Medicare
Medicare Supplement (Medigap) Plans in 2026: How Plan G and Plan N Compare
If you have Original Medicare, a Medicare Supplement policy, better known as Medigap, is the private insurance that helps cover the deductibles, copays, and coinsurance that Medicare leaves for you to pay. The confusing part is that Medigap comes in standardized plans labeled by letter, and today most shoppers narrow it down to Plan G or Plan N. This guide explains what Medigap does, how those letters are standardized, and how to compare policies on your own terms; it is independent, educational information, not a sales pitch.
Updated for 2026 · Page 1 of 1
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If you have Original Medicare, you have probably noticed that it pays most, but not all, of your medical bills. Part A and Part B leave you responsible for deductibles, coinsurance, and copays that have no annual ceiling, which means a single serious illness could expose you to thousands of dollars in out-of-pocket costs. A Medicare Supplement policy, almost always called Medigap, is private insurance designed to help pay those leftover amounts. This guide explains what Medigap actually does, how the standardized plan letters like G and N differ, and how a supplement fits alongside Original Medicare and a separate prescription drug plan.
The word people find confusing is standardized. In most states, a Medigap plan with a given letter must cover exactly the same set of gaps no matter which company sells it, because the benefits are set by federal rules rather than by each insurer. That means Plan G from one well-known carrier and Plan G from a smaller one pay the same claims in the same way; the differences are price, customer service, and financial strength, not coverage. Understanding that one fact changes how you shop, because it turns a bewildering pile of brochures into an apples-to-apples comparison you can do on your own.
This article is educational information from an independent, ad-supported publisher. We are not Medicare, not a government agency, and not an insurance company, agent, or broker, and nothing here is personalized insurance or financial advice. Our aim is to explain the real mechanics of Medicare Supplement plans in plain English so you can ask sharper questions and check what genuinely fits your health and budget. Actual premiums vary by age, health, location, coverage, and provider, so treat every dollar figure you encounter, including anything in a mailer, as a starting point to verify rather than a promise.
What Medigap is and what it is not
Medigap is a supplement, which means it works only alongside Original Medicare, never on its own and never on top of a Medicare Advantage plan. When you have both Original Medicare and a Medigap policy, Medicare pays its share of a covered service first, and then your Medigap policy pays some or all of the deductibles, coinsurance, and copays that Medicare left behind, depending on which plan letter you bought. Because these gaps are what the policy fills, the coverage is genuinely useful mainly to people who stay with Original Medicare rather than switching to a private Advantage plan.
It is just as important to understand what Medigap does not do. A Medigap policy does not include prescription drug coverage, so you generally need a separate Part D plan for medicines. It also does not cover things Original Medicare itself excludes, such as most routine dental, vision, hearing aids, or long-term custodial care. And it pays no cash to you; a supplement lowers what you owe on a medical bill, it does not send you a check, a benefit card, or any kind of giveback. Anyone describing a Medigap plan as free money or a cash benefit is not describing how these policies actually work.
How the standardized plan letters work
Medigap plans are sold under letter names, and in most states you may see Plans A, B, C, D, F, G, K, L, M, and N. Each letter is a fixed package of benefits defined by federal standardization rules, so the letter tells you exactly which Medicare gaps the policy covers, from the Part A hospital coinsurance to the Part B coinsurance to foreign travel emergency care. Two plans that share a letter cover the same items, which is why comparing letters, and then comparing prices within a letter, is the clearest way to shop. Three states, Massachusetts, Minnesota, and Wisconsin, standardize their plans differently, so residents there should check their state's own framework.
One rule has reshaped the market in recent years. Because of a federal change, people who first became eligible for Medicare on or after January 1, 2020 cannot buy any Medigap plan that pays the Part B deductible, which retired the once-popular Plan F and Plan C for newly eligible enrollees. As a result, Plan G has become the most comprehensive option widely available to new members, and Plan N has become a popular lower-premium alternative. If you were already eligible before 2020, you may still be able to buy or keep Plan F, but for most people shopping today the practical choice comes down to G versus N.
Plan G explained
Plan G is the most complete Medigap option available to people who became eligible for Medicare in 2020 or later. After you pay the annual Part B deductible yourself, Plan G is designed to cover essentially all of the other gaps Original Medicare leaves, including the Part A hospital deductible and coinsurance, the 20 percent Part B coinsurance, the first three pints of blood, skilled nursing coinsurance, hospice cost-sharing, and a limited amount of foreign travel emergency care. In practice that means once the Part B deductible is met, most Medicare-covered doctor and hospital bills leave you owing little or nothing.
The appeal of Plan G is predictability. People who want to see any provider in the country that accepts Medicare, avoid networks and referrals, and minimize surprise bills often gravitate to it, especially if they expect regular medical care. The trade-off is a higher monthly premium than leaner plans, since more coverage costs more. A high-deductible version of Plan G also exists, which charges a much lower premium in exchange for you paying more out of pocket before the coverage kicks in. Whether the fuller premium is worth it depends on how much care you expect and how much you value avoiding variable costs.
Plan N explained and how it compares to G
Plan N covers many of the same gaps as Plan G but asks you to share a little more of the cost at the point of care, which is why its premium is usually lower. With Plan N you still pay the annual Part B deductible, and after that you may owe a small copay of up to twenty dollars for some office visits and up to fifty dollars for an emergency room visit that does not lead to admission. Plan N also does not cover Part B excess charges, which are extra amounts a provider can bill when they do not accept Medicare's approved rate as full payment, though many providers do accept it and many states limit or bar excess charges entirely.
The honest way to compare G and N is to weigh premium savings against the copays and the small chance of an excess charge. If you do not visit the doctor often, Plan N's lower premium can leave you ahead over a year, and the copays feel minor. If you use care frequently or want the simplest possible experience with no per-visit copays, Plan G's steadier structure may be worth the higher premium. Neither is universally better; the right pick depends on how often you expect to use care, your local premiums, and whether providers in your area accept Medicare assignment.
How Medigap pairs with Part D and Original Medicare
A common setup is a three-part combination: Original Medicare for your core hospital and medical coverage, a Medigap policy to handle the cost-sharing that Original Medicare leaves behind, and a standalone Part D plan for prescription drugs. Because Medigap does not include drug coverage, the Part D plan is what protects you against pharmacy costs, and skipping it when you have no other creditable drug coverage can lead to a lifelong late-enrollment penalty added to your Part D premium. Together these three pieces aim to give broad provider access with fewer surprises, at the cost of paying more than one premium each month.
It helps to see how this differs from Medicare Advantage. Advantage plans bundle medical and usually drug coverage into one private plan with a network and an out-of-pocket maximum, and you cannot use a Medigap policy with them. The Original Medicare plus Medigap plus Part D path trades that bundling for nationwide freedom and very predictable cost-sharing. Deciding between the two paths is really the first question; choosing a specific Medigap letter only matters once you have decided to stay with Original Medicare.
Guaranteed-issue windows and medical underwriting
Timing is the single most important thing to get right with Medigap. Your Medigap Open Enrollment Period is a one-time, six-month window that starts the month you are both 65 or older and enrolled in Part B. During this window you have a guaranteed-issue right, which means an insurer cannot deny you a policy, charge you more, or make you wait because of your health history. Missing this window is the mistake that most often leaves people stuck, because outside of it insurers in most states can use medical underwriting to review your health and may decline you or charge a higher premium.
There are other, narrower guaranteed-issue situations set by federal law, such as losing certain coverage or an Advantage plan leaving your area, and some states add their own protections, including annual windows or rules that let you switch plans regardless of health. This is exactly why moving from Medicare Advantage back to Original Medicare later can be harder than it sounds: buying a Medigap policy at that point may require underwriting depending on your state and timing. Because the rules vary by state, it is worth confirming your local protections before you assume a plan will be available to you later at a price you like.
How to compare Medigap policies fairly
Because benefits within a letter are standardized, the smartest comparison is to first choose the plan letter that matches how you want to share costs, and only then compare prices among insurers selling that same letter. A Plan G is a Plan G regardless of the logo on it, so paying extra for a bigger brand name buys you service and stability, not better coverage. Ask how each insurer sets and raises premiums, since the pricing method, whether based on your age at purchase, your current age, or a flat community rate, affects how much the premium climbs as you get older.
Beyond price and pricing method, look at the insurer's financial strength ratings from independent rating firms and its track record of premium increases, since a low starting premium that rises steeply can cost more over time than a slightly higher, more stable one. Confirm the plan is offered in your state and, where relevant, whether a household or non-smoker discount applies. Real premiums vary by age, health, location, coverage, and provider, so gather a few quotes for the same plan letter and compare them side by side rather than reacting to a single mailer or advertisement.
Frequently asked questions
- What is the difference between Medigap and Medicare Advantage?
- Medigap supplements Original Medicare by paying the cost-sharing it leaves behind, while Medicare Advantage is a separate private plan that replaces how you receive your benefits. You cannot use both at once; a Medigap policy only works with Original Medicare. Advantage plans bundle coverage into a network with an out-of-pocket maximum, whereas Original Medicare plus Medigap gives nationwide access with more predictable cost-sharing. Which path fits depends on whether you value bundling and low premiums or freedom and predictability.
- Is Plan G or Plan N better?
- Neither is better for everyone; it depends on how you use care. Plan G covers essentially all gaps after the Part B deductible with no per-visit copays, which suits frequent users who want predictability, but it costs more each month. Plan N has a lower premium in exchange for small copays on some visits and does not cover Part B excess charges, which can favor people who see the doctor less often. Compare the premium savings against the copays over a realistic year to see which comes out ahead for you.
- Does a Medigap plan include prescription drug coverage?
- No. Medigap policies sold today do not include prescription drug coverage, so you generally need a separate Part D plan for your medicines. If you go without creditable drug coverage when you are first eligible, you may face a lifelong late-enrollment penalty added to your Part D premium later. Run your specific prescriptions through a Part D plan's formulary before choosing one, since coverage and costs differ by plan. Together, Original Medicare, a Medigap policy, and a Part D plan form a common three-part setup.
- When is the best time to buy a Medigap policy?
- The safest time is your Medigap Open Enrollment Period, a one-time six-month window that begins when you are 65 or older and enrolled in Part B. During this window you have a guaranteed-issue right, so insurers cannot deny you, charge more, or delay coverage based on your health. Outside of it, insurers in most states can use medical underwriting and may decline you or raise the premium. Some states and certain life events provide additional guaranteed-issue protections, so it is worth checking your local rules.
- Are Plan G policies the same from every insurance company?
- In most states, yes, on coverage. Because Medigap benefits are standardized, a Plan G covers the same set of Medicare gaps no matter which company sells it, so the policies differ on price, customer service, financial strength, and how premiums rise over time rather than on what they pay. That means you can compare Plan G quotes head to head and choose largely on cost and stability. Massachusetts, Minnesota, and Wisconsin standardize their plans differently, so residents there should use their state's framework.
- Can I be turned down for a Medigap policy?
- It depends on your timing and state. During your six-month Medigap Open Enrollment Period, or in specific guaranteed-issue situations set by law, you cannot be turned down or charged more because of your health. Outside those windows, insurers in most states may use medical underwriting, which can lead to a higher premium or a denial based on your health history. A few states have extra rules that make switching easier regardless of health, so confirm the protections where you live before assuming a plan will be available later.
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