The differences between Medigap Plans A, C, F, G, and N come down to which Medicare out-of-pocket costs each one picks up and what you trade in premium for that coverage. Plan A covers only the core benefits. Plans C and F cover almost everything but are closed to anyone who became eligible for Medicare on or after January 1, 2020. Plan G covers everything Plan F does except the annual Part B deductible. Plan N drops excess-charge coverage and adds small copays in exchange for a lower premium. Because every plan carrying the same letter must offer identical benefits regardless of which company sells it, the choice is really about the letter, the price, and when you first became eligible for Medicare.
What Each Plan Covers at a Glance
Every lettered plan is built from the same menu of standardized benefits. The differences show up in which items each plan includes.
- Plan A: Part B coinsurance, first 3 pints of blood, Part A hospice coinsurance, and Part A hospital coinsurance plus 365 additional days after Medicare benefits end.
- Plan C: Everything Plan A covers, plus the Part A deductible, skilled nursing facility coinsurance, the Part B deductible, and foreign travel emergency. No excess charges.
- Plan F: Everything Plan C covers, plus Part B excess charges. The most complete standardized plan.
- Plan G: Identical to Plan F except it does not cover the Part B deductible ($283 in 2026).
- Plan N: Similar to Plan G but does not cover Part B excess charges or the Part B deductible, and charges copays of up to $20 for most office visits and up to $50 for emergency room visits that don’t result in admission.
Those are the mechanical differences. The rest of the picture is who can still buy which plan, and how the tradeoffs play out in practice.1Medicare.gov. Compare Medigap Plan Benefits
Plan A: Core Benefits Only
Plan A is the floor. It covers Part B coinsurance (the 20% you’d otherwise owe on outpatient services), the first three pints of blood, Part A hospice coinsurance, and Part A hospital coinsurance for up to 365 additional days after Medicare benefits run out. That last piece is the real safety net, keeping a long inpatient stay from running into open-ended bills.
What Plan A leaves on your tab is the longer list. You still pay the $1,736 Part A deductible each benefit period, the $283 annual Part B deductible, any Part B excess charges, skilled nursing coinsurance of $217 per day for days 21 through 100, and anything that happens during foreign travel. Premiums are the lowest of any Medigap plan, but a single hospital stay followed by rehab in a skilled nursing facility can erase years of premium savings.
Plans C and F: Closed to Newer Beneficiaries
Plan F has long been the most generous standardized Medigap policy. It covers every benefit on the menu: both deductibles, both coinsurance categories, excess charges, skilled nursing, blood, hospice, and foreign travel emergencies. After the premium, your cost for covered services is effectively zero.
Plan C mirrors Plan F except it does not cover Part B excess charges. If every doctor you see accepts Medicare assignment, that gap costs you nothing. If any don’t, you’d owe up to 15% above the Medicare-approved amount on those visits.
The important point for most readers: insurers can no longer sell any Medigap plan that covers the Part B deductible to anyone who became newly eligible for Medicare on or after January 1, 2020.2National Association of Insurance Commissioners. Medigap FAQ Both Plan C and Plan F cover that deductible, so both are off the table for anyone newly eligible after that date. If you qualified before 2020, you can still buy either plan or keep one you already have.
If you are grandfathered into Plan F, keep an eye on renewal pricing. The pool of enrollees in these plans only shrinks over time, since no new members are joining to replace older ones leaving. That tends to push premiums up faster than in plans still open to new members.
Plan G: The Standard Choice for New Enrollees
Plan G covers everything Plan F covers with one exception: the annual Part B deductible. You pay $283 out of pocket each year for outpatient care, and after that the plan handles the Part A deductible, hospital coinsurance, skilled nursing coinsurance, the 20% Part B coinsurance, Part B excess charges, blood, hospice coinsurance, and foreign travel emergency.
Excess-charge coverage is the piece that distinguishes Plan G from Plan N. When you see a doctor who doesn’t accept Medicare assignment, Plan G absorbs the additional charge of up to 15% above the Medicare-approved amount. Eight states ban excess charges entirely, so if you live in one of those, the protection is redundant. Everywhere else, it matters most with specialists in high-demand fields, who are the providers most likely to bill above Medicare rates.
High-Deductible Plan G
A high-deductible version of Plan G trades a much lower monthly premium for a $2,950 out-of-pocket deductible in 2026 (not counting premiums) before the plan pays anything.3Centers for Medicare & Medicaid Services. Deductible Amount for Medigap High Deductible Options F, G and J for Calendar Year 2026 Once you clear that deductible, coverage is identical to standard Plan G.
This option works for people in good health with savings to absorb a bad year. If you rarely need medical care, the premium savings can run well above $2,950 over a few years. If you manage chronic conditions and expect to hit the deductible annually, the standard version almost always wins on total cost.
Plan N: Lower Premiums, Small Copays
Plan N covers the Part A deductible, hospital coinsurance, skilled nursing coinsurance, blood, hospice coinsurance, and foreign travel emergency. It differs from Plan G in three specific places: no Part B deductible coverage, no excess charges, and copays at the point of care.
After you’ve met the $283 Part B deductible for the year, Plan N charges a copay of up to $20 for most office visits, including specialist visits. Emergency room visits carry a copay of up to $50, waived if you’re admitted to the hospital from the ER.4Centers for Medicare & Medicaid Services. Revised Questions and Answers Regarding Implementation of Medicare Supplement Plan N Copayment, Deductible and Coinsurance Those are caps, not fixed charges, so actual copays can be lower depending on the Medicare coinsurance for the service.
In exchange, Plan N premiums usually run noticeably below Plan G premiums from the same insurer. You accept predictable small copays and some exposure to excess charges in return for the monthly savings.
How to Choose Between Plan G and Plan N
For anyone newly eligible for Medicare, the real decision is Plan G versus Plan N. Work the numbers in this order.
Start with the premium difference. Get quotes from the same insurer for both plans and calculate the annual savings of choosing Plan N. Then add up your expected copays. Twelve office visits a year at the $20 cap is up to $240. Add the $283 Part B deductible that both plans leave uncovered, since it washes out of the comparison. If Plan N’s total expected cost (premium plus copays plus any excess charges) still comes in below Plan G’s premium, Plan N wins on price.
Then look at your doctors. If all of them accept Medicare assignment, excess charges aren’t a factor and Plan N looks stronger. If you see specialists who don’t accept assignment and you don’t live in a state that bans excess billing, Plan G’s protection has real value. You can check assignment status in Medicare.gov’s provider directory before you commit.
People with predictable, moderate healthcare use often come out ahead on Plan N. People who prefer never to see a surprise bill tend to prefer Plan G. Neither is wrong; it’s a question of how much unpredictability you’re willing to absorb.
Why Two Policies for the Same Plan Can Cost Very Different Amounts
Identical benefits do not mean identical prices. Insurers use three different pricing methods, and the method matters more than the starting premium because it determines how fast the price grows.5Medicare.gov. Choosing a Medigap Policy
- Community-rated: Everyone pays the same premium regardless of age. Your rate won’t rise because you got older, though inflation and claims experience can still push it up. Over a long enrollment, this method usually costs less.
- Issue-age-rated: Your premium is set by your age when you first buy. Once you’re in, age-related increases stop, though inflation adjustments continue.
- Attained-age-rated: Your premium is based on your current age and climbs as you get older. These plans often have the lowest starting price, which is why they look attractive at 65 and start to hurt in your late 70s and 80s.
Always ask which method applies before comparing quotes. A community-rated plan at $180 a month will often cost less over 20 years than an attained-age plan starting at $120. Some insurers also offer household discounts of roughly 5% to 7% when two people at the same address each hold a policy.
What None of These Plans Cover
Even Plan F has limits worth knowing before you buy.
No Medigap policy sold since 2006 includes prescription drug coverage. For medications, you need a separate Medicare Part D plan, and delaying Part D past your initial eligibility window triggers a permanent late-enrollment penalty that stays on your premium for as long as you have coverage.6Medicare.gov. Learn How Medigap Works
You cannot hold a Medigap policy and a Medicare Advantage plan at the same time. It is illegal for anyone to sell you a Medigap policy while you are enrolled in Medicare Advantage.7Medicare.gov. When Can I Buy a Medigap Policy If you are considering a switch back to Original Medicare, confirm your timing and whether you qualify for guaranteed issue rights before you drop your current plan.
Medigap fills gaps in Original Medicare, so anything Original Medicare doesn’t cover stays uncovered. That includes long-term custodial care, routine dental work, eyeglasses, and hearing aids. For those, you’d need standalone policies or other programs.
One timing point sits behind every plan choice: your six-month Medigap Open Enrollment Period, which starts the first day of the month you are both 65 and enrolled in Part B. During that window, insurers must sell you any Medigap plan they offer at the standard price regardless of your health history.7Medicare.gov. When Can I Buy a Medigap Policy After it closes, insurers in most states can use medical underwriting to deny you, charge more, or impose waiting periods for pre-existing conditions. Picking the right letter matters less if you wait too long to buy any of them.