Medicare Supplement Plan G and Plan N cover the same core benefits, but they differ in two important ways: Plan G covers Part B excess charges and has no copays, while Plan N skips excess charge coverage and charges small copays at office and emergency room visits. That trade-off makes Plan N cheaper each month, so the real question is whether the savings on premiums outweigh the extra costs you might face.
What Both Plans Cover
Plan G and Plan N share a long list of identical benefits. Both cover the Part A hospital deductible, skilled nursing facility coinsurance, Part A hospice coinsurance, Part B coinsurance (at 100% for Plan G, and 100% minus small copays for Plan N), the first three pints of blood, and foreign travel emergency care up to plan limits. Neither plan covers the Part B annual deductible, which is $257 in 2025. You pay that out of pocket before either plan’s benefits kick in for outpatient services.
Because their shared coverage is so extensive, the practical differences come down to just two areas: copays on certain visits and protection against excess charges.
Plan N’s Copays at the Doctor and ER
Plan N charges a copay of up to $20 for each office visit, including visits to specialists. It also charges up to $50 for each emergency room visit. The key word is “up to.” If the actual Part B coinsurance for that visit is less than $20 or $50, you pay the lower amount instead.
The ER copay disappears entirely if you’re admitted to the hospital from that emergency room visit. Once the care shifts to inpatient status and gets billed under Part A, Plan N waives the $50. So the copay only applies to ER visits where you’re treated and sent home.
Plan G has no copays at all. Every office visit and ER visit is fully covered after you’ve met the Part B deductible.
Part B Excess Charges
This is the most misunderstood difference between the two plans. Medicare sets an approved amount for every service. Most doctors accept that amount as full payment (called “accepting assignment”). But doctors who don’t accept assignment can charge up to 15% above Medicare’s approved amount. That extra 15% is called a Part B excess charge.
Plan G covers excess charges in full. Plan N does not cover them at all, meaning you’d pay that extra amount yourself.
In practice, the risk depends heavily on where you live. Eight states ban Part B excess charges entirely: Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. If you live in one of those states and get your care there, excess charges are not a factor. The protection only applies to care received within those states, though. Travel to a state that allows excess charges and you could still face them.
Nationwide, the vast majority of doctors accept Medicare assignment. According to Medicare’s own data, over 97% of providers do. So even outside the eight states that ban the practice, the odds of encountering an excess charge are relatively low. Still, if you see specialists who don’t accept assignment, those 15% surcharges can add up, and Plan G is the only current plan (besides the grandfathered Plan F) that eliminates that exposure.
How Premiums Compare
Plan N premiums run noticeably lower than Plan G premiums. When Plan N launched in 2010, its average monthly premium was $28 compared to $166 for Plan G, though both have risen since then. The gap varies by insurer, your age, and your location, but you can generally expect Plan N to cost somewhere between $30 and $70 less per month than Plan G from the same carrier.
That monthly savings is the core appeal of Plan N. Over a year, saving $40 a month puts $480 back in your pocket. The question is whether your copays and any potential excess charges eat into those savings. If you visit the doctor four times a year and never hit the ER, your copays total roughly $80, leaving you well ahead. If you’re in and out of specialist offices frequently, the math tightens.
The High-Deductible Plan G Option
There’s a lesser-known variant called High-Deductible Plan G. It covers the same benefits as standard Plan G, but you pay a $2,870 annual deductible (in 2025) before the plan starts covering anything. In exchange, the monthly premium drops significantly, often to a fraction of what standard Plan G costs.
This option works best for people who rarely use medical services and want catastrophic protection. You’re essentially self-insuring for the first $2,870 in out-of-pocket costs each year, then getting full Plan G coverage beyond that. There is no high-deductible version of Plan N.
Which Plan Fits Different Situations
Plan G makes the most sense if you want the simplest, most predictable coverage. After paying the $257 Part B deductible each year, you face zero additional costs for covered services, no matter how many doctors you see or how often you visit the ER. You’re also fully protected against excess charges if you happen to see a non-participating provider.
Plan N makes sense if you’re comfortable with small, predictable copays and want to lower your monthly premium. It’s an especially strong choice if you live in one of the eight states that ban excess charges, since that removes the biggest coverage gap. It also works well if you don’t visit the doctor frequently, because fewer visits mean fewer copays, and your premium savings stay intact.
For people who are healthy and want the lowest possible monthly cost while still having solid Medigap coverage, Plan N often wins on total annual spending. For people who use a lot of medical services or value zero-copay simplicity, Plan G’s higher premium buys genuine peace of mind. The right choice comes down to how often you use care, where you live, and how much you value predictability over savings.