Susan Park
You’re standing in the pharmacy checkout line, prescription in hand, and you suddenly wonder whether you picked the right Medicare supplement plan. Your neighbor swears by her Plan G. Your brother-in-law says Plan N saves him a bundle every month. And you have absolutely no idea who’s right for your situation. That confusion is completely normal, and it’s exactly why Plan N deserves a close, honest look.
What Medicare Supplement Plan N Actually Is
Medicare supplement insurance, also called Medigap, is private insurance that wraps around your Original Medicare (Parts A and B) to cover costs that Medicare leaves on your plate. Think of Original Medicare as a generous but imperfect umbrella. It covers a lot, but it still leaves gaps like copays, coinsurance, and the Part B deductible. A Medigap plan fills those gaps, either fully or partially depending on which plan letter you choose.
Plan N is one of ten standardized Medigap plans available in most states. Standardized means that a Plan N sold by Aetna covers the exact same benefits as a Plan N sold by Mutual of Omaha. The only real differences between carriers are the monthly premium and their customer service reputation. That’s genuinely helpful when you’re shopping.
So what does Plan N cover? Here’s the core package:
- Medicare Part A coinsurance and hospital costs for up to 365 days after Medicare benefits are exhausted. This matters if you ever face a long hospital stay.
- Medicare Part B coinsurance, except for a copay of up to $20 for office visits and up to $50 for emergency room visits that don’t result in inpatient admission.
- Part A hospice care coinsurance or copayment
- Skilled nursing facility coinsurance for days 21 through 100 of a stay
- The Part A deductible (what you pay when admitted to the hospital)
- Foreign travel emergency care (at 80%, after a small deductible)
- The first three pints of blood
What Plan N doesn’t cover is just as important. It does not pay the Part B deductible, which in 2024 is $240 per year. It does not cover Part B excess charges. And it does not cover prescription drugs. You’ll need a separate Part D plan for medications.
How Plan N Compares to Plans G and F
| Feature | Plan G | Plan N |
|---|---|---|
| Part A deductible | Covered | Covered |
| Part B deductible | NOT covered | NOT covered |
| Part B coinsurance | Covered 100% | Copay up to $20 (office) / $50 (ER) |
| Part B excess charges | Covered | NOT covered |
| Skilled nursing facility | Covered | Covered |
| Foreign travel emergency | 80% (after deductible) | 80% (after deductible) |
| Typical monthly premium | Higher | Lower |
This is the comparison question I hear most often, and for good reason. Plans F, G, and N are the three most popular Medigap options, and understanding the differences makes choosing much easier.
Plan F is the most comprehensive coverage available, but it’s only open to people who became eligible for Medicare before January 1, 2020. If you’re newly eligible, you can skip Plan F entirely.
That leaves most people choosing between Plan G and Plan N.
| Feature | Plan G | Plan N |
|---|---|---|
| Part A deductible | Covered | Covered |
| Part B deductible | NOT covered | NOT covered |
| Part B coinsurance | Covered 100% | Copay up to $20 (office) / $50 (ER) |
| Part B excess charges | Covered | NOT covered |
| Skilled nursing facility | Covered | Covered |
| Foreign travel emergency | 80% (after deductible) | 80% (after deductible) |
| Typical monthly premium | Higher | Lower |
The key trade-off is straightforward. Plan G costs more per month but pays your doctor’s office visits and emergency room copays in full, and it covers excess charges. Plan N costs less per month but asks you to pay small copays at the doctor’s office and leaves you responsible if a provider bills above Medicare’s approved amount.
Plan N tends to work well for people who are relatively healthy, don’t visit specialists frequently, and want to keep their monthly premium lower while still having solid hospital and skilled nursing coverage. Plan G tends to suit people who see multiple doctors regularly and prefer the predictability of mostly fixed out-of-pocket costs.
Neither plan is objectively better. The right answer depends on your health, your doctor relationships, and your financial situation.
The Part B Excess Charge Question
Best Medicare Supplement Plans - What’s Changed for 2026 · Medicare Specialist - Abt Insurance Agency on YouTube
This deserves its own section because it confuses a lot of people, and it can matter quite a bit financially.
When a doctor accepts Medicare’s approved payment amount as full payment, they’re called a “participating provider.” Most doctors in the United States are participating providers. But some doctors are “non-participating” or “opt-out” providers, and those doctors can legally charge up to 15% more than Medicare’s approved amount. That extra 15% is called a Part B excess charge.
Plan G covers those excess charges. Plan N does not.
Here’s the practical question to ask yourself: do your current doctors and specialists accept Medicare as full payment? If you’re not sure, check Medicare.gov’s physician finder tool, or simply call your doctor’s billing office and ask directly. If everyone you see is a participating provider, the excess charge gap between Plan G and Plan N may never affect you.
I’ve seen clients avoid Plan G entirely because they confirmed that every provider they use accepts assignment, as it’s called in Medicare language. If that’s your situation, you’re likely paying for a benefit in Plan G that you’ll never use.
What Plan N Typically Costs and Who Sells It
Premium ranges vary significantly by age, gender, tobacco use, location, and the pricing method the insurance company uses. I can’t give you a “typical” monthly cost that will be accurate for your situation. What I can tell you is that Plan N premiums are consistently and meaningfully lower than Plan G premiums from the same carrier, often by $20 to $60 per month.
That savings adds up. Over a full year, even $30 per month in premium savings is $360 back in your pocket. Whether that offsets any copays you pay under Plan N depends entirely on how often you go to the doctor.
Most major Medigap carriers offer Plan N, including Aetna, Cigna, Mutual of Omaha, UnitedHealthcare, and many regional carriers. The AARP Medicare resource center has comparison tools and guides that can help you see what’s available in your area. Don’t assume the biggest name automatically means the best deal. Sometimes a smaller regional carrier offers identical coverage at a noticeably lower premium.
Medigap plans are priced in three ways. Community-rated plans charge everyone the same premium regardless of age. Issue-age-rated plans base your premium on how old you are when you first buy the policy, and it doesn’t increase just because you get older. Attained-age-rated plans start lower but increase as you age. Understanding which method a carrier uses before you buy can save you real money over the long run.
How to Apply for Plan N: A Step-by-Step Approach
Buying a Medigap plan doesn’t have to be complicated, but it does require some timing awareness.
Step 1: Confirm your Medicare enrollment. You need to be enrolled in both Medicare Part A and Part B before a Medigap plan takes effect. If you’re still on an employer plan, sort out your Part B enrollment timing first, because late enrollment in Part B can create coverage gaps.
Step 2: Identify your Open Enrollment Period (OEP). Your Medigap OEP is a six-month window that starts the month you turn 65 and are enrolled in Part B. During this window, insurers cannot deny you coverage or charge you more due to pre-existing health conditions. This is the best time to buy any Medigap plan, including Plan N. Outside this window, insurers in most states can use medical underwriting, meaning they can turn you down or charge higher premiums.
Step 3: Get quotes from multiple carriers. Use your state’s Medigap comparison resources or contact a licensed insurance broker who works with multiple carriers. You want at least three to five quotes for identical Plan N coverage.
Step 4: Verify your doctors. Before you commit, call your primary care doctor, any specialists you see regularly, and your preferred hospital. Confirm they accept Medicare assignment. This directly impacts whether Plan N’s lack of excess charge coverage matters to you.
Step 5: Review the carrier’s financial stability. Look for a carrier with an A.M. Best financial strength rating of A or better. You want a company that will be paying claims reliably for decades.
Step 6: Reach out to your local SHIP counselor. The State Health Insurance Assistance Program (SHIP) offers free, unbiased counseling from trained volunteers in every state. A SHIP counselor can review your specific quotes and situation without trying to sell you anything. This step alone has saved clients from costly mistakes.
Step 7: Submit your application. Once you’ve chosen a carrier, the application is usually straightforward. You’ll provide your Medicare information, confirm your Part B effective date, and set up premium payment. Coverage typically begins the first of a month.
This article is for informational purposes only. Medicare rules change annually. Always verify current plan details at Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227). This site does not sell insurance or recommend specific plans.
Question?
Sources
- AARP Medicare resource center
- State Health Insurance Assistance Program (SHIP)
- Withings Body+ Smart Scale with BMI and Body Composition
- Medicare and You 2024 Official Handbook (Amazon)
- Life Alert Style Medical Alert Button for Seniors
Submit your question via email or chat.
Recommended Resources
Disclosure: As an Amazon Associate, we earn a small commission from qualifying purchases at no extra cost to you. We only recommend products that genuinely support the topics covered in this article.
- Medicare For Dummies (~$22), The definitive consumer guide to Medicare, enrollment windows, Part A/B/C/D, and supplement plans.
- Get What’s Yours for Medicare (~$17), Maximize your Medicare benefits and minimize out-of-pocket costs. Covers Part D drug coverage gaps and Medigap in depth.
