Plan G vs. Plan N: Which Costs Less in 2026–2027?
Bottom Line
Standard Plan N costs less when premium savings exceed visit copays and uncovered excess charges; G costs less when those bills exceed savings. Check switching rights before choosing N, because upgrading after health changes isn't guaranteed.
Plan N costs less over a full year when its premium savings exceed the visit copays and Part B excess charges you owe. Plan G can cost less when those additional bills outweigh its higher premium. Neither is cheaper for everyone: compare matched premiums, expected care and a busier-than-expected year.
If you are also reviewing life insurance for your family or estate, comparing guaranteed universal life rates is a separate coverage and budgeting decision. Life insurance is not a Medicare benefit or an enrollment requirement.
What changes between Plan G and Plan N?
As you explore Medicare Supplement plan options, remember that Medicare Supplement and Medigap mean the same product. Plan G and Plan N supplement Original Medicare Part A and Part B; they cannot pay Medicare Advantage cost sharing.
This comparison uses standard Plan G and Plan N, excluding high-deductible Plan G and Medicare SELECT. Massachusetts, Minnesota and Wisconsin standardize Medigap differently.
Understanding what Medicare Plan N covers starts with the costs you keep:
| Cost for Medicare-covered care | Standard Plan G | Plan N |
|---|---|---|
| Annual Part B deductible | You pay | You pay |
| Part B office-visit cost sharing after the deductible | Covered | Up to $20 for some office visits |
| Emergency-room cost sharing after the deductible | Covered | Up to $50 when the visit does not result in inpatient admission |
| Part B excess charges | Covered | You pay, when applicable |
| Part A deductible and hospital coinsurance | Covered | Covered |
These are standardized benefit differences. The office copay does not apply to every appointment or every Part B service.
A large hospital bill alone does not make Plan G the cheaper choice. Both plans cover the Part A deductible and hospital coinsurance, plus Medicare-covered skilled nursing facility coinsurance. Your particular mix of copays and excess charges matters more than the total billed amount.
Start with matched premiums
When budgeting for a Medicare Supplement policy, keep the applicant and quote assumptions consistent: age, ZIP code, tobacco status where applicable, effective date, underwriting category, payment method and discount eligibility. Premiums vary by insurer and location; the pricing method also affects future costs.
Request both letters from each insurer. Then compare Plan G with Plan G and Plan N with Plan N across companies. A small premium gap at one insurer can be a large gap at another. If G’s quoted premium is no higher than N’s on matched terms, G has the cost advantage for the benefits compared here.
Ask whether discounts expire, how premiums change with age, and whether an increase is already scheduled. Rate history can inform your decision, but it does not establish next year’s price.
A matched Maryland example
For a concrete look at what Plan G costs in Maryland, CareFirst’s Baltimore-area brochure lists these monthly rates effective January 1, 2026: $233.86 for Plan G and $175.62 for Plan N. Both use the same profile: a 65-year-old woman in the Level 1 category, before household or payment discounts. For this example, assume she applies during her Medigap open enrollment period; the brochure says health and tobacco questions do not determine that category’s rate during this window.
These are matched published rates, not personalized quotes. They illustrate local pricing; the standardized plan benefits do not become different Maryland benefits. Confirm the rate for your own application date.
Holding those premiums constant for 12 months gives Plan G premiums of $2,806.32 and Plan N premiums of $2,107.44—a $698.88 annual difference.
Five full-year cost scenarios
The following calculations are hypothetical care scenarios using that published rate pair, not predictions of anyone’s claims.
Totals include 12 Medigap premiums, the standard 2026 Part B premium of $202.90 per month, and the medical cost sharing shown. They assume premium-free Part A and no premium penalties or income-related adjustments. The 2026 Part B deductible is $283. Prescription costs and excluded services are addressed separately below.
Except for the no-claims row, assume the full deductible has been paid and the listed visits occur afterward. Each listed office visit generates the maximum $20 Plan N copay; each ER visit generates $50 and does not lead to inpatient admission. Assume no excess charges except in the final row.
| Hypothetical care during the year | Plan G annual total | Plan N annual total | Lower cost |
|---|---|---|---|
| No medical claims | $5,241.12 | $4,542.24 | Plan N by $698.88 |
| 4 copay-eligible office visits | $5,524.12 | $4,905.24 | Plan N by $618.88 |
| 18 office visits and 1 ER visit | $5,524.12 | $5,235.24 | Plan N by $288.88 |
| 36 office visits and 1 ER visit | $5,524.12 | $5,595.24 | Plan G by $71.12 |
| 12 office visits and $500 in allowable Part B excess charges | $5,524.12 | $5,565.24 | Plan G by $41.12 |
The $500 excess-charge amount is an illustrative assumption, not an estimate of a typical bill. These totals are not annual spending limits. They hold 2026 premiums constant and should not be treated as 2027 estimates.
Calculate your break-even point
Use this test with your own matched quotes:
Annual Plan N premium savings − Plan N office copays − Plan N ER copays − Part B excess charges = Plan N’s net savings.
A positive result favors Plan N on cost; a negative result favors Plan G. Shared costs, including the same Part B premium and deductible, cancel out.
In this example, with no ER copays or excess charges, 35 office copays of $20 total $700—just above the $698.88 premium difference. If your actual copays are smaller, it takes more visits to reach that point. If your quoted premium gap is smaller, Plan G becomes competitive sooner.
Check your providers before assuming zero excess charges
Accepting Medicare assignment means accepting Medicare’s approved amount as full payment for a covered service, apart from the applicable deductible and coinsurance. A nonparticipating provider may charge more; in many cases the limit is 15% above the approved amount for nonparticipating providers.
Ask each doctor’s billing office whether the provider accepts assignment for your planned services. Check specialists and providers you use while traveling, too.
Plan G’s excess-charge benefit does not turn an opted-out doctor’s private contract into ordinary Medicare-covered care. Medicare generally does not pay opted-out providers, with limited emergency exceptions.
Add prescription coverage and other expenses
Arrange prescription coverage alongside Plan G or Plan N as a separate decision. Neither includes Part D coverage; with Original Medicare, you can buy a standalone Part D plan.
Enter your medications and pharmacies in Medicare’s comparison tool and compare annual premiums plus estimated prescription spending. Holding the same drug plan constant keeps the G-versus-N comparison meaningful.
Going 63 consecutive days without Part D or other creditable drug coverage after your initial enrollment period can trigger a late enrollment penalty. Check your enrollment timing even if you take few prescriptions.
Budget separately for services Medigap generally excludes, such as routine dental and vision care, hearing aids and long-term custodial care. Neither plan’s medical-cost calculation is your entire household health budget.
Check switching rights before choosing the lower premium
Your federal Medigap open enrollment lasts six months, starting the first month you are at least 65 and enrolled in Part B. Outside that window, without an applicable guaranteed-issue right or state protection, insurers may use medical underwriting, charge more or decline an application. Confirm which plan letters your protection allows. Under-65 purchase rights depend on state law.
The October 15–December 7 Medicare enrollment period permits Medicare Advantage and Part D changes. It does not generally guarantee access to Medigap without underwriting. Do not choose Plan N assuming you can freely upgrade to Plan G after your health changes.
Maryland provides an additional window for existing Maryland-issued Medigap policies: the birthday and following 30 days, for equal or lesser benefits without underwriting. Its chart allows standard Plan G to Plan N, but not Plan N to Plan G under this protection.
Choose a premium and a risk level you can sustain
Plan N deserves consideration when its savings remain meaningful after a realistic care scenario and you can reserve money for variable bills. Plan G deserves consideration when the premium gap is small or you value avoiding the specified copays and excess-charge exposure.
To compare personalized Medigap quotes, prepare your applicant details, desired start date, current coverage, provider assignment answers and expected visit count. Obtain written Plan G and Plan N prices using identical assumptions, then run both an ordinary year and a heavier-use year through the calculation. Choose the coverage whose premium and potential bills fit your budget—and whose enrollment terms you can actually meet.