Plan G vs Plan N
Both are standardized by law, so this is a comparison of rules rather than products. We give a verdict, and the reasoning behind it.
Plan G against Plan N, with a verdict
Every Medicare Supplement sold in the United States is standardized by letter. A Plan G is a Plan G whichever company writes it, and a Plan N is a Plan N. The benefits inside each letter are set by law and do not vary. What varies is the premium, the company behind it, and how the rate behaves over the next twenty years.
That standardization is what makes this page possible. We are not comparing products, we are comparing two sets of rules. Anyone who tells you they cannot answer which is better is either a captive agent who can only sell one book, or is hedging.
We can answer it. The short version is at the bottom of this page, and the reasoning is above it.
Head to head
Both plans pair with Original Medicare and both require a separate Part D prescription drug plan. Neither has a network.
| Plan G | Plan N | |
|---|---|---|
| Part B deductible | Not covered. You pay it once each year. | Not covered. You pay it once each year. |
| Part B coinsurance | Paid in full after the deductible. Your share of Medicare approved doctor, lab, scan and outpatient costs is zero. | Paid in full after the deductible, except for the copays in the next two rows. |
| Office visits | No copay. | A copay at each office visit, up to a limit fixed in the plan design. |
| Emergency room | No copay. | A copay for an emergency room visit, waived if the visit results in an inpatient admission. |
| Part B excess charges | Covered in full. | Not covered. Exposure is capped by federal law at 15 percent above the Medicare approved amount, and only from non participating providers. |
| Part A deductible and hospital coinsurance | Covered. | Covered. |
| Skilled nursing facility coinsurance | Covered. | Covered. |
| Hospice coinsurance | Covered. | Covered. |
| Foreign travel emergency | Covered at 80 percent, after a yearly foreign travel deductible, up to a lifetime maximum. | Covered at 80 percent, after a yearly foreign travel deductible, up to a lifetime maximum. |
| Choice of provider | Any doctor or hospital in the country that accepts Medicare. | Any doctor or hospital in the country that accepts Medicare. |
| Monthly premium | Higher. | Lower. That difference is the entire case for Plan N. |
Excess charges, explained properly
This is the part that gets muddled most often, including by people selling these plans. There are three categories of provider under Medicare and they behave differently.
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Participating providers. They accept assignment, meaning they agree to take the Medicare approved amount as full payment. They cannot bill an excess charge. The great majority of physicians who see Medicare patients are in this category, and every provider inside the large local systems generally is.
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Non participating providers. They still take Medicare and Medicare still pays its share, but they have not agreed to accept assignment on every claim. They may bill you up to 15 percent above the Medicare approved amount. That 15 percent is a federal ceiling, not a suggestion. Plan G pays it. Plan N does not, and it lands on you.
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Providers who have opted out of Medicare entirely. A different situation altogether. They see you under a private contract, Medicare pays nothing at all, and neither Plan G nor Plan N pays anything either. No supplement of any letter protects you here. This is why we ask people to confirm that a new specialist takes Medicare, not merely that they take your supplement.
California has not banned excess billing the way a handful of states have, so the exposure on Plan N is real rather than theoretical. In day to day practice it is also narrow, because most local providers accept assignment. The honest summary is that it is a small risk you can mostly manage by asking one question at the front desk, and Plan N is the plan where you have to remember to ask it.
What neither plan covers
Both are supplements, so they cover what Medicare covers and nothing beyond it.
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The annual Part B deductible. Neither G nor N pays it. That is not a design choice by the carrier, it is federal law: plans that cover the Part B deductible are closed to anyone who became eligible for Medicare on or after January 1 2020, which is what closed Plan F to new enrollees.
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Prescription drugs. You buy those separately with a Part D prescription drug plan, and the choice of drug plan deserves as much attention as the choice of supplement.
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Dental, vision, hearing aids and long term care, none of which Medicare covers.
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Your Part B premium, and the supplement premium itself.
The verdict
For most people in Santa Barbara County who can carry the premium comfortably, Plan G. Not because Plan N is a bad plan, it is a well designed plan and it is the right answer for a real share of our clients, but because of one asymmetry that almost nobody mentions.
Under the California Birthday Rule you may move each year, without underwriting, to a policy with equal or lesser benefits. Plan N has lesser benefits than Plan G. So a Plan G holder can move down to Plan N in any birthday window, for any reason, at any age, and never answer a health question. A Plan N holder who later wants Plan G is asking to move up, which the birthday rule does not permit, and will normally have to pass medical underwriting to do it.
Starting on Plan G therefore buys you an option you can exercise for the rest of your life. Starting on Plan N spends it. When the premium difference between the two is comfortable, that option is worth more than the saving.
When it is not comfortable, take Plan N without embarrassment. A Plan N you can afford to keep for twenty years beats a Plan G you drop after four.
When Plan N is the right call
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The premium difference is the difference between keeping the supplement and giving it up. Affordability that lasts is the point.
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You use care lightly. If you see a doctor a handful of times a year, a per visit copay is a smaller number than twelve months of the premium difference.
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Your providers are inside the main local systems and accept assignment, which removes most of the excess charge exposure in practice.
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You would rather hold any supplement, with its freedom to use any Medicare provider anywhere, than move to a network plan to save the same money.
We will run your actual numbers
Because the benefits are fixed by law, the only real work left is matching you to a company with a sound rate history and a premium that will still make sense in ten years. We represent the major carriers writing Medicare products in California and we are paid the same whichever letter you choose, which is why we are comfortable publishing a verdict.
Tell us how often you see a doctor and what you can comfortably budget each month, and we will show you both plans side by side with real quotes.
Or call us on (805) 966-4900. There is never a charge for our help.
Plan G or Plan N?
We are paid the same either way, which is why we will tell you which one fits. There is never a charge for our services.