Medicare Plan N: How It Differs From Plan G & Who Should Choose It

The second most popular Medigap supplement among new Medicare beneficiaries (after Plan G) is Medicare Plan N. It has almost the same gaps in Original Medicare, but at a lower monthly premium, with 2 trade-offs: small copays at the time of service (20 office visits, 50 ER visits) and no coverage of Part B excess charge. Typical 2026 premiums run $100 to $200 per month at age 65.

This guide provides the answer to such questions as what plan n medicare covers, how Plan N cost compares to plan G, who should choose the plan n and when the lower premium really saves money. The sources of information are Medicare.gov, CMS, NAIC, and KFF. 

What is Medicare Plan N?

Medicare Plan N (also called Medicare supplement Plan N or Medigap Plan N) is a federally standardized Medigap supplement insurance plan offered by private insurers. It is similar to other Medigap plans in that it works with Original Medicare to cover any deductibles, coinsurances, and copays that are not paid by Original Medicare.

Plan N coverage is predetermined by federal law. Plan N by one insurance company will have the same items covered as Plan N by another insurance company. The premium and customer service are the only differences between insurers offering the same plan letter. That is why it is the correct strategy to shop at the lowest cost of the Medicare Plan N. There is no difference in coverage between insurers.

Plan N has been popularized by Plan F closing to new enrollees in 2020, since it includes a meaningful premium discount compared to Plan G without most major coverage. KFF Medigap research indicates that Plan G and Plan N, collectively, represent most new Medigap enrollments. 

Plan N coverage: what's included and what isn't

Plan N coverage covers nearly every gap in Original Medicare, with two specific exclusions worth understanding before enrolling.

What Plan N covers:

• Part A hospital coinsurance plus 365 additional hospital days after Medicare benefits end

• Part A deductible ($1,684 per benefit period in 2026)

• Part B coinsurance (the 20% you'd otherwise owe after the Part B deductible), with the copay exceptions noted below

• First three pints of blood for transfusions

• Hospice care coinsurance

• Skilled nursing facility care coinsurance (days 21 through 100)

• Foreign travel emergency care (80%, lifetime maximum of $50,000)

What Plan N does not cover:

• The $257 annual Part B deductible (you pay this yourself)

• Part B excess charges (when providers charge above Medicare's approved amount)

• Office visit copays (up to $20 each)

• ER visit copays for visits not resulting in admission (up to $50 each)

• Prescription drugs (you need a separate Part D plan)

• Dental, vision, hearing care

• Long-term custodial care

The two Plan-N-specific copays are small but worth budgeting for. Most beneficiaries on Plan N pay $20 for each office visit and $50 for ER visits not resulting in admission. Heavy users of healthcare can hit these copays often enough that the premium savings vs Plan G evaporate.

Medicare Plan N cost in 2026

Medicare Plan N cost varies significantly by state, age, gender, tobacco use, and insurer. Typical 2026 monthly premiums for a non-smoker at age 65 range from $100 to $200, with regional variation:

The premium difference between Plan N and Plan G in the same state is typically $30 to $80 per month. That amounts to a savings of between 360 to 960 of annual premium savings, not including the Plan-N-specific copays.

Pricing methods (community-rated, issue-age-rated, attained-age-rated) work the same for Plan N as for Plan G. Majority of the insurance companies apply attained-age-rated insurance where the premiums rise with age besides with inflation. Shop around with more than one insurance company and verify the track record of increasing the rates before signing. 

Plan N vs Plan G: when does Plan N save money?

Plan N vs Plan G is the most useful comparison before enrolling. Plan G has higher premiums but no copays. Plan N has lower premiums plus copays. The right choice depends on how often you visit the doctor.

Here's the math for a sample beneficiary saving $50 per month with Plan N (a typical premium difference):

Another less-discussed distinction is that Plan G will cover part B excess charges, whereas plan N will not. Excess charges occur when a provider does not accept Medicare-approved amount as full payment and charges an excess of 15 percent more. This is very unlikely, but possible. To the majority of individuals, the fact that Plan N does not cover excess-charges is not a practical concern. Those who regularly visit providers who charge higher than the approved amounts by Medicare (more prevalent in certain specialty practices) should use Plan G instead. 

Best Medicare Plan N providers and how to shop

The best Medicare Plan N for you is the one with the lowest premium and stable rate history in your state. Plan N coverage is federally standardized, so all insurers offer identical benefits.

How to shop:

• Get quotes from at least 3 to 5 insurers in your state through a licensed Medicare broker

• Check rate-increase history for each insurer (some raise premiums faster than others)

• Look at the company's financial rating from AM Best (A or higher preferred)

• Verify the pricing method (community, issue-age, or attained-age)

• Re-shop every 1 to 2 years because Medigap premiums can rise faster than inflation in certain states

Brokers compare quotes free of charge, paid by the insurer. They don't charge you, and the premium you see through a broker is the same as going direct.

When to enroll in Plan N

The Medigap enrollment rule that is most important is equally applied to Plan N: the enrolled person has a 6-month Medigap Open Enrollment Period which guarantees acceptance. The month you turn 65 and enroll in Part B, the insurers must offer you any Medigap plan they offer during that month, at the best rate they can offer.

In most states, outside the window, insurers are permitted to underwrite (check your medical history) and either refuse to cover you or charge higher premiums based upon the pre-existing conditions. In a handful of states (Connecticut, Maine, Massachusetts, New York) year-round guaranteed issue without underwriting is required. Several other states have annual "birthday rules" or "anniversary rules" permitting specific switches in Medigap, without underwriting.

If you have Medicare Advantage and want to switch to Original Medicare with a Medigap plan, you have a one-time "trial right" within the first 12 months of your initial Medicare Advantage enrollment to switch back without underwriting.