Medicare Part N, more accurately called Medigap Plan N, is a supplemental insurance policy sold by private companies to help cover out-of-pocket costs that Original Medicare (Parts A and B) doesn’t pay. It picks up most of your remaining bills after Medicare pays its share, with two small exceptions: you’ll owe up to $20 for doctor office visits and up to $50 for emergency room visits that don’t lead to a hospital admission.
Plan N is one of ten standardized Medigap plans available in most states. It’s popular because it typically carries lower monthly premiums than the more comprehensive Plan G, while still covering the bulk of what Medicare leaves behind.
What Plan N Covers
Plan N covers 100% of your Part A coinsurance and hospital costs, meaning you won’t face surprise bills for inpatient stays. It also covers 100% of Part B services (outpatient care, doctor visits, lab work) with the exception of the small copayments described below. Beyond that, it picks up the first three pints of blood you might need, skilled nursing facility coinsurance, and hospice care coinsurance.
Plan N also includes foreign travel emergency coverage, which Original Medicare almost never provides. If you have a medical emergency outside the U.S. during the first 60 days of a trip, Plan N pays 80% of covered charges after a $250 yearly deductible, up to a $50,000 lifetime limit.
The Copayments You’ll Pay
The defining feature of Plan N is its copayment structure. For each doctor’s office visit, including specialist appointments, you pay up to $20. For each emergency room visit, you pay up to $50. That ER copayment is waived if you’re admitted to the hospital, since the visit then gets billed under Part A inpatient care rather than Part B.
These copayments are capped, not fixed. If the actual Part B coinsurance for a particular visit is less than $20 or $50, you pay the lower amount instead.
What Plan N Does Not Cover
Plan N leaves two notable gaps. First, it does not cover the annual Part B deductible, which is $257 in 2025 and rises to $283 in 2026. You pay that out of pocket each year before your Part B benefits kick in.
Second, Plan N does not cover Part B excess charges. These occur when a doctor who accepts Medicare but hasn’t agreed to Medicare’s approved payment amount charges up to 15% more than what Medicare approves. If you see a doctor who bills excess charges, you’re responsible for that extra amount. In practice, most doctors accept Medicare’s approved amount (called “accepting assignment”), so this gap affects a relatively small number of visits. But it’s worth checking whether your providers accept assignment if this concerns you.
Plan N vs. Plan G
Plan G is the most popular Medigap plan and the closest comparison to Plan N. The coverage difference is straightforward: Plan G covers everything Plan N covers, plus it eliminates the office visit and ER copayments, and it covers Part B excess charges. Neither plan covers the Part B deductible.
The trade-off is cost. Plan G premiums are higher, though exact amounts vary by insurance company, your age, and where you live. Choosing Plan N makes financial sense if the premium savings outweigh the copayments you expect to pay. Someone who visits the doctor frequently may find Plan G’s higher premium worth it to avoid $20 copays at every appointment. Someone in good health who rarely sees a doctor may save money overall with Plan N’s lower premiums.
Eligibility and When to Enroll
To buy Plan N, you need to be enrolled in both Medicare Part A and Part B. The most important enrollment window is your Medigap Open Enrollment Period: a six-month window that begins the first day of the month you turn 65 and are signed up for Part B. During this period, insurance companies must sell you any Medigap plan they offer at the standard price, regardless of your health history. They cannot charge you more or deny you coverage for pre-existing conditions.
Outside this window, the picture changes significantly. There’s no federal guarantee that a company will sell you a policy, and if one does, it can use medical underwriting to charge higher premiums based on your health or deny coverage altogether. Some states offer additional protections, but the six-month open enrollment window remains the safest and most affordable time to buy.
How Standardization Works
Medigap plans are standardized by federal law, which means Plan N offers identical coverage whether you buy it from one company or another. The only differences between companies are the premium price, customer service, and financial stability of the insurer. This makes comparison shopping relatively simple: once you’ve decided Plan N is the right fit, you’re mainly comparing price and reputation.
Three states, Massachusetts, Minnesota, and Wisconsin, use their own standardized Medigap systems rather than the standard letter plans. If you live in one of these states, you won’t find a plan labeled “Plan N,” but you can find equivalent coverage options under those states’ own frameworks.
What Plan N Costs You in a Typical Year
Your total annual out-of-pocket spending with Plan N includes the monthly premium, the Part B deductible ($257 in 2025, $283 in 2026), and whatever copayments you accumulate from office and ER visits. For someone who sees a doctor six times a year and doesn’t visit the emergency room, the copayment total would be around $120 on top of the premium and deductible. The monthly premium itself varies widely by location and insurer, so getting quotes from multiple companies is essential.
One thing Plan N won’t expose you to is catastrophic costs. Because it covers 100% of Part A hospital expenses and nearly all Part B costs, the financial risk of a major hospitalization or surgery is effectively eliminated. The only variable costs are the deductible and small copayments, making your annual healthcare spending highly predictable.