Medicare Plan G vs Plan N: The Math at 65, 70, and 75

Medicare Plan G and Plan N are the two most-shopped Medigap (Medicare Supplement) policies for new enrollees in 2025. Both fill the gaps Medicare leaves behind. They differ in two specific places — and those differences matter more than the premium gap suggests.

Here's how to pick.

What Plan G covers

Plan G covers essentially everything Medicare Part A and Part B don't, except the Part B deductible:

• Part A deductible (hospital): $1,632 in 2025
• Part A coinsurance for hospital stays beyond 60 days
• Part B coinsurance (typically 20% of Medicare-approved costs)
• Part B excess charges (when a provider charges above Medicare's approved amount)
• First three pints of blood
• Skilled nursing facility coinsurance
• Hospice care coinsurance
• Foreign travel emergency (up to plan limits)

Your annual out-of-pocket for medical in 2025 with Plan G: $257 (just the Part B deductible).

What Plan N covers

Plan N covers everything Plan G covers, with two carve-outs:

1. Office visit copay of up to $20 per visit (you pay this, plan doesn't)
2. ER visit copay of up to $50 per visit (waived if admitted)
3. Doesn't cover Part B excess charges

Your annual out-of-pocket with Plan N: $257 (Part B deductible) + $20 per office visit + $50 per ER visit + any Part B excess charges.

The premium gap in 2025

For a typical 65-year-old female non-tobacco-using applicant:

• Plan G: $148/month average ($1,776/year)
• Plan N: $104/month average ($1,248/year)
• Difference: $44/month, $528/year

For 65-year-old male: roughly $156/$112 ($528/year delta).

The Plan N savings are real — but you have to net out the copays and any excess charge exposure.

When Plan N's math beats Plan G

Plan N usually wins for:

• Healthy enrollees who see a doctor 4 or fewer times per year
• Markets where most providers accept Medicare assignment (no excess charges)
• Cost-sensitive shoppers who can absorb occasional copay surprises

Math example: 4 office visits/year ($80 copay) + 1 ER visit ($50 if not admitted) = $130 in copays. Net savings vs Plan G: $528 - $130 = $398/year.

When Plan G's math beats Plan N

Plan G usually wins for:

• Enrollees who see specialists frequently
• Markets with significant Part B excess charge exposure (notably parts of New York, New Jersey, and certain rural areas)
• Anyone who hates calculating "did I see the doctor enough times to justify the copay savings?"

Math example: 12 office visits + 2 specialist visits + a non-assigned specialist with 15% excess charge on a $2,500 procedure = $280 copays + $375 excess = $655. Plan N is now $127/year more expensive than Plan G. Plan G wins.

The Part B excess charge issue

Most Medicare providers accept assignment, meaning they bill Medicare's approved rate. Some don't, and can legally charge up to 15% above the approved rate. Plan G covers excess charges. Plan N doesn't.

In some states, providers are prohibited from charging excess (CT, MA, MN, NY, OH, PA, RI, VT). In those states, the excess charge gap on Plan N is irrelevant. In other states, it's a real exposure.

Before choosing Plan N, call your top 3 most-used providers and ask if they accept Medicare assignment. If they all do, Plan N's gap doesn't bite. If any don't, Plan G is structurally safer.

The switching trap

Outside of certain protected enrollment windows, switching from Plan N to Plan G later requires medical underwriting. Carriers can decline you for pre-existing conditions, charge higher rates, or refuse coverage entirely.

This means you should choose carefully at age 65, when you're in your guaranteed-issue window. The plan you start with is, for most readers, the plan you'll have for the rest of your life.

What we'd actually do

For most readers at 65:

1. Get quotes for both Plan G and Plan N from 3-4 carriers.
2. Calculate your expected utilization (office visits + specialist + ER).
3. If Plan N's net savings (premium savings minus expected copays) is over $300/year and your providers all accept Medicare assignment, take Plan N.
4. Otherwise, take Plan G.

For most healthy 65-year-olds in standard markets, Plan G is the cleaner choice. For cost-sensitive 65-year-olds in low-utilization patterns, Plan N's math works.

Either way: choose carefully. Re-shopping is harder than you think.