Updated August 3, 2026. Quick answer: Plan N is cheaper every month and Plan G is more predictable. The difference is two things: copays (Plan N charges them, Plan G does not) and Part B excess charges (Plan G covers them, Plan N does not). Neither covers the Part B deductible, which is $283 in 2026.
What each covers
Plan G: Part A coinsurance and hospital costs up to 365 extra days, Part A deductible, 100% of Part B coinsurance, first 3 pints of blood, Part A hospice coinsurance, skilled nursing facility coinsurance, 100% of Part B excess charges, and 80% of foreign travel emergency up to plan limits. Does NOT cover the Part B deductible.
Plan N: Same as Plan G except: it does NOT cover Part B excess charges, and it charges copays. Plan N pays 100% of the Part B coinsurance. You must pay a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don’t result in an inpatient admission.
The copays are the easy part
Plan N’s copays are capped and small: up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to an inpatient admission. Note the second condition — if you are admitted, the ER copay does not apply.
For most people this is arithmetic: count your likely office visits in a year, multiply by $20, and compare with the annual premium difference. If the premium gap is larger than your realistic copay total, Plan N wins on cost.
Excess charges are the part worth understanding
“If you have Original Medicare, and the amount a doctor or other health care provider is legally permitted to charge is higher than the Medicare-approved amount, the difference is called the excess charge.”
And there is a ceiling on it: “the charge can’t be more than 15% above the Medicare-approved amount for non-participating healthcare providers. This amount is called “the limiting charge.””
So an excess charge is not open-ended — it is capped at 15% above the Medicare-approved amount, and it can only arise with a provider who has not agreed to accept assignment. Plan G covers that 15%; Plan N leaves it with you.
How much this matters is local, not general. The share of providers who do not accept assignment varies by area and speciality, and several states restrict or prohibit excess charges outright. That is worth checking where you actually live rather than treating it as a universal risk or a universal non-issue.
Choosing between them honestly
- Plan N suits someone who wants a lower fixed cost, sees providers who accept assignment, and does not mind paying small amounts at the point of care.
- Plan G suits someone who wants to hand over one premium and be done — no bills to reason about, no exposure to excess charges.
They are the same standardised benefits from every insurer, so the only real differences between two companies selling the same letter are price, service and how aggressively they raise rates. Which is exactly why the ability to switch later matters.
The plans you probably cannot buy
“Plans C and F are no longer available to people new to Medicare on or after January 1, 2020. However, if you were eligible for Medicare before January 1, 2020, but haven’t yet signed up, you may be able to buy Plan C or Plan F. People new to Medicare on or after January 1, 2020, have the right to buy Plan D or G instead of Plan C or F.”
Also worth knowing: high-deductible Plan G is the same coverage behind an annual deductible, at a much lower premium.
General information drawn from Medicare, CMS and state insurance-department publications, not insurance advice. Medicare rules, plan availability and dollar figures change every year, and state rules differ. Every figure here is year-labelled and every source is named so you can check it against your own situation. We do not sell insurance and receive nothing if you buy a plan.