Health Profile**
Medigap plans are federally standardized. Every insurer offering Plan G must provide the same core benefits as every other insurer offering Plan G. The plan letters A through N define what is covered; the insurer determines what you pay for that coverage. This standardization matters because it means you are comparing prices for an identical product. A Plan G from UnitedHealthcare covers exactly the same benefits as a Plan G from Aetna or Blue Cross Blue Shield. The only meaningful differences between insurers are the premium, the pricing structure, and the financial stability of the company. What Plan G Covers Plan G is the most comprehensive Medigap option available to new enrollees. It covers 100% of all Medicare-covered out-of-pocket costs, including the Part A hospital deductible, the daily coinsurance for extended hospital stays, the 20% Part B coinsurance on outpatient services, and skilled nursing facility coinsurance. Plan G represents 39% of all Medigap enrollees the most popular plan by enrollment. The only cost that Plan G does not cover is the Part B annual deductible, which is $283 in 2026. Once you pay that deductible, there are no further out-of-pocket costs for Medicare-covered services for the rest of the year. No copays for doctor visits. No coinsurance for procedures. Complete cost predictability.
Plan N covers most of the same benefits as Plan G, but with three meaningful differences that lower its premium. First, copays for office visits: Plan N enrollees pay up to $20 for some office visits. Emergency room visits that do not result in inpatient admission carry a copay of up to $50. Second, the Part B deductible: Plan N does not cover the annual Part B deductible ($283 in 2026), same as Plan G. Third, Part B Excess Charges: This is the most important structural difference. When a doctor does not accept Medicare "assignment" meaning they have not agreed to bill only the Medicare-approved amount they can charge up to 15% more than the Medicare-approved rate. Plan G covers these excess charges. Plan N does not. These charges are prohibited in some states, including Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont. In states where they are allowed, they represent a genuine tail risk for Plan N enrollees who see non-assignment doctors. ++ ++ The Premium Difference And the Pricing Structure The premium difference between Plan G and Plan N is meaningful. Based on 2026 data, the average monthly premium for a 65-year-old enrolling in Plan G is approximately $165.85 per month. Plan N premiums for the same age group typically run $20 to $40 less per month, depending on insurer and geography. Over a year, that difference amounts to $240 to $480 in premium savings. Whether that trade-off makes sense depends on how frequently you use medical services and whether the copays and potential excess charges you absorb with Plan N would exceed the premium you save. What most buyers do not consider carefully is how the premium will change over time. There are three pricing structures for Medigap: Pricing Model How It Works Long-Term Impact Community-Rated Everyone pays same Most stable; increases premium regardless of only from general age inflation and pool-wide cost changes Issue-Age-Rated Premium based on age Locked-in starting (Entry-Age) when first purchased; rate; still subject to does not increase as inflation adjustments you age Attained-Age-Rated Premium increases every Starts lower; becomes year as you get older most expensive for those who live into their 80s and 90s The practical consequence of pricing structure: a Plan N with a low starting premium under an attained-age-rated model can become substantially more expensive than a Plan G purchased under an issue-age-rated or community-rated model by the time you are in your 80s. The premium you see at 65 is not the premium you will pay at 80. In 2026, the average Plan G premium for a 65-year-old is approximately $165.85 per month, rising to $205.12 by age 75 and $266.87 by age 85 under attained-age pricing. Tobacco use can increase these premiums by up to 50% in most states.
The most critical fact about Medigap enrollment is that in most states, guaranteed acceptance the ability to purchase any Medigap plan without medical underwriting only exists during the six-month Initial Enrollment Period when you first become eligible for Medicare Part B. Outside of that window, insurers can require full medical underwriting, which means reviewing your health history and potentially denying your application or charging higher premiums based on existing conditions. If you wait beyond your Initial Enrollment Period, the plan options available to you may be significantly narrower. A few states Connecticut, Massachusetts, Maine, New York, and Washington have year-round guaranteed issue rules. If you live in one of these states, you have more flexibility. For everyone else, the decision is most consequential at initial enrollment.
Plan G tends to make sense for people who visit doctors frequently, manage chronic conditions requiring regular specialist care, or place a high value on predictability knowing that once the $283 deductible is paid, every Medicare-covered service is covered in full for the rest of the year. Plan N tends to make sense for people who are relatively healthy, see physicians infrequently, live in a state that prohibits excess charges, and are disciplined about verifying that their doctors accept assignment. The premium savings are real and accumulate over time but only if the avoided copays and excess charges are minimal. ++ ++ These are the mechanics. The right answer for any individual depends on health status, state of residence, and how much premium uncertainty they are willing to carry over a multi-decade retirement. What matters is making this decision with those variables explicitly considered, not by defaulting to whatever plan a broker leads with. Medigap plan selection is specific to your state, your health profile, and the insurers operating in your market. The Retirement Shield newsletter covers Medicare cost trends and coverage changes. To compare specific plan premiums in your ZIP code, connect with a Medicare-specialized insurance broker the service is typically free, and premiums are the same regardless of which broker you use.