Plan G vs Plan N
Complete Cost Analysis
Using official CMS data and real premium rates, we analyze which Medigap plan provides better value based on your healthcare usage patterns.
Quick Decision Guide
Answer these questions to see which plan typically works better for you
Consider Plan G If You:
- • Want absolute predictability in healthcare costs
- • Don't mind paying higher premiums for peace of mind
- • Have frequent doctor visits or specialist appointments
- • Prefer minimal out-of-pocket costs after deductibles
Consider Plan N If You:
- • Want to minimize monthly premium costs
- • Don't mind small, predictable copays
- • Have relatively few doctor visits per year
- • Are comfortable with minimal financial risk
Key Coverage Differences
| Benefit | Plan G | Plan N |
|---|---|---|
| Part A Deductible | ✓ Covered | ✓ Covered |
| Part B Deductible | ✗ Not Covered ($240/year) | ✗ Not Covered ($240/year) |
| Part B Coinsurance | ✓ 100% Covered | Copays Apply* |
| Office Visit Copay | $0 | Up to $20 |
| Emergency Room Copay | $0 | Up to $50** |
| Part B Excess Charges | ✓ 100% Covered | ✗ Not Covered |
* Plan N copays only apply when Part B coinsurance would normally apply
** Emergency room copay waived if admitted to hospital
Annual Cost Analysis by Healthcare Usage
Based on typical premium differences of $50-80/month between Plan G and Plan N across most states. Excess charge risk: 0.3% of claims, averaging <$20 (official CMS/MedPAC data).
Low Healthcare Usage
2-4 doctor visits/year
Plan G Annual Cost
Premium: $1,800-2,400
Part B Deductible: $240
Copays: $0
Total: $2,040-2,640
Plan N Annual Cost
Premium: $1,200-1,800
Part B Deductible: $240
Copays: $40-80
Total: $1,480-2,120
Plan N Saves: $560-520/year
Winner: Plan N
Medium Healthcare Usage
6-10 doctor visits/year
Plan G Annual Cost
Premium: $1,800-2,400
Part B Deductible: $240
Copays: $0
Total: $2,040-2,640
Plan N Annual Cost
Premium: $1,200-1,800
Part B Deductible: $240
Copays: $120-200
Total: $1,560-2,240
Plan N Saves: $480-400/year
Winner: Plan N
High Healthcare Usage
15+ doctor visits/year
Plan G Annual Cost
Premium: $1,800-2,400
Part B Deductible: $240
Copays: $0
Total: $2,040-2,640
Plan N Annual Cost
Premium: $1,200-1,800
Part B Deductible: $240
Copays: $300-400
Total: $1,740-2,440
Plan N Saves: $300-200/year
Winner: Still Plan N (barely)
Key Insight
Even with high healthcare usage, Plan N typically costs $200-300 less annually than Plan G. The premium savings usually outweigh the copay costs for most beneficiaries.
Break-Even Analysis: When Does Plan G Make Sense?
Monthly Premium Difference
Plan G typically costs $50-80 more per month than Plan N, or $600-960 annually.
Plan N Maximum Annual Copays
• 30 office visits × $20 = $600
• 5 ER visits × $50 = $250
• Total maximum copays: $850
The Math
For Plan G to be worth it financially:
Annual copays must exceed premium difference
Need 30+ office visits + 5+ ER visits annually
This represents extremely high healthcare utilization
⚠️ Less than 5% of Medicare beneficiaries reach this usage level
The Excess Charges Factor
Plan G's major selling point is coverage for Part B excess charges. However, official government data shows:
0.3%
Claims with excess charges
Source: MedPAC
<$20
Average excess amount
Industry analysis
98%
Providers accept assignment
Source: CMS
Annual Excess Charge Risk Analysis:
- • 99.7% chance of $0 in excess charges
- • 0.3% chance of <$20 in excess charges
- • Expected annual cost: Less than $5
- • Plan G premium to avoid this risk: $600-960 annually
Cost-benefit ratio: Pay $600-960 to avoid <$5 in expected costs
Special Considerations
When Plan G Might Be Worth It
- • Chronic conditions: If you consistently have 25+ medical visits annually
- • Peace of mind: You strongly prefer predictable costs over savings
- • Budget simplicity: You want one fixed premium with no copays
- • Small premium gap: In your area, Plan G costs <$30/month more
Why Plan N Usually Wins
- • Lower premiums: Save $600-960 annually in most states
- • Predictable copays: Small, fixed amounts you can budget for
- • Minimal risk: Excess charges are extremely rare and small
- • Better value: Savings typically exceed total copay costs
State-by-State Variations
Premium differences vary significantly by state and carrier. In some states, Plan G and Plan N have smaller premium gaps, making Plan G more attractive. Always compare actual rates in your specific area.
The Bottom Line
Based on official CMS data and typical premium differences, Plan N provides better value for 85-90% of Medicare beneficiaries.
Plan N Advantages:
- • $600-960 lower annual premiums
- • Predictable, small copays
- • Excellent value proposition
- • Same core benefits as Plan G
Plan G Advantages:
- • No copays after deductible
- • Covers rare excess charges
- • Maximum predictability
- • Simpler budgeting
The best choice depends on your specific situation, premium rates in your area, and personal preferences.
Related Articles
The Truth About Medicare Part B Excess Charges
Official CMS and MedPAC data on how often excess charges actually occur.
Medicare Supplement Open Enrollment Guide
Critical differences between enrollment periods that could cost you thousands.
Medicare Supplement vs Medicare Advantage
Complete guide to choosing between Medicare Advantage and Medigap plans.