If you’re on Medicare Supplement Plan G and the premium has recently climbed, switching to Plan N is a common way to lower your monthly Medigap cost. Plan N premiums typically run 20–35% lower than Plan G with the same carrier, age, and state. But Plan N isn’t identical to Plan G — it covers slightly less, and switching brings its own set of rules. Here we review if it is worth it to switch to N for your situation, and a few alternatives that may work better than downgrading your Medigap plan.
How Much You’d Actually Save Switching to Plan N
In most states, a 65-year-old non-smoker pays roughly 20–35% less for Plan N than Plan G with the same insurance company. Depending on your age and current plan this could save you $500+ a year.
To find out your exact savings, run an instant Medigap quote to see pricing in your area. Note: the quote tool defaults to Plan G, so you will have to toggle to N to see prices.
What Plan N Covers — And the Three Differences From Plan G
Plan G and Plan N are nearly identical. Both cover Part A hospital coinsurance and the Part A deductible, Part B coinsurance, skilled nursing facility coinsurance, blood (first three pints), hospice care coinsurance, and foreign travel emergency. Plan N differs in three specific places:
- Office visit copay up to $20. You may pay up to $20 each time you see your doctor.
- ER copay up to $50. Unless you’re admitted, an emergency room visit may cost up to $50.
- Part B excess charges are not covered. This is the bigger and less-understood gap.
The first two are predictable and small. The third is the one that surprises people — it gets its own section below.
The Part B Excess Charges Question
Medicare publishes an “approved amount” for every covered service. Doctors who accept Medicare assignment agree to accept that amount as full payment. Doctors who don’t accept assignment can legally charge up to 15% above the Medicare-approved amount — that 15% surcharge is called a Part B excess charge.
Plan G covers excess charges. Plan N does not. If you switch to Plan N and see a doctor who charges excess, you pay it out of pocket.
Eight states ban excess charges entirely. In Connecticut, Massachusetts, Minnesota, New York, Ohio, Pennsylvania, Rhode Island, and Vermont, no doctor can bill them — so the Plan G vs. Plan N gap doesn’t exist on this point. Source: Medicare.gov.
In the other 42 states, the practical question is whether your doctors accept Medicare assignment. Most do — the vast majority of practicing physicians nationally accept assignment. Excess charges are rare but are not covered on Plan N.
Will You Need to Go Through Medical Underwriting to Switch?
In most states, switching Medigap plans means a new application, health questions, and the possibility of being declined or charged more for pre-existing conditions. That process is called Medical Underwriting and it usually applies when switching from G to N even with the same insurance provider.
A handful of states make switching easier with year-round guaranteed issued coverage, birthday rules, or other special state switching laws. For the full state-by-state picture, see our Medicare Insurance Switching Ultimate Guide.
If you’re outside the easy-switching states, the smart move is to check your underwriting odds before applying. Different carriers weigh the same conditions very differently, and one denial doesn’t mean every carrier will say no.
Ways to Keep Plan G Before Downgrading to Medigap Plan N
Plan N is a fine plan, and for some people it’s the right answer. But before downgrading, consider the following:
1. Switch Carriers, Keep Plan G
Plan G is standardized — every carrier is required to cover the exact same benefits. We’ve seen the same person quoted $180 a month and $135 a month for identical Plan G coverage from different carriers in the same zip code. Run a fresh quote and see what other carriers are charging before you assume Plan G is unaffordable.
2. High Deductible Medigap Plan G
This is the same Plan G coverage with a yearly deductible — $2,960 — that you pay out of pocket before the plan covers anything. The premium is dramatically lower, often under $70 a month for a 65-year-old. It works well if you don’t expect heavy medical use and have the deductible saved. Source: CMS.gov.
3. Discounts You May Be Eligible For and Not Using
Most carriers offer a household discount (often 7–12% off if a spouse or roommate also has a Medigap plan with the same carrier), an annual payment discount (paying yearly rather than monthly), an electronic payment discount, and non-smoker rates. Discounts vary by carrier and state. Many people qualify and never apply because no one mentions it.
When the Switch to Medigap Plan N Actually Makes Sense
If you’ve already shopped Plan G across carriers, ruled out High Deductible Plan G, and exhausted available discounts, Plan N is a sensible next step — especially if:
- Your providers all accept Medicare assignment, so excess charges don’t apply. Remember, nearly all doctors accept the Medicare assignment, so this is rarely an issue.
- You don’t see your doctor often enough for the $20 office-visit copay to matter.
- You’re in good enough health to pass underwriting, or you live in a state with an easier switching rule.
- The premium difference would meaningfully ease your budget.
Plan N may not be the right move if:
- You see a specialist who doesn’t accept Medicare assignment and charges excess, and you don’t live in one of the eight states that ban excess charges.
- You see your primary care doctor frequently enough that $20 copays add up.
- Your health has changed since your original Medigap enrollment and you’re worried about underwriting approval.
How to Actually Make the Switch
If Plan N still looks right after the considerations above, the steps are straightforward:
- Get a Plan N quote. Here you will see multiple carriers — premiums vary widely. We usually recommend picking the lowest priced one.
- Check your underwriting odds before applying, if your state doesn’t offer easy Medigap switching.
- Apply for the new Plan N policy first. Don’t cancel your current Plan G until the new policy is approved.
- Once approved, cancel your Plan G by calling your old plan or sending the cancellation in writing. Enrolling in a new Medigap plan does not automatically cancel the old one.
For the full mechanics of switching, give us a call at 800-930-7956 or check out Switching Medigap Plans: Complete Details.