This Guide Is for You If
- You want most of what Plan G covers, at a noticeably lower monthly premium
- You're comfortable with a small, predictable copay in exchange for savings
- You travel often, split time between states, or just want nationwide access with no networks
- You're trying to decide between Plan N and Plan G and want the real math, not a rule of thumb — our Medicare Supplement plans comparison can help if you're also weighing other plan letters
What Plan N Covers
- Part A coinsurance and hospital costs — including up to an additional 365 days after Medicare benefits are used up
- Part B coinsurance — Plan N generally covers Medicare Part B coinsurance after the Part B deductible, except for applicable office visit and emergency room copayments
- Skilled nursing facility coinsurance — covers the daily coinsurance for Medicare-covered skilled nursing facility care after Medicare's fully covered days have been used
- Blood — the first three pints used in a medical procedure
- Part A hospice coinsurance or copayment
- Foreign travel emergency coverage — generally 80% of covered charges after a deductible, up to plan limits
Plan N's lower premium comes from shifting a few specific expenses back to you — not from removing its major hospital and skilled-nursing benefits.
What Plan N Doesn't Cover
Part B Deductible
Same deductible Plan G leaves you with.
You pay it out of pocket before Part B coinsurance benefits apply.
Part B Excess Charges
Up to 15% above the Medicare-approved amount, if you ever see a provider who doesn't accept assignment.
Plan G covers this; Plan N doesn't.
Prescription Drugs
No Medigap plan includes Part D — you'd pair Plan N with a standalone drug plan.
Vision, Dental, Hearing
These need a separate standalone policy, same as with every other Medigap plan.
How the Copay Actually Works
Plan N charges up to $20 for certain Part B office visits and up to $50 for an ER visit that doesn't result in inpatient admission.
The office copay only applies to visits Medicare processes as office-visit charges, and the actual amount can end up being less than $20 depending on the Medicare-approved amount for that visit.
The ER copay is waived if you're admitted as an inpatient from that visit — Plan N's hospital benefits apply instead.
From the Field
Many of the Plan N clients we work with have relatively limited outpatient use, such as routine primary-care visits and occasional specialist appointments.
For someone with that pattern, the copays may remain well below the annual premium savings, depending on the actual difference between Plan N and Plan G.
That isn't true in every market, which is why we compare the actual annual premium difference rather than relying only on a general rule.
How Excess Charges Work
A nonparticipating provider who doesn't accept Medicare assignment for a particular service may be permitted to bill more than Medicare's applicable payment amount.
That additional amount is called a Medicare Part B excess charge, and Plan N doesn't cover it.
The exact maximum is determined using Medicare's limiting-charge formula.
It's therefore more complicated than simply adding 15% to the standard Medicare-approved amount.
Excess charges apply only when the provider is eligible to impose one and doesn't accept assignment for the service.
Before receiving nonemergency care, you can ask whether the provider accepts Medicare assignment.
Some states provide additional protections involving excess charges.
Because state rules can change, check with your State Health Insurance Assistance Program or state insurance department if this issue could affect your decision.
How Much Does Plan N Cost?
Plan N premiums vary by age, ZIP code, sex, tobacco use, household discounts, and carrier — the number that actually matters is the gap between Plan N and Plan G in your own ZIP code, not a national average.
Plan N
Plan G
Sample ranges were retrieved for a 65-year-old nonsmoking male using the ZIP codes noted above.
The ranges include quotes from seven available carriers and do not include household discounts, policy fees, or underwriting adjustments.
A Simplified Savings Example
Say Plan N costs $35 less per month than Plan G in your area.
- Annual premium savings: $420
- Ten office copays at $20 each: up to $200
- No non-admitted ER visits, no excess charges that year
In this example, Plan N still comes out about $220 ahead for the year.
A smaller premium gap or more frequent visits can shift that math toward Plan G, so it's worth running your own numbers rather than assuming.
This simplified example assumes the maximum $20 charge for all ten applicable visits — actual copays may be lower.
Our Take on Plan N
We recommend considering Plan N more often than many people expect, particularly when the premium difference between Plan N and Plan G is substantial.
The decision usually comes down to whether the annual premium savings are likely to outweigh the office copays, possible emergency-room copays, and potential excess charges.
Someone who uses outpatient care occasionally may find that Plan N provides the better value, while someone who prefers simpler cost-sharing may still favor Plan G.
Like Plan G, Plan N can be used with any provider nationwide who accepts Original Medicare.
Because standard Medigap coverage does not use a local provider network, it can work well for people who travel or split time between states.
Providers can still change whether they accept Medicare or new patients, so confirm acceptance before receiving nonemergency care.
Plan N's core benefits are standardized and do not undergo annual network redesign.
However, premiums, Medicare deductibles, and other costs can still change over time.
Pros
- Lower monthly premium than Plan G — often the biggest single factor in the decision
- Nationwide access — to any provider who accepts Original Medicare
- Coverage that travels with you — useful for snowbirds and frequent travelers
- Standardized core benefits — Plan N's core Medigap benefits don't undergo annual network or benefit redesign, although premiums, Medicare deductibles, and other costs can change
- Relatively predictable cost-sharing — office copays are limited to up to $20 per applicable visit and the non-admitted ER copay is up to $50, although Plan N has no annual out-of-pocket maximum
Cons
- Office and ER copays — small, but they're real out-of-pocket costs Plan G doesn't have
- No excess-charge protection — you may owe an additional amount when an eligible provider doesn't accept Medicare assignment
- Still no Part B deductible coverage — same as Plan G
- Smaller premium gap in some states — the trade is less compelling where Plan N and Plan G are priced close together
That's why we frequently recommend comparing Plan N and Plan G side by side, using the actual premiums available to you, rather than assuming one is automatically the better fit.
Common Mistakes and Misconceptions
MythReality
"Plan N is simply an inferior Plan G." Plan N covers fewer expenses than Plan G, but it may provide better overall value when the premium savings exceed the additional copays and possible excess charges.
MythReality
"The $20 copay applies to every visit." It only applies to visits Medicare processes as office-visit charges under Part B.
MythReality
"Every doctor can add a 15% excess charge." Excess charges apply only when an eligible provider doesn't accept Medicare assignment and is permitted to bill above Medicare's approved amount.
MythReality"You need the biggest company to get the best Plan N." Coverage is standardized — premium, discounts, and service are what actually differ by carrier. See
the companies we'd compare first for how we approach that comparison.
When We Don't Recommend Plan N
- You routinely see a provider who doesn't accept Medicare assignment — the excess-charge exposure outweighs the premium savings
- The Plan N/Plan G premium gap in your ZIP code is small — the copay tradeoff matters less when there isn't much to save
- You strongly prefer the simplest possible cost-sharing, with nothing to think about besides the Part B deductible — or you're curious whether High Deductible Plan G fits your numbers even better
Plan N is one of our most-recommended plans, not our only recommendation.
How to Enroll in Medicare Supplement Plan N
You need Medicare Part A and Part B, and you must live in a state where the policy is sold.
The best time to apply is during your six-month Medigap Open Enrollment Period, starting the first day of the month you're 65 or older and enrolled in Part B.
Within that window, insurers generally can't deny your application or charge you more because of your health.
Outside your Medigap Open Enrollment Period, medical underwriting may apply unless you qualify for a guaranteed-issue right or an additional protection provided by your state.
This means you should consider not only which plan fits today, but also whether you may be able to change plans later.
Some states provide additional Medigap enrollment or switching protections beyond federal law, so it's worth checking the rules where you live before making a final decision.
Bottom Line
Medicare Supplement Plan N covers most of the significant gaps in Original Medicare and typically costs less per month than Plan G.
The trade-off is specific: you pay the Medicare Part B deductible, up to $20 for certain office visits, up to $50 for an emergency room visit that doesn't result in inpatient admission, and any applicable Part B excess charges.
For many people, the decision isn't whether Plan N is "good."
It's whether the premium savings are likely to exceed the additional costs you'll actually incur.
That's why we almost always compare both Plan N and Plan G using your actual ZIP code, age, and available premiums before making a recommendation.
