If you’re comparing Plan G vs Plan N California Medicare Supplement options, there are a few important differences you should understand before choosing your plan. These are two popular Medicare Supplement (Medigap) options for people who are new to Medicare and want coverage to help with some of the costs that Original Medicare doesn’t pay.
So which is better: Plan G or Plan N?
The short answer is that Plan G generally offers more predictable out-of-pocket costs, while Plan N can offer a lower monthly premium in exchange for some additional cost sharing. For many people, the decision comes down to this:
Would you rather pay a little more each month for Plan G, or potentially save on your monthly premium with Plan N and accept some copays and other possible out-of-pocket costs?
Let’s take a closer look.
Plan G vs. Plan N: Quick Comparison
| Benefit | Plan G | Plan N |
|---|---|---|
| Medicare Part A coinsurance and hospital costs | Covered | Covered |
| Medicare Part B coinsurance | Covered | Covered, except certain copays |
| Blood – first 3 pints | Covered | Covered |
| Part A hospice coinsurance/copay | Covered | Covered |
| Skilled nursing facility coinsurance | Covered | Covered |
| Medicare Part A deductible | Covered | Covered |
| Medicare Part B deductible | Not covered | Not covered |
| Medicare Part B excess charges | Covered | Not covered |
| Foreign travel emergency | 80% up to plan limits | 80% up to plan limits |
| Office visit copay | None after applicable Medicare deductible | Up to $20 |
| Emergency room copay | None after applicable Medicare deductible | Up to $50 in certain situations |
Both plans provide substantial coverage, but there are a few important differences.
How Medicare Supplement Plan G Works
Medicare Supplement Plan G provides one of the highest levels of coverage available to people who became eligible for Medicare on or after January 1, 2020. Plan G covers most of the gaps left by Original Medicare, with one major exception:
Plan G does not pay the annual Medicare Part B deductible.
You are responsible for that deductible each year. After the deductible is satisfied, Plan G generally pays the remaining Medicare-approved cost sharing covered by the policy. One reason people like Plan G is its simplicity and predictability. There are generally no office visit copays under Plan G, and Plan G also covers Medicare Part B excess charges.
How Medicare Supplement Plan N Works
Plan N provides many of the same benefits as Plan G, but you agree to take on a little more of the cost in exchange for what is often a lower monthly premium. Like Plan G, Plan N does not cover the Medicare Part B deductible.
However, Plan N may also require:
Up to a $20 copay for certain office visits
Up to a $50 copay for certain emergency room visits that do not result in an inpatient admission
Payment of Medicare Part B excess charges
These differences are why Plan N premiums may be lower than Plan G premiums from the same or competing insurance companies.
What Are Medicare Part B Excess Charges?
One of the biggest differences between Plan G and Plan N is coverage for Medicare Part B excess charges. Most doctors who treat Medicare patients accept Medicare assignment. This means they agree to accept the Medicare-approved amount for covered services. Some providers, however, may not accept assignment.
In certain circumstances, these providers can charge up to 15% above the Medicare-approved amount. This additional amount is known as a Part B excess charge.
Plan G covers Part B excess charges. Plan N does not.
For many beneficiaries, excess charges may rarely come up, but it’s still an important difference to understand when comparing the two plans.
Can I See Any Doctor With Plan G or Plan N?
This is one of the biggest advantages of Medicare Supplement insurance. Both Plan G and Plan N work alongside Original Medicare. There generally isn’t a Medicare Supplement provider network. You can see any doctor or hospital in the United States that accepts Medicare, regardless of which insurance company issued your Medigap policy.
This can be particularly attractive for people who:
Travel frequently
Spend part of the year in another state
Want access to specialists outside San Diego
Don’t want to deal with a Medicare Advantage provider network
Want greater flexibility in choosing healthcare providers
For many of my San Diego clients, provider flexibility is one of the primary reasons they consider Medicare Supplement coverage.
Is Plan G Better Than Plan N?
Not necessarily. Plan G isn’t automatically better because it provides more coverage, and Plan N isn’t automatically better because it may cost less. The better choice depends on the individual.
Plan G may be a good fit for someone who values predictable healthcare expenses and doesn’t mind paying a higher monthly premium for fewer potential out-of-pocket costs. Plan N may be attractive to someone who is comfortable paying occasional office or emergency room copays in exchange for the possibility of a lower monthly premium.
The key is looking at the difference in premiums and deciding whether the savings offered by Plan N justify the additional cost sharing.
An Example: Plan G vs. Plan N
Here’s a simple hypothetical example.
Suppose Plan G costs:
$180 per month
and Plan N costs:
$145 per month
That’s a difference of:
$35 per month
or:
$420 per year
In that situation, someone considering Plan N might ask:
Am I likely to spend more than $420 during the year on Plan N office visit copays, emergency room copays and potential excess charges?
If the answer is no, Plan N could potentially save that person money. But premiums vary considerably depending on the insurance company, age, location, household discounts and other factors. That’s why I prefer to compare the actual Plan G and Plan N rates available to you rather than make a blanket recommendation.
Plan G vs. Plan N for Someone Who Goes to the Doctor Frequently
If you see doctors and specialists frequently, Plan G may become more attractive because you won’t have Plan N’s potential office visit copays. However, the number of doctor visits alone shouldn’t determine your decision. You also need to consider the difference in monthly premium.
For example, paying a significantly higher premium for Plan G solely to avoid a handful of $20 office visit copays may not always make financial sense.
We can compare the numbers together.
Plan G vs. Plan N in California for Travelers
Both Plan G and Plan N can be excellent options for people who travel frequently within the United States. Because they work with Original Medicare, you generally have access to Medicare-participating providers throughout the country. Both plans also include limited foreign travel emergency coverage, subject to the plan’s deductible, lifetime limit and other requirements.
If you spend significant time outside the United States, however, Medicare Supplement foreign travel coverage shouldn’t be confused with comprehensive international health insurance or travel insurance.
Does Plan G or Plan N Include Prescription Drug Coverage?
No.
Neither Medicare Supplement Plan G nor Plan N includes outpatient prescription drug coverage. If you choose Original Medicare with a Medicare Supplement plan, you’ll typically want to consider enrolling in a separate Medicare Part D prescription drug plan.
Part D plans can vary significantly in terms of:
Monthly premiums
Deductibles
Drug formularies
Copays
Pharmacy networks
Preferred pharmacies
I help my clients compare Part D plans using their actual prescriptions and preferred pharmacies.
Does Plan G or Plan N Include Dental and Vision?
Standardized Medicare Supplement Plan G and Plan N benefits generally do not include routine dental and vision coverage. Some insurance companies may offer additional services, discounts, memberships or optional benefits alongside their Medicare Supplement policies.
Those extras can be nice, but I don’t recommend choosing a Medicare Supplement company solely because of an additional perk. The Medicare Supplement coverage itself, premium, rate history, company and your long-term needs are more important considerations.
Plan G vs. Plan N in California
California residents have another important factor to consider when choosing Medicare Supplement coverage: the California Medicare Supplement Birthday Rule. California’s Birthday Rule can provide qualifying Medicare Supplement policyholders an annual opportunity around their birthday to switch to another Medicare Supplement policy with equal or lesser benefits without going through medical underwriting, subject to California’s rules.
This can be especially valuable if your Medicare Supplement premium increases over time. For example, someone with Plan G may be able to compare Plan G rates from other insurance companies during their Birthday Rule period. Someone with Plan N may similarly have opportunities to compare qualifying coverage.
The California Birthday Rule is one reason I recommend that my Medicare Supplement clients periodically review their premiums rather than simply assuming they should remain with the same insurance company forever.
Are Plan G and Plan N Benefits Different Between Insurance Companies?
This is another question I get frequently. Medicare Supplement plans are standardized. That means a Plan G from one insurance company provides the same standardized core Medicare Supplement benefits as Plan G from another company.
The same is true for Plan N.
However, insurance companies can differ in areas such as:
Monthly premium
Household discounts
Rate increases
Customer service
Financial strength
Enrollment experience
Additional non-Medigap services or perks
That’s why comparing Medicare Supplement insurance companies can still be worthwhile even though the core plan benefits are standardized.
Should I Choose Plan G or Plan N?
There isn’t one answer that’s right for everyone. I generally tell clients to think about the decision this way:
Plan G may be worth considering if:
You want more predictable medical expenses
You prefer not to have Plan N office visit copays
You want coverage for Part B excess charges
You’re comfortable paying a potentially higher monthly premium
Plan N may be worth considering if:
You want to potentially reduce your monthly premium
You’re comfortable with occasional office visit copays
You’re comfortable with the possibility of an emergency room copay
You understand that Part B excess charges aren’t covered
The premium savings compared with Plan G are meaningful
Neither approach is inherently better.
The goal is to find the balance between monthly premium and potential out-of-pocket costs that you’re comfortable with.
Frequently Asked Questions About Plan G vs. Plan N
Does Plan G cover the Medicare Part B deductible?
No. If you became eligible for Medicare on or after January 1, 2020, Plan G does not cover the Medicare Part B deductible.
Does Plan N cover the Medicare Part B deductible?
No. Plan N also does not cover the Medicare Part B deductible.
Does Plan N have a copay every time I see a doctor?
Not necessarily. Plan N can require a copayment of up to $20 for certain office visits. The actual application of the copay depends on how the Medicare-approved service is billed.
Does Plan N have a $50 emergency room copay?
Plan N can require a copayment of up to $50 for certain emergency room visits. The copay is waived if the visit results in an inpatient hospital admission.
Does Plan G have doctor copays?
Plan G does not have the office visit copay structure found with Plan N. You remain responsible for the Medicare Part B deductible.
Can I switch from Plan G to Plan N in California?
Potentially. California Medicare Supplement policyholders have certain protections under the California Birthday Rule that may allow them to change to a plan with equal or lesser benefits without medical underwriting during the applicable enrollment window.
The specific circumstances matter, so it’s a good idea to review your options before making a change.
Which Is Better: Medicare Plan G or Plan N?
For someone who wants maximum predictability and fewer out-of-pocket surprises, Plan G may be worth the additional premium.
For someone who wants to keep monthly premiums lower and is comfortable sharing some of the cost when receiving care, Plan N may be the better value.
But there’s no universal winner.
I recommend comparing the actual premiums available in your ZIP code and then looking at the annual difference between Plan G and Plan N.
Sometimes the difference is small enough that Plan G makes sense.
Other times, Plan N’s premium savings can be substantial enough to make it very attractive.
Need Help Comparing Plan G and Plan N in San Diego?
If you’re trying to decide between Medicare Supplement Plan G and Plan N, I’d be happy to help you compare your options.
I’m Steve Korts, an independent Medicare broker serving San Diego County and North County San Diego.
I can help you compare Medicare Supplement rates from multiple insurance companies and explain the differences so you can make an informed decision.
I also help with Medicare Part D prescription drug coverage, so we can look at your Medicare coverage as a whole rather than just the Supplement.
There is no additional cost to you for my services when enrolling in a Medicare plan I represent.
Whether you’re turning 65, retiring, moving to San Diego, or already enrolled in a Medicare Supplement plan, feel free to reach out.
Schedule a free Medicare consultation today.
This information is intended for educational purposes and is not a complete description of Medicare or Medicare Supplement benefits. Medicare Supplement availability, premiums, eligibility and enrollment rules can vary. Contact Medicare, the insurance company, or a licensed insurance agent for additional information.