Medigap Plan G vs Plan N Calculator: Which Saves You More Money?

Medigap Plan G vs Plan N Calculator: Which Saves You More Money?

Plan G and Plan N are the two most popular Medigap options. This guide helps you calculate which one saves you more based on your healthcare usage.

Quick Answer

Choose Plan G if: You visit doctors frequently, want predictable costs, or are concerned about excess charges.

Choose Plan N if: You’re healthy, rarely see doctors, and want lower premiums.

Break-even point: If the premium difference exceeds your expected copays, Plan N wins. Otherwise, Plan G wins.

Use our Medicare Supplement Penalty Calculator to compare both plans for your situation.

Detailed Guidance

Plan G vs Plan N: Coverage Comparison

BenefitPlan GPlan N
Part A deductible & coinsurance✓✓
Part B coinsurance (20%)✓✓
Part B deductible✗ (you pay $240)✗ (you pay $240)
Part B excess charges✓✗
Skilled nursing coinsurance✓✓
Foreign travel emergency✓ (80%)✓ (80%)
Office visit copay$0$20
ER visit copay$0$50 (waived if admitted)
Out-of-pocket maximumNoneNone
Average Monthly Premium (65, non-tobacco)$145$105

Key Differences Explained

1. Excess Charges (Plan N’s Hidden Risk)

Part B excess charges occur when a doctor doesn’t accept Medicare assignment and charges up to 15% more than the Medicare-approved amount.

  • Plan G: Covers excess charges completely
  • Plan N: You pay the excess (up to 15% more)

Example: A $200 specialist visit with excess charges:

  • Medicare pays 80%: $160
  • Doctor bills 15% excess: $30
  • Plan G pays: $30 (you pay $0)
  • Plan N pays: $0 (you pay $30 extra)

2. Copays (Plan N’s Predictable Costs)

  • Plan N: $20 per office visit, $50 per ER visit (waived if admitted)
  • Plan G: $0 copays

3. Premium Difference

Plan N typically costs $30-50 less per month than Plan G.

Break-Even Calculator

To find your break-even point:

Annual Premium Savings (Plan N) = Monthly Savings × 12
Annual Copay Cost (Plan N) = Office Visits × $20 + ER Visits × $50
Excess Charge Risk = Potential Excess Charges

If Premium Savings > Copay Cost + Excess Risk, choose Plan N

Example: 12 doctor visits, 1 ER visit per year:

  • Plan G premium: $145/month = $1,740/year
  • Plan N premium: $105/month = $1,260/year
  • Annual premium savings: $480
  • Plan N copays: 12 × $20 + 1 × $50 = $290
  • Net savings with Plan N: $190

If you have 24 doctor visits:

  • Plan N copays: 24 × $20 = $480
  • Annual premium savings: $480
  • Break-even (no net difference)

With excess charges (2 visits × $30 each):

  • Additional Plan N cost: $60
  • Plan N net savings: $190 - $60 = $130

Who Should Choose Plan G?

  • Frequent doctor visitors (15+ per year)
  • Those who see specialists who may not accept assignment
  • People who want 100% predictable costs
  • Those who travel and may see out-of-network providers
  • Anyone concerned about excess charge risk

Who Should Choose Plan N?

  • Healthy individuals with few doctor visits
  • Those who primarily see Medicare-participating providers
  • Budget-conscious enrollees who can absorb copays
  • People who want lower premiums and can pay copays as needed

Plan Selection Checklist

  • Estimate your annual doctor visits
  • Estimate your annual ER visits
  • Calculate total Plan N copays
  • Check if your doctors accept Medicare assignment
  • Get quotes for both Plan G and Plan N in your area
  • Calculate annual premium for each
  • Factor in excess charge risk
  • Consider your health trajectory
  • Review Plan N Copay Break-Even analysis
  • Use our calculator for precise numbers

Frequently Asked Questions

Is Plan G worth the extra premium?

Plan G is worth it if you visit doctors more than 15-20 times per year, or if you’re concerned about excess charges. Calculate your break-even using our calculator.

Can excess charges really add up?

Yes. If you see a non-participating provider, you could pay up to 15% more. On a $10,000 procedure, that’s $1,500 out of pocket with Plan N.

Can I switch from Plan N to Plan G later?

You can apply, but outside Medigap Open Enrollment, you’ll face medical underwriting and may be denied. Some states have guaranteed issue windows. See our Switching Rules Checklist.

Does Plan N have an out-of-pocket maximum?

No. Neither Plan G nor Plan N has an out-of-pocket maximum. Plans K and L are the only Medigap plans with OOP limits.

What about Plan G High Deductible?

Plan G High Deductible has a $2,800 deductible (2026) but much lower premiums. It’s worth considering if you want catastrophe coverage and minimal premiums.

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