: in most states the gap between G and N tends to widen as you age, because carriers price Plan N to the healthier crowd it attracts. New York is different, and that is the next section.

The New York twist: community rating and year-round enrollment

New York is one of a handful of states where Medigap works differently from the federal default, and it changes this decision.

Why that matters here: in most states, choosing Plan N at 65 is a bet that your health will hold, because upgrading to Plan G later can mean health questions and a possible decline. In New York that bet has no downside. Start on Plan N while you are healthy and keep the premium difference; if your visit count climbs, switch to Plan G that month. That flexibility is the single biggest reason I see more New Yorkers land on Plan N than my clients in states without year-round protection. The same year-round guarantee is why the "you must decide now or you're locked out forever" pitch some agents use does not apply in New York. Hear me now, believe me later: nobody in this state has to buy a supplement out of fear.

Which one is for me?

Two things both plans make you handle

First, the annual Part B deductible. Neither G nor N covers it (for anyone who became eligible for Medicare in 2020 or later, no plan can). It resets every January and it is modest; budget for it and move on. Second, prescriptions. Medigap covers none of them. You pair either plan with a standalone Part D drug plan, and that choice is worth more of your attention than most people give it, because the drug plan is where the real year-to-year cost swings live. I look at both with you.

Common questions about Plan G vs Plan N