Medigap Plan G vs. Plan N vs. High-Deductible G: 2026 Comparison

Once you've decided on Original Medicare + Medigap over Medicare Advantage, the next choice is which supplement plan to buy. For anyone enrolling today, it comes down to three options: Plan G, Plan N, or High-Deductible Plan G. Here's how to decide.

2026 coverage comparison

Sources: medicare.gov Medigap plan comparison; CMS 2026 Medicare Parts A & B Premiums and Deductibles. Premium ranges are national estimates for a 65-year-old nonsmoker — get quotes in your state before deciding.

Plan G: the gold standard for new enrollees

Plan G is the most comprehensive Medigap plan available to anyone who became Medicare-eligible after 2019. It covers nearly everything Medicare doesn't, with one exception: the annual Part B deductible, which is $283 in 2026.¹ Once you pay that $283 out of pocket at the start of each year, Plan G covers 100% of Medicare-approved costs for the rest of the year.

What that means in practice: your total annual exposure is your monthly premium plus $283. If you're hospitalized, need skilled nursing, or have a major surgery, you pay nothing beyond that fixed annual amount — no 20% coinsurance piling up, no per-admission deductible on top. Every Medicare-accepting provider in the country is available to you with no network restrictions.

Plan G also covers Part B excess charges — the up-to-15% premium above Medicare's approved rate that non-assignment providers are allowed to bill. In states without excess charge protections, this matters if any of your regular doctors don't accept Medicare assignment. (See below for details.)

Who Plan G fits best: Anyone who wants maximum predictability, uses healthcare regularly, or travels and wants access to any Medicare provider nationwide. Retirees with meaningful chronic conditions, or those who simply want to stop thinking about healthcare cost math each year.

Plan N: same network, lower premium, with copays

Plan N covers the same core benefits as Plan G with two differences: it does not cover Part B excess charges, and it adds copays — up to $20 for most office visits and up to $50 for emergency room visits that don't result in an inpatient admission.

In exchange, Plan N typically runs $30–60 per month less than Plan G in most markets — that's $360–720 per year in premium savings. Whether that trade is worth it depends on how often you use outpatient care and whether your providers accept Medicare assignment.

Plan N break-even math

Suppose Plan G costs you $220/month and Plan N is $175/month — a $45/month difference ($540/year). You'd need to pay $540 worth of copays for Plan N to cost the same as Plan G. At $20 per office visit, that's 27 office visits per year before you break even. Most people in good health at 65 don't come close to that; most people with serious chronic conditions do.

The harder-to-quantify risk is excess charges. If you're in a state without excess charge protections and one of your specialists is a non-assignment provider, a single procedure could carry a 15% surcharge that Plan N won't cover — potentially hundreds of dollars that erases years of premium savings in one visit.

Who Plan N fits best: Relatively healthy enrollees who primarily see assignment providers, prefer to pay-as-you-go on routine visits, and can absorb the occasional copay. If you're in New York, Ohio, Connecticut, Minnesota, Pennsylvania, Massachusetts, Rhode Island, or Vermont — states that prohibit Part B excess charges — Plan N's main coverage gap doesn't apply.

High-Deductible Plan G: low premium, catastrophic backstop

High-Deductible Plan G has identical coverage to standard Plan G — but you pay all Medicare-covered costs yourself until you reach the annual deductible of $2,950 in 2026.² After that, HD Plan G covers costs exactly as standard Plan G does. The Part B deductible ($283) counts toward your $2,950 HD deductible, so you're not paying it twice.

The reward for taking on that deductible: monthly premiums in the $50–80 range nationally for a 65-year-old — versus $150–300 for standard Plan G. If you rarely use healthcare, you could pocket $1,000–$2,000+ per year in premium savings while still having full protection against catastrophic costs.

Who HD Plan G fits best: Healthy enrollees in their 60s who want the lowest possible premium and are comfortable self-insuring a $2,950 annual deductible. Often a good fit for early Medicare enrollees who are still working part-time or have HSA assets they're drawing down (note: once you enroll in Part A, you can no longer contribute to an HSA — but you can spend existing HSA balances on Medicare premiums and out-of-pocket costs).

Plan F: if you're grandfathered in

Plan F is the only Medigap plan that covers the Part B deductible ($283), making it the only truly "first-dollar" coverage option. If you became eligible for Medicare before January 1, 2020, you may have bought or still hold a Plan F policy. Insurers can no longer sell Plan F to people who became Medicare-eligible on or after January 1, 2020, per MACRA 2015.³

If you have Plan F, the relevant question now is whether to stay or switch to Plan G. Plan F's risk pool is closed to new younger enrollees, which means it will gradually skew older and sicker — putting upward pressure on premiums over time. Check annually: if your Plan F premium has grown substantially above what a comparable Plan G would cost, the $283 deductible savings is not worth the premium gap.

Understanding Part B excess charges

When a provider accepts Medicare "assignment," they agree to accept Medicare's approved payment as payment in full. Most U.S. physicians accept assignment. Those who don't ("non-participating providers") may charge up to 15% above Medicare's approved amount for their services — this is called a Part B excess charge.

Plans G and F cover excess charges. Plan N does not.

In practice, Medicare's Care Compare tool lets you check assignment status for any provider. If all your regular doctors accept assignment — and you're willing to check before seeing a new specialist — Plan N's gap is a manageable risk. If you'd rather not think about it, Plan G is cleaner.

A separate category: providers who have fully "opted out" of Medicare (common among concierge physicians and some specialists) can bill any amount they choose. Medigap plans do not cover opted-out providers because no Medicare-approved amount exists. This is a different issue from excess charges and affects both Plan G and Plan N equally.

The guaranteed issue window — your only protection against underwriting

You have a six-month Medigap Open Enrollment Period starting the month you're both age 65+ and enrolled in Part B. During this window, any Medigap insurer must sell you any plan at standard rates — no health questions, no medical underwriting.

Outside this window, most states allow insurers to decline applications or charge higher rates based on health history. Someone who starts with Medicare Advantage at 65 and wants to switch to Plan G at 72 may find they can't get coverage at any price if they've developed serious health conditions. The enrollment window doesn't repeat.

This makes the initial plan selection especially consequential. If you're healthy at 65, the premium math might favor Plan N or HD Plan G — but part of the value of Plan G is optionality: if your health changes later, you're already in Plan G and never need to go through underwriting again.

IRMAA doesn't care which Medigap plan you pick

Your choice of Plan G, N, or HD Plan G doesn't affect your IRMAA calculation. IRMAA surcharges are added to your Part B and Part D premiums — they're calculated on your MAGI, not your supplemental coverage choice. You'll pay the same IRMAA surcharge whether you have Plan G or Plan N.

What your Medigap plan does affect: your total healthcare spending budget and cash-flow predictability, which in turn affects how you structure retirement income and how much you need in a healthcare reserve. Advisors who work on IRMAA management can model this alongside your Roth conversion and income sequencing strategy.

Decision framework

One thing all of these plans have in common: premium rates vary substantially by insurer, age, and state — often $80–150/month for the same plan in the same zip code. Getting quotes from 3–5 carriers is not optional. A fee-only advisor who focuses on Medicare planning can model total projected costs over 10–20 years across all three options, factoring in your health profile and expected utilization, so the comparison is apples-to-apples rather than just premium shopping.

Related resources

• Medicare Advantage vs. Original Medicare + Medigap — the upstream decision: which path to take in the first place
• IRMAA Bracket Calculator — see which Part B and Part D surcharge tier your MAGI lands in for 2026
• How to Reduce IRMAA Surcharges: 7 Strategies — the Medigap premium itself isn't the only Medicare cost lever
• Medicare and HSA Rules — if you're deciding between HD Plan G and HSA contributions, read the enrollment trap first
• Medicare Enrollment Timeline — your Medigap Open Enrollment Period starts when Part B does; timing matters