Medigap Plans Compared: G, N and the Others, and When You Can Buy One

1What Medigap pays, and what it does not

Medigap fills the cost-sharing gaps in Original Medicare: the Part A hospital deductible, hospital and skilled nursing coinsurance, the 20 percent Part B coinsurance, and, depending on the plan, the Part B deductible, excess charges and emergency care abroad. Medicare pays its share of a covered bill first, and the Medigap policy pays its share after.

It is also not the same as Medicaid, the separate program for people with low incomes that can pay Medicare's costs instead; our guide to Medicare and Medicaid explains the difference. Medigap does not cover what Medicare itself does not cover, such as long-term custodial care, routine dental care, eyeglasses or hearing aids, and it does not include prescription drugs; for those you need a separate Part D plan. You still pay the Part B premium, $202.90 a month in 2026, on top of the Medigap premium. Each policy covers one person, so a married couple needs two.

2The plans side by side

Insurers do not have to offer every plan. Every insurer that sells Medigap must offer Plan A, and beyond that each chooses which letters to sell, so the plans available, and their prices, vary by state and company. The table shows the plans most people choose between.

Swipe sideways to see the whole table.

Massachusetts, Minnesota and Wisconsin standardize their plans differently, so the letters above do not apply there.

3Plan G or Plan N?

For people turning 65 now, the choice usually comes down to these two. Plan G covers everything but the Part B deductible, so after $283 a year you pay nothing for Medicare-covered care. Plan N usually costs less each month but adds small copays and leaves you exposed to excess charges: a doctor who does not accept Medicare's approved amount as full payment can bill up to 15 percent more, and Plan N does not cover it.

The arithmetic depends on your doctors and on prices where you live. If the yearly premium difference is larger than the copays you expect, and your doctors accept assignment, Plan N can come out ahead. If you see many specialists or want no surprises, Plan G is simpler. Get quotes for both from several insurers, since prices for the identical plan can differ widely.

4Why the first six months matter most

Your Medigap open enrollment period lasts six months and starts the first month you have Part B and are 65 or older. During it, an insurer must sell you any Medigap policy it offers in your state, at the same price as a healthy person, whatever your health history. It happens once and does not repeat each year.

After it ends, insurers in most states can ask health questions, charge more or turn you down, unless you have a guaranteed issue right. That is why the decision is hard to undo: someone who picks a Medicare Advantage plan at 65 and wants Original Medicare with Medigap at 72 may not be able to buy a policy if their health has changed. If you are still working and covered by an employer plan, you can delay Part B, and the window starts later, when you enroll. Our guide to Medicare enrollment explains the timing.

5Guaranteed issue rights

Outside the open enrollment period, federal law guarantees you can buy certain Medigap plans in a few situations, usually within 63 days of losing other coverage:

• Your Medicare Advantage plan leaves your area or stops serving Medicare.
• Employer or union coverage that paid after Medicare ends.
• You joined Medicare Advantage when first eligible at 65 and want to switch to Original Medicare within the first 12 months.
• You dropped a Medigap policy to try Medicare Advantage for the first time and leave it within 12 months.
• Your Medigap insurer goes bankrupt or misleads you.

Some states give more rights than federal law, including yearly switching windows or protections for people under 65. Your State Health Insurance Assistance Program can tell you what applies where you live.

6On Medicare before 65

People who get Medicare early because of a disability or kidney failure face a harder market. Federal law does not require insurers to sell Medigap to anyone under 65, so whether you can buy a policy, and at what price, depends on your state; some require insurers to offer at least one plan to younger enrollees, often at a higher price. Everyone gets a fresh chance at 65: a new six-month open enrollment period begins then, with the same protections as for anyone turning 65. Our guide to Medicare before 65 explains how early coverage starts.

7How prices are set

The benefits of a given plan are fixed, but the premium is not. Insurers price policies in one of three ways: community-rated, where everyone pays the same regardless of age; issue-age-rated, where the price depends on your age when you buy; or attained-age-rated, where the price rises as you get older. An attained-age policy can look cheapest at 65 and become the most expensive at 80, so ask which method an insurer uses. Premiums can also rise with inflation and claims, whatever the method.

8Medigap or Medicare Advantage

The two cannot be combined: Medigap works only with Original Medicare, and an insurer may not sell you a policy while you are in Medicare Advantage unless you are switching back. Medicare Advantage often has lower premiums and extra benefits but uses networks and sets its own copays; Original Medicare with Medigap costs more each month but lets you see any provider that accepts Medicare and makes costs predictable. Our guide to Original Medicare and Medicare Advantage weighs the two, and Medicare's fall open enrollment is when most plan changes happen.