Medigap Plan G or Plan N at 65: Why the Plan Letter Choice Could Cost a Retiree $36,000 Over a 20-Year Retirement

Once you turn 65, you’re generally eligible to enroll in Medicare. But eligibility is just the starting point.

While original Medicare provides valuable health coverage, it can leave you with steep out-of-pocket costs. Deductibles, copays, coinsurance, and other expenses can accumulate quickly, putting real strain on a fixed retirement budget. Original Medicare also imposes no annual cap on what you can spend out of pocket, which means a serious illness or a string of specialist visits could translate into thousands of dollars in unexpected bills.

That’s where Medigap comes in.

Also known as Medicare supplement insurance, Medigap policies are sold by private insurers and are designed to cover many of the costs that original Medicare leaves behind. Among the available plan letters, Plan G and Plan N are consistently the most popular choices for new enrollees who became eligible after January 1, 2020.

Plan G offers broader coverage than Plan N, while Plan N offers lower monthly premiums. Choosing wisely between the two can save you thousands of dollars over the course of retirement.

Plan G vs. Plan N: Understanding the similarities and differences

Medigap Plan G and Plan N share a strong foundation of core benefits. Both cover:

• Medicare Part A coinsurance
• The Part A hospital inpatient deductible
• Skilled nursing facility coinsurance
• Blood transfusions (the first three pints each year)
• Foreign travel emergency care, up to plan limits

One cost neither plan covers is the Part B deductible. For 2026, that deductible is $283, up $26 from $257 in 2025. It adjusts annually alongside Medicare’s actuarial rates, so enrollees should budget for it to rise over time.

Despite their similarities, Plan G and Plan N differ in two important ways.

First, Plan G covers Part B excess charges. These are additional amounts that certain providers are legally permitted to bill above Medicare-approved rates when they do not accept Medicare assignment. Plan N provides no protection against these charges. About 97% of providers do accept Medicare assignment, so excess charges are relatively uncommon, but they can be significant when they occur.

Second, Plan G covers your full Part B coinsurance once the annual deductible is met, meaning you owe nothing for Medicare-approved outpatient care beyond that one yearly amount. Plan N covers Part B coinsurance for most services but not all. With Plan N, you could face copays of up to $20 for certain office visits and up to $50 for emergency room visits where you are not admitted to the hospital.

How Plan N could cost you $36,000 more in your lifetime

Because Plan N covers less, its premiums run lower. Depending on your age, gender, and location, Plan N typically costs $20 to $80 less per month than a comparable Plan G policy. That spread can be meaningful, but the savings can evaporate if your actual healthcare usage is high.

If you visit the doctor frequently, make occasional emergency room trips, or happen to see providers who do not accept Medicare assignment, the copays and excess charges under Plan N can quickly erode the premium advantage. Over a 20-year retirement, those added out-of-pocket costs could total an additional $36,000 compared with the predictable, all-in cost of Plan G.

So how do you choose? The answer comes down to your health history and your tolerance for variable costs.

Frequent healthcare users, people managing chronic conditions, or anyone who values completely predictable bills will generally find Plan G the stronger fit. Enrollees who are in good health, see the doctor rarely, and are comfortable with modest copays may find Plan N saves them real money each year.

It is also worth knowing that a third option exists for new enrollees: High-Deductible Plan G. It carries the same broad coverage as standard Plan G but comes with a significantly lower monthly premium in exchange for a high deductible (set at $2,870 in 2026) that you must meet before the plan begins paying. For healthy enrollees who want a safety net against catastrophic costs, it can be worth a look alongside Plans G and N.

The once-popular Plan F, which covered the Part B deductible in addition to all the benefits Plan G provides today, was discontinued for anyone who became eligible for Medicare on or after January 1, 2020. For new enrollees, Plan G is the closest equivalent, and that heritage helps explain why it has become the dominant choice in the market.

Your best approach is to compare the full range of available Medigap options in your area, factor in your health history and expected usage, and weigh both premium costs and realistic out-of-pocket exposure before committing to a plan.

Editor’s note: This article was updated to reflect the 2026 Medicare Part B deductible of $283 (up from $257 in 2025) and the current standard Part B premium of $202.90 per month, and to expand the Plan G vs. Plan N monthly premium range to $20 to $80 based on current market data. A note on High-Deductible Plan G was also added, along with context on the prevalence of providers who accept Medicare assignment.

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