From Yahoo Finance · · 3m
Plan N saves money monthly, but one bill could cost you
Medigap Plan N is cheaper than Plan G, but it leaves you exposed to excess charges from certain doctors.
In brief
Medigap Plan N is cheaper than Plan G, but it leaves you exposed to excess charges from certain doctors. Plan N makes sense only if your doctors accept Medicare assignment and your state limits excess charges. Otherwise, Plan G's higher premium is worth the protection. Originally reported by Yahoo Finance.
Plan N costs less every month
Plan N premiums are lower than Plan G, making it tempting during open enrollment. But the savings depend on avoiding one specific bill that Plan G covers.
The one thing Plan N doesn't cover
Plan N leaves a gap: Part B excess charges that certain doctors can legally bill. Plan G covers these charges, but Plan N does not.
What both plans do cover
Plan G and Plan N cover the Part A hospital deductible, skilled nursing coinsurance, the first three pints of blood, hospice costs, and 80% of foreign travel emergencies. Both leave the annual Part B deductible of 283 dollars in 2026.
Plan N's three differences from Plan G
Plan N charges up to 20 dollars for office visits and up to 50 dollars for emergency room visits that don't result in admission. It also doesn't cover Part B excess charges, though it does cover the standard 20% coinsurance.
Only certain doctors can bill you extra
Medicare has three types of doctors. Participating providers accept Medicare's approved amount. Opted-out providers bill privately. Only enrolled but non-participating providers can legally bill above the approved amount on claims they don't assign.
The math behind excess charges
Non-participating doctors' approved amount is set at 95% of the participating fee. They can bill up to 115% of that lower figure, creating a 15% margin called the Part B excess charge.
Your state might protect you
Several states restrict Part B excess charges, including Connecticut, Vermont, New York, Rhode Island, Massachusetts, Minnesota, Ohio, and Pennsylvania. But protections vary by income, service type, and where care is delivered.
One big bill wipes out years of savings
Plan N's monthly savings are real, but a single large physician fee from a non-participating specialist can erase a year's worth of premium savings. The risk is concentrated and unpredictable.
Two questions decide your choice
Ask your regular doctors if they accept Medicare assignment on every claim. Then call your state insurance department to learn what excess charge protections apply where you live.
Make calls during open enrollment
The six-month Medigap open enrollment window is when insurers cannot deny you coverage for health reasons. After it closes, switching from Plan N to Plan G may trigger underwriting that could result in denial.
Plan N wins only in specific situations
Choose Plan N if your doctors accept assignment and your state limits excess charges. Otherwise, Plan G's higher premium buys protection that Plan N's monthly savings cannot guarantee.
Here's the gist
Plan N makes sense only if your doctors accept Medicare assignment and your state limits excess charges. Otherwise, Plan G's higher premium is worth the protection.
