Plan N Vs Plan G Cost Math
Plan N vs Plan G is the classic Medigap trade: N saves roughly $20–45/month in exchange for copays and excess-charge exposure — the break-even sits near 8–10 office visits per year.
| Cost Item | Plan G | Plan N |
|---|---|---|
| Typical 65-yo metro premium | $130–160 | $100–130 |
| Annual premium difference | — | ~$300–500 saved |
| Office copays (up to $20) | $0 | $20 × visits |
| ER copay (up to $50) | $0 | $50 × visits |
| Part B excess charges | $0 | Exposure if provider non-assigning |
Running your own break-even
Count last year’s office visits and ER trips, multiply by copays, add any known non-assigning providers’ excess charges, and compare against the premium gap. Under ~$300 total copay exposure, N wins; heavy specialist users with non-assigning providers lose more than the savings — details in the Plan N file.
The excess-charge wildcard
Excess charges cap at 15% over Medicare’s approved amount and only appear from providers who do not accept assignment. One specialist visit with excess billing can erase a month of N savings; verify assignment status before binding, or neutralize the risk with Plan G.
FAQ
Is Plan N always cheaper than G?
Monthly, usually 15–30%; total cost depends on utilization and excess charges.
Can I switch N to G later?
Yes with underwriting outside OEP/GI — do the math before relying on it.
Related reading: Plan N file · Plans board · Rate files