MEDIGAP PLAN G AND PLAN N

This educational resource is provided by CHL Insurance Solutions, a local independent agency. This page is intended for informational purposes only and does not constitute medical, legal, tax, financial advice, nor is it an offer of insurance or a sales solicitation.

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Understanding The Difference Between Plan G and Plan N

When exploring options for supplemental coverage, beneficiaries often look at Medigap Plan G and Medigap Plan N. Both plans are Medicare Supplement Insurance policies designed to work alongside Original Medicare (Part A and Part B). They are distinct from Medicare Advantage plans, as they do not replace Original Medicare but instead supplement Parts A and B and help pay for certain out-of-pocket costs that Original Medicare does not cover.

Because these plans are standardized by the federal government, the basic benefits for Plan G are the same regardless of the insurance company, and the same applies to Plan N. However, the premium costs for these plans vary significantly based on the insurance carrier, your age, your health status (where applicable), and your geographic location.

CORE SIMILARITIES

Both Plan G and Plan N provide coverage for several fundamental "gaps" in Original Medicare. These include:

• Medicare Part A Coinsurance and Hospital Costs: Up to an additional 365 days after Medicare benefits are exhausted.

• Medicare Part A Deductible: The cost-sharing required for hospital stays.

• Medicare Part B Coinsurance or Copayment: Subject to the specific rules of the plan (see Plan N differences below).

• Skilled Nursing Facility Care Coinsurance: Coverage for care in a certified facility.

• Hospice Care Coinsurance or Copayment: Support for end-of-life care.

• Foreign Travel Emergency: Coverage for emergency medical care outside the U.S. (up to plan limits).

Neither plan covers the Medicare Part B annual deductible. Beneficiaries are responsible for paying this deductible out-of-pocket before the supplement plan begins to cover Part B services.

STRUCTURAL DIFFERENCES: PLAN G VS. PLAN N

While the core benefits are similar, Plan G and Plan N have different cost-sharing structures. These differences generally center on how outpatient services and "excess charges" are handled.

MEDICARE PART B EXCESS CHARGES

Under Original Medicare, some providers do not accept "assignment," meaning they may charge more than the Medicare-approved amount (up to 15% more). This is known as an "excess charge."

• Plan G: Includes coverage for Medicare Part B excess charges.

• Plan N: Does not cover Medicare Part B excess charges. If you visit a provider who does not accept assignment, you may be responsible for these additional costs.

COPAYMENT STRUCTURE

The way you pay for office visits and emergency room services differs between the two plans.

• Plan G: Generally has no copayments for covered Medicare Part B services once the annual Part B deductible has been met.

• Plan N: Includes a copayment structure for certain services. After the Part B deductible is met, beneficiaries may pay:

  • Up to $20 for some office visits.

  • Up to $50 for emergency room visits (this copayment is waived if the beneficiary is admitted to any hospital and the emergency visit is covered as a Part A expense).

SELECTING A PLAN BASED ON INDIVIDUAL NEEDS

Neither Plan G nor Plan N is universally appropriate for every beneficiary. Because individual health needs, budget requirements, and local provider billing practices vary, the "right" plan is a matter of personal choice and specific circumstances.

Factors that may influence a beneficiary's decision include:

• Provider Networks: Whether your preferred doctors accept Medicare assignment (which impacts the relevance of excess charge coverage).

• Usage Patterns: How often you visit a doctor's office or seek emergency care (which impacts total copayment costs under Plan N).

• Carrier Selection: Each insurance company sets its own premiums. It is important to compare actual quotes and plan documents from multiple carriers in your specific zip code.

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Important Disclaimer:

Premiums are not standardized and vary by insurance carrier, age, and location. Contact a licensed insurance agent or the specific carrier for a formal quote. Medigap plans are NOT Medicare Advantage plans. Medigap plans are supplemental to Original Medicare. Plan availability may vary by state. Some states (such as Massachusetts, Minnesota, and Wisconsin) have different standardization rules for Medigap plans. For detailed information on these and other Medicare Supplement plans, you can review the official "Choosing a Medigap Policy" guide provided by CMS, call 1-800-MEDICARE, or visit Medicare.gov.

TPMO Disclaimer: We do not offer every plan available in your area. Currently we represent 5 organizations which offer 55 products in your area. Please contact Medicare.gov, 1‑800‑MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

Note: Organization and Product counts are based on the Gainesville, FL area. Actual plans available may vary based on your zip code.

Non-Government Entity: CHL Insurance Solutions, LLC is a private, licensed insurance agency (FL Lic: L131407; GA Lic: 241106). We are not part of the federal Medicare program.