Medicare Supplement (Medigap):
Plan G, Plan N, and How the Gaps Get Filled
Original Medicare pays most of the bill. A Medicare Supplement pays most of what is left. Here is how the plans work, how Plan G and Plan N differ, and why one 6-month window matters more than anything else on this page.
What Is a Medicare Supplement (Medigap) Plan?
A Medicare Supplement, also called Medigap, is private insurance that pays the deductibles and coinsurance Original Medicare leaves to you. It fits people who want to see any doctor who accepts Medicare and want predictable costs. The thing people get wrong: treating it as something you can buy any time. Your one 6-month guaranteed window is the whole game.
Original Medicare, Parts A and B, is your foundation. It pays its share, and the rest is yours: the Part A hospital deductible, the Part B deductible, the Part B coinsurance, and the daily charges when a hospital or skilled nursing stay runs long. There is no annual limit on what you can owe.
A Supplement plugs those holes. Medicare pays first, the Supplement pays second, and for most covered care you see little or nothing in the mail. You pay a monthly premium for that certainty.
Two things a Supplement is not:
- Not a Medicare Advantage plan. Advantage delivers your benefits through a network; a Supplement adds to Original Medicare with no network. You cannot have both. Read the Medicare Advantage guide.
- Not drug coverage. Supplements sold today do not include prescriptions. You add a separate Part D plan.
Key point: With Original Medicare plus a Supplement, any doctor or hospital in the country that accepts Medicare will see you. No network, no referral.
This guide is educational, not personalized advice. Your doctors, prescriptions, health, budget, and where you spend the year decide what fits you.
What a Supplement Covers, and What It Never Covers
The gaps a Supplement pays
The plans are standardized by the federal government and sold by letter. Every company selling a letter must cover the same gaps; only the price and the company vary. The full chart is worth ten minutes: compare Medigap plan benefits.
The 2026 gaps the most-chosen plans are built to handle:
| Gap in Original Medicare | 2026 amount | Notes |
|---|---|---|
| Part A hospital deductible | $1,736 per benefit period* | Resets each benefit period, not each year |
| Hospital days 61 to 90 | $434 per day* | Daily coinsurance after day 60 |
| Lifetime reserve days (91 and beyond) | $868 per day* | Reserve days after day 90 |
| Skilled nursing, days 21 to 100 | $217.00 per day* | After a qualifying inpatient stay |
| Part B annual deductible | $283 per year* | Plan G and Plan N leave this one to you |
| Part B coinsurance | Usually 20% of the Medicare-approved amount* | No yearly limit under Original Medicare alone |
Source: CMS, 2026
A woman in her 70s called us about a bill from a rehabilitation facility after her husband’s surgery. His skilled nursing stay ran past the days Medicare covers in full, and the daily coinsurance had started adding up. That is exactly the line a Supplement is built to pay. They did not have one. The teaching point: the daily charges surprise families, not the office visit.
What no Supplement pays
- The Part B premium. Everyone pays it: $202.90 per month in 2026 for most people,* more at higher incomes (see What changes on January 1).
- Prescription drugs. That is a separate Part D plan.
- Routine dental, vision, and hearing. Original Medicare does not cover them; there is nothing to supplement.
- Long-term custodial care.
- Anything Original Medicare denies. A Supplement follows Medicare’s decision.
Plans C, D, F, G, M, and N pay 80% of the cost of emergency care during foreign travel, up to plan limits, and the benefit carries its own deductible.* If you travel, ask.
Plan G vs Plan N (and What Happened to Plan F)
Most people land on one of two letters. Both cover the hospital gaps; they differ on the small stuff, and the small stuff is the decision.
| Plan G | Plan N | |
|---|---|---|
| Part A deductible and daily coinsurance | Covered | Covered |
| Skilled nursing coinsurance | Covered | Covered |
| Part B deductible ($283 in 2026*) | You pay it | You pay it |
| Part B coinsurance after the deductible | Covered | Covered, except a copay of up to $20 for some office visits and up to $50 for emergency room visits that do not end in an inpatient admission* |
| Part B excess charges (billing above the Medicare-approved amount) | Covered | Not covered |
| Monthly premium | Higher, all else equal | Lower, all else equal |
Source: medicare.gov Medigap plan comparison
A retired engineer in his 70s called when his annual premium notice arrived, asking whether Plan N would cost him less than his Plan G. We did not answer with a number. We asked how often he sees a doctor, whether any of them bill excess charges, and how he feels about a copay at the emergency room. A few visits a year, no excess charges: Plan N was a reasonable trade for him. For his neighbor with a standing specialist schedule, it might not be. The teaching point: Plan G buys quiet. Plan N buys a lower premium in exchange for a little participation. Neither is the better plan; one is the better fit for how you use care.
What happened to Plan F
Plan F covered everything, including the Part B deductible. It is no longer sold to people new to Medicare on or after January 1, 2020.* If you were eligible for Medicare before that date, you may still be able to buy it. A couple in their late 70s asked whether to move from Plan F to Plan G because their premiums kept rising. A closed plan tends to get more expensive as its pool ages, and moving usually means health questions. The answer depends on health and the two premiums.
Same letter, different price
Because a letter’s benefits are fixed by law, the premium is the variable. Companies price the same letter differently and raise rates on different schedules: what affects Medigap costs. That is why a Certified Medicare Planner® shows every company we represent for your letter, side by side, whether or not we are paid on it.
Want to see how this applies to your situation?
The 6-Month Window That Decides Everything
Your Medigap Open Enrollment Period is a one-time, 6-month window that starts the first month you are 65 or older and enrolled in Part B.* During those six months, a company must sell you any Supplement it offers, at the price it charges healthy people, with no health questions and no exclusions for conditions you already have. Source: when can I buy Medigap.
After the window closes, the rules change. Outside a few protected situations, a company can ask about your health, charge more, or decline you.
A woman in her late 60s from the Valley came into our offices well after her Part B had started. She had chosen Medicare Advantage at 65, then a doctor she trusted left the network, and now she wanted a Supplement. Her window had closed months earlier, so she went through underwriting. She was approved. Not everyone who applies after the window is. The teaching point: the window is not a formality. It is the only time the decision is entirely yours.
If you are still working at 65
The window is tied to Part B, not your birthday. If you keep employer coverage past 65 and delay Part B, the window has not started. It begins when Part B does.*
Whether you can safely delay Part B depends on employer size: with 20 or more employees the group plan pays first and you may delay without penalty; with fewer than 20, Medicare pays first and you generally need Part B at 65. When employment or group coverage ends, you get an 8-month Special Enrollment Period for Part B. COBRA and retiree coverage do not count as current employment.* That is what our Stay-or-Go Analysis™ is for. Read leaving employer coverage and turning 65 first.
Can You Switch Supplements Later?
Yes, and this is where people get hurt. You can apply for a different Supplement any time of year; there is no annual season for Medigap. But outside your 6-month window, approval usually depends on health questions, and the company can say no.
The exceptions are guaranteed issue rights, and the two we see most are these. Your Advantage plan leaves Medicare, stops serving your area, or you move out of its service area: you must return to Original Medicare, and you can apply from 60 days before that coverage ends until 63 days after it ends. Employer, union, retiree, or COBRA coverage that pays after Medicare ends: you have 63 days after it ends. In both cases the company must sell you Plan A, B, D, G, K, or L (and Plan C or F if you were eligible for Medicare before January 1, 2020), must cover your pre-existing conditions, and cannot charge you more for your health. There is also a trial right: if you joined an Advantage plan when you were first eligible for Medicare at 65, or dropped a Supplement to join one for the first time, and you leave within the first 12 months, you can buy a Supplement on the same terms (any policy sold in your state if you joined Advantage at 65; if you dropped a Supplement, your old policy if the same company still sells it, otherwise the letters above). Some states add rights of their own. Nevada requires every company to give its own policyholders a window each year, starting the first day of their birthday month and open at least 60 days, to move to any of that company’s Nevada policies with the same or lesser benefits without being denied or charged more for their health.* Ask us what applies in your state. Start here: ready to buy a Medigap policy.
A man in his 80s called after a mid-year rate increase notice. His first instinct was to drop the Supplement for an Advantage plan with no premium of its own. We slowed down. If he left and later wanted a Supplement back, he would face underwriting, and that was not a sure thing. Separately, David walked a high-income client through the same kind of increase and why the plan was still doing exactly what she bought it for. The teaching point: a Supplement is close to a one-way door. Rate increases are normal. Leaving is the decision to think hardest about.
What Changes on January 1
A Supplement does not send an Annual Notice of Change the way an Advantage or Part D plan does, because its benefits do not change. Three things around it do:
- Medicare’s numbers reset. For 2026 the Part A hospital deductible is $1,736, the Part B deductible is $283, and the standard Part B premium is $202.90 per month.* Your Supplement pays the new amounts automatically.
- Your premium moves on the company’s schedule, not necessarily January 1. Read the notice when it comes.
- Your Part D plan changes. Its premium, formulary, and pharmacy network can change every year. For 2026 the Part D out-of-pocket cap is $2,100 and the maximum deductible is $615. You review the drug plan each fall during the Annual Enrollment Period, October 15 to December 7, and any change takes effect January 1. The Supplement stays put.
One more January surprise. A retired client sold a rental property and, two years later, her Part B premium jumped. That is IRMAA, the Income-Related Monthly Adjustment Amount, based on your tax return from two years earlier. For 2026, it begins when 2024 modified adjusted gross income was above $109,000 single or $218,000 married filing jointly. A Supplement cannot cover it. The teaching point: a property sale, a Roth conversion, or a large withdrawal shows up on your Medicare bill two years later. Plan the year, not just the plan.
Supplement vs Medicare Advantage
Both are legitimate paths. Neither is universally better. The Medicare Advantage guide has the other half of the story.
| Original Medicare + Supplement + Part D | Medicare Advantage (Part C) | |
|---|---|---|
| Doctors and hospitals | Any provider in the U.S. that accepts Medicare | Plan network; HMO needs referrals, PPO costs more out of network |
| Monthly cost | Part B premium + Supplement premium + Part D premium | Part B premium + plan premium, if any |
| Cost when you use care | Small or none after the Part B deductible (Plan N adds some copays) | Copays up to the plan’s annual in-network limit |
| Drug coverage | Separate Part D plan | Usually built in |
| Dental, vision, hearing | Not included; standalone plans available | Often included as extra benefits |
| Changes each year | Benefits never change; premium may | Premiums, copays, networks, and extras can change January 1 |
| Getting in later | Health questions after your 6-month window | Enrollment periods, no health questions |
| Travel in the U.S. | Covered anywhere Medicare is accepted | Emergencies anywhere; routine care follows the network |
Source: compare Original Medicare and Medicare Advantage
A couple in their late 60s splits the year between Arizona and a northern state. Which path lets them see doctors in both places without thinking about it? A Supplement travels with Original Medicare; an Advantage network mostly does not. That settled it, and price never came up. The teaching point: start with how you live, then look at the plans.
How to Choose, and How We Help
Three questions decide most of it:
- Where is your 6-month window? Open, closed, or not started because you are still working.
- Which doctors and which drugs? Doctors need to accept Medicare, which most do. Prescriptions need a Part D plan that covers them at your pharmacy.
- How do you feel about bills? If a copay at the emergency room would bother you, Plan G. If a lower premium is worth an occasional copay, Plan N.
That is how a Certified Medicare Planner® works: doctors and prescriptions loaded before any recommendation, every company we represent for your letter on the screen side by side, and a written summary afterward. It is our own standard, not a government credential; read what it promises you.
Start with how Medicare works and turning 65, or, if you are already covered, already on Medicare. The workshop on October 2, 2026 walks through all of it in an hour: reserve a seat.
Frequently Asked Questions
Nothing. They are two names for the same thing: private insurance that pays the deductibles and coinsurance Original Medicare leaves to you. The government’s word is Medigap. The industry’s word is Medicare Supplement. Both mean the standardized lettered plans, such as Plan G and Plan N, sold by private insurance companies.
Yes, if you want prescription coverage. Supplement plans sold today do not include drugs, so you pair the Supplement with a standalone Part D plan. Going without creditable drug coverage can also trigger a late enrollment penalty of 1% of the national base premium for each month you went without it.*
It is personal to you: the 6-month window that starts the first month you are 65 or older and enrolled in Part B.* During it, companies must sell you any plan they offer with no health questions. It happens once. If you delay Part B for employer coverage, the window waits until Part B begins.
Not during your 6-month open enrollment window, and not in the guaranteed issue situations Medicare defines, such as your Advantage plan leaving Medicare or your area, or employer coverage that pays after Medicare ending, as long as you apply within 63 days after that coverage ends.* Outside those, a company can ask health questions and may decline you, charge more, or delay coverage. Timing matters more than the letter.
Neither is better. Both cover the hospital gaps. Plan G also covers Part B excess charges and has no copays. Plan N has a lower premium, adds a copay of up to $20 for some office visits and up to $50 for emergency room visits that do not end in an inpatient admission,* and does not cover excess charges. The right fit depends on how often you use care and how you feel about small bills.
No. Original Medicare does not cover routine dental, vision, or hearing care, and a Supplement only pays the gaps in what Original Medicare covers. People on this path who want those benefits add standalone dental, vision, and hearing plans. Medicare Advantage plans often bundle them instead, with a network.
You can apply, and timing decides how easy it is. You leave the Advantage plan during an enrollment period and apply for the Supplement, usually with health questions. A trial right protects you if you joined an Advantage plan when you were first eligible for Medicare at 65, or dropped a Supplement to join one for the first time, and you leave within the first 12 months: the company must sell you a Supplement and cannot charge more for your health.* Talk it through before you drop anything.
Sources
* All 2026 Medicare cost figures and enrollment rules from the Centers for Medicare & Medicaid Services (CMS) and medicare.gov:
- Part A and Part B deductibles, coinsurance, premiums, and IRMAA thresholds: cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
- Medigap basics: medicare.gov/health-drug-plans/medigap
- Medigap plan comparison chart: medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits
- Medigap costs and pricing methods: medicare.gov/health-drug-plans/medigap/basics/costs
- Medigap Open Enrollment and when to buy: medicare.gov/health-drug-plans/medigap/ready-to-buy/when and ready-to-buy
- Part D 2026 cap and deductible: cms.gov/newsroom/fact-sheets/final-cy-2026-part-d-redesign-program-instructions
- Working past 65 and the Part B Special Enrollment Period: medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65
- Employer size and who pays first: medicare.gov/health-drug-plans/coordination/who-pays-first
- Late enrollment penalties: medicare.gov/basics/costs/medicare-costs/avoid-penalties
- Original Medicare vs Medicare Advantage: medicare.gov compare page
- Part B coinsurance and the absence of a yearly limit under Original Medicare: medicare.gov/basics/costs/medicare-costs
- Plan N copays, foreign travel emergency benefit, Plan C and F availability, guaranteed issue situations, and trial rights: Choosing a Medigap Policy, CMS Product No. 02110
- Annual Enrollment Period dates and coverage start: medicare.gov joining a plan
- Switching or dropping a Medigap policy and state rights: medicare.gov switch or drop a Medigap policy
- Nevada annual Medigap open enrollment period (birthday rule): Nevada Revised Statutes 687B.352
All figures should be verified against the latest CMS fact sheet at cms.gov before relying on them for enrollment decisions.
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