Medigap Plan G vs. Plan N in 2026: Costs, Coverage & Enrollment Rules

 

Original Medicare helps pay for hospital and medical care, but it does not pay every deductible, coinsurance amount, or copayment. A Medicare Supplement Insurance policy, commonly called Medigap, can help pay some of those remaining costs.

Medigap is private insurance that works with Original Medicare Part A and Part B. It is not Medicare Advantage, and it does not replace your Part B premium, prescription drug coverage, or routine dental and vision care.

For the broader choice between Original Medicare and Medicare Advantage, see Original Medicare vs. Medicare Advantage in 2026.

Key Point

Plan G and Plan N are standardized Medigap options in most states. Their core benefits are set by law, but premiums can vary widely by insurer, location, age, pricing method, discounts, and enrollment timing.

1. What Is Medigap?

Medigap is extra insurance sold by private companies to help with certain out-of-pocket costs under Original Medicare. Medicare pays its share of a covered service first, and the Medigap policy can then pay some or all of the remaining eligible cost-sharing.

Generally, you need both Medicare Part A and Part B to buy a Medigap policy. You continue paying your monthly Medicare Part B premium and also pay a separate monthly premium to the Medigap insurance company.

As long as you pay your premiums, a Medigap policy is generally guaranteed renewable. This means the insurer cannot cancel your coverage simply because of health conditions or high medical costs.

In most states, plans with the same letter provide the same standardized basic benefits. For example, Plan G from one insurer has the same basic covered benefits as Plan G from another insurer in the same state. Massachusetts, Minnesota, and Wisconsin standardize Medigap policies differently.

2. Plan G vs. Plan N at a Glance

Coverage Feature	Medigap Plan G	Medigap Plan N
Part A hospital coinsurance and extra hospital days	Covered.	Covered.
Part A deductible	Covered.	Covered.
Skilled nursing facility coinsurance	Covered.	Covered.
Part B annual deductible	Not covered.	Not covered.
Part B coinsurance or copayments	Generally covered after the Part B deductible.	Covered, except for certain office-visit and emergency-room copayments.
Part B excess charges	Covered.	Not covered.
Foreign travel emergency coverage	80% of eligible emergency costs, subject to policy limits.	80% of eligible emergency costs, subject to policy limits.
Prescription drugs, routine dental, vision, and hearing	Not included.	Not included.

2026 note: The Medicare Part B annual deductible is $283. After that deductible is met, Plan G generally covers the remaining Medicare-approved Part B cost-sharing. Plan N may charge up to $20 for certain office visits and up to $50 for certain emergency-room visits that do not result in an inpatient admission.

3. Understanding Plan G

Plan G is often chosen by people who prefer to reduce unpredictable Medicare-approved medical cost-sharing after meeting the annual Part B deductible.

Plan G covers Part A deductibles and coinsurance, skilled nursing facility coinsurance, hospice coinsurance or copayments, Part B coinsurance, and Part B excess charges. It does not cover the Part B deductible for people newly eligible for Medicare on or after January 1, 2020.

Part B excess charges can arise when a non-participating provider does not accept Medicare assignment and is permitted to bill above the Medicare-approved amount. In many cases, the limiting charge cannot exceed 15% above the Medicare-approved amount. Plan G covers these eligible excess charges; Plan N does not.

Plan G May Appeal to People Who:

• Want fewer routine copays for Medicare-covered Part B services after meeting the Part B deductible.
• Want coverage for eligible Part B excess charges.
• Prefer more predictable cost-sharing for Medicare-approved care.
• Are comfortable paying a potentially higher monthly Medigap premium.

4. Understanding Plan N

Plan N has many of the same major benefits as Plan G, including Part A deductible coverage, hospital coinsurance, skilled nursing facility coinsurance, and foreign travel emergency coverage within policy limits.

In exchange for a potentially lower premium, Plan N requires some cost-sharing. You may pay up to $20 for certain office visits and up to $50 for certain emergency-room visits that do not lead to an inpatient admission. Plan N also does not pay Part B excess charges.

Premium differences between Plan G and Plan N are not fixed nationwide. Compare actual premiums, household discounts, rating method, expected office visits, provider participation, and future premium history in your area before deciding.

Plan N May Appeal to People Who:

• Want broad Original Medicare provider access but may accept some copayments.
• Expect relatively few office and emergency-room visits.
• Use providers who accept Medicare assignment.
• Want to compare lower monthly premium options against possible out-of-pocket copays.

5. What Medigap Does Not Cover

Medigap supplements Original Medicare. It generally does not cover services that Original Medicare does not cover.

• Standalone Medicare Part D prescription drug coverage.
• Routine dental care, dentures, routine eye exams, eyeglasses, or hearing aids.
• Long-term custodial care, such as help with bathing, dressing, and other daily activities.
• Private-duty nursing.
• Medicare Advantage plan premiums, deductibles, copays, or coinsurance.

People with Medigap who want prescription drug coverage generally need a separate Medicare Part D plan. Consider Part D coverage even if you do not currently take prescriptions, because going without creditable drug coverage for 63 days or more can trigger a late-enrollment penalty.

6. The Critical 6-Month Medigap Enrollment Period

Your federal Medigap Open Enrollment Period lasts for six months. It begins the first month you are age 65 or older and enrolled in Medicare Part B.

During this one-time period, you can generally buy any Medigap policy sold in your state. Insurance companies cannot use medical underwriting to deny your application or charge you more because of pre-existing health conditions.

After your Medigap Open Enrollment Period ends, your choices may be more limited. Depending on your state and situation, an insurer may charge more, require medical underwriting, or decline your application unless you have a guaranteed issue right.

Important: Medicare’s Annual Enrollment Period, October 15 through December 7, lets you change Medicare Advantage or Part D coverage. It does not create a general federal right to buy Medigap without medical underwriting.

7. Guaranteed Issue Rights and Switching Plans

Guaranteed issue rights are special situations where insurance companies generally must sell you certain Medigap policies without medical underwriting. Examples can include losing qualifying employer coverage, moving out of a Medicare Advantage plan service area, or certain situations involving plan termination.

State laws can provide additional protections beyond federal rules. Before leaving Medicare Advantage or changing Medigap coverage, confirm your Medigap rights with your State Health Insurance Assistance Program or State Insurance Department.

You can switch Medigap policies, but do not cancel your current policy until you have been accepted for a new one and have decided to keep it. Medicare provides a 30-day “free look” period when you buy a new Medigap policy, though you may need to pay both premiums during that month.

8. High-Deductible Plan G

In some states, a high-deductible version of Plan G is available. It generally has a lower monthly premium but requires you to pay Medicare-covered deductibles, copayments, and coinsurance up to the annual deductible before the policy begins paying benefits.

For 2026, the high-deductible Plan G amount is $2,950. This option may suit people who want catastrophic-cost protection and are comfortable paying more out of pocket in a typical year. It should be compared with standard Plan G, Plan N, and other available coverage options.

9. How to Compare Medigap Policies

1. Confirm that you have Original Medicare Part A and Part B.
2. Check whether you are in your six-month Medigap Open Enrollment Period or have a guaranteed issue right.
3. Compare the same plan letter across multiple insurers, such as Plan G versus Plan G.
4. Ask how each insurer sets premiums and how rates have changed over time.
5. Review discounts, policy fees, customer service, complaint history, and any Medicare SELECT network requirements.
6. Check whether your doctors accept Medicare assignment if you are considering Plan N.
7. Add the total cost of Part B, Medigap, Part D, dental, vision, and expected medical services before comparing options.

10. Frequently Asked Questions

Can I have Medigap and Medicare Advantage at the same time?

No. Medigap works only with Original Medicare. It cannot be used to pay Medicare Advantage plan costs.

Does Plan G pay the 2026 Part B deductible?

No. For people newly eligible for Medicare on or after January 1, 2020, Medigap policies cannot cover the Part B deductible. The 2026 Part B deductible is $283.

Is Plan G always better than Plan N?

No. Plan G generally provides more complete Part B cost-sharing protection, including excess-charge coverage. Plan N may have a lower premium but includes certain copayments and does not cover Part B excess charges. The better fit depends on your providers, expected use of care, budget, and premium quotes in your location.

Can I buy Medigap after my first six months?

Possibly, but federal protections are more limited after the Medigap Open Enrollment Period. You may face medical underwriting, higher premiums, fewer choices, or denial unless you qualify for guaranteed issue rights or live in a state with additional consumer protections.

For related Medicare decisions, read Turning 65? Medicare Enrollment Deadlines and Late Penalties and Original Medicare vs. Medicare Advantage in 2026.

Sources and Further Reading

• Medicare.gov: What Is Medicare Supplement Insurance?
• Medicare.gov: Compare Medigap Plan Benefits
• Medicare.gov: Medigap Open Enrollment Rules
• Medicare.gov: Comparing Medigap Costs
• Medicare.gov: Changing a Medigap Policy
• CMS: 2026 Medicare Part B Premiums and Deductibles
• CMS: 2026 High-Deductible Plan G Amount

Last reviewed: July 2026

Educational disclaimer: This article is for general educational purposes only and is not insurance, legal, medical, tax, or financial advice. Medigap availability, premiums, insurer underwriting, guaranteed issue rights, and state protections vary by location and can change. Review current Medicare.gov information and speak with your State Health Insurance Assistance Program, State Insurance Department, or a licensed insurance professional before enrolling.