If you have decided that Original Medicare plus a Medigap policy is the right path for you, the next question is which plan letter to choose. Two options dominate: Plan G and Plan N. They are both strong. The difference comes down to how much you use the health care system and how much predictability you want in your costs.
Here is a clear breakdown — without the insurance jargon.
What Medigap Actually Does
Medigap — also called Medicare Supplement insurance — works alongside Original Medicare. It does not replace Medicare; it fills the gaps. The main gap in Original Medicare is the Part B cost-share: after your annual deductible, you pay 20% of the Medicare-approved amount for most services, with no yearly cap. A major illness or surgery can result in thousands of dollars out of pocket. Medigap is designed to cover most or all of that exposure.
Medigap plans are standardized. Every insurance company selling Plan G must offer the same core benefits. The only differences between companies on the same plan letter are price and customer service. This means the comparison between Plan G and Plan N is purely about what each plan covers — not which company sells it.
Plan G vs. Plan N: Side by Side
Broadest coverage available to new enrollees
- Part A deductible: covered
- Part A coinsurance (hospital days 61–90+): covered
- Part B deductible: not covered (you pay once per year)
- Part B 20% cost-share: fully covered
- Part B excess charges: covered
- Foreign travel emergency: covered (80%)
- Skilled nursing coinsurance: covered
Strong coverage with modest cost-sharing
- Part A deductible: covered
- Part A coinsurance: covered
- Part B deductible: not covered
- Part B 20% cost-share: covered (with copays)
- Part B excess charges: not covered
- Foreign travel emergency: covered (80%)
- Skilled nursing coinsurance: covered
The Key Differences to Understand
Part B Excess Charges
Plan G covers "excess charges" — Plan N does not. An excess charge happens when a doctor does not accept Medicare's approved amount as payment in full. In California, excess charges are limited by state law, so this is less of a concern here than in some other states. But if you travel frequently or spend time in states without similar protections, it is worth considering.
Copays Per Visit
Plan N charges a copay of up to $20 for doctor's office visits and up to $50 for emergency room visits (waived if you are admitted). If you visit the doctor regularly — monthly or more — those copays add up. Run the math: if you pay $30 less per month in premium with Plan N but pay $20 per office visit 15 times a year, you are spending $300 more annually in copays while saving $360 in premium. The math is close — which is why your usage pattern matters.
Pricing Method
Beyond the plan letter, how an insurer prices the plan affects your long-term costs. Plans can be community-rated (same premium regardless of age), issue-age-rated (based on the age when you enrolled), or attained-age-rated (increases as you get older). Two insurers can offer the same Plan G at very different prices — and with very different rate histories. This is where comparing across carriers matters.
What most people get wrong: They compare only the monthly premium. The right comparison is premium + likely out-of-pocket costs over time, accounting for your health, how often you see doctors, and whether you travel. We run that comparison for you.
What About Plan F?
You may have heard of Plan F — it was the most popular Medigap plan for years because it covered everything, including the Part B deductible. Plan F is no longer available to people who became eligible for Medicare on or after January 1, 2020. If you are newly eligible, Plan G is the most comprehensive option available to you.
High-Deductible Plan G
There is also a high-deductible version of Plan G. It carries a much lower monthly premium, but you pay the deductible (set annually by CMS — check medicare.gov for the current figure) before the policy pays anything. Once you have met the deductible, the coverage is the same as standard Plan G. This option can work well for people who want protection against catastrophic costs while accepting more routine out-of-pocket risk.
The Bottom Line
Plan G gives you the most complete coverage and the most predictable costs. Plan N gives you meaningful coverage at a lower monthly premium, with small copays for office visits. The right choice depends on how you use health care, how much you value cost certainty, and how the premium difference compares to your realistic out-of-pocket exposure under Plan N.
There is no universally right answer — but there is a right answer for your situation. We compare premiums across the carriers we represent, explain the pricing method each one uses, and walk you through the numbers without pressure.
Cesar & Associates is an independent insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area. Plan availability, costs, and benefits vary by county, your doctors, and your prescriptions. Please review your options with a licensed agent.