Plan G and Plan N are the two most popular Medicare Supplement plans sold in California, and most of the Medigap questions we field in the office come down to one of these two. Both plans cover the big-ticket items, hospital stays, skilled nursing coinsurance, and most of your Part B coinsurance, but they split on smaller, everyday costs in a way that can add up over a year. Neither is "better" across the board. The right one depends on how often you see a doctor and how much monthly premium you're comfortable paying.
If you're comparing supplement options before your birthday rule window or ahead of a plan switch, here's what actually separates these two plans, in plain terms.
What Plan G Covers That Plan N Doesn't
Plan G is the more comprehensive of the two. Once you meet the annual Part B deductible, Plan G pays the rest of your Medicare-approved costs in full, with no copays for doctor visits, specialist visits, or emergency room trips. It also covers Part B excess charges, the extra amount a doctor can legally bill above the Medicare-approved rate if they don't accept assignment. In exchange for that predictability, Plan G carries a higher monthly premium than Plan N.
What Plan N Covers and Where It Costs You
Plan N covers the same major categories as Plan G, hospital stays, skilled nursing coinsurance, and the bulk of Part B coinsurance, but it adds small copays: typically up to $20 for an office visit and up to $50 for an ER visit that doesn't result in an inpatient admission. Plan N also does not cover Part B excess charges, so if your doctor bills above the Medicare-approved amount, you're responsible for that difference. In return, Plan N's monthly premium usually runs $20 to $50 lower than Plan G, depending on your carrier and county.
Plan G: predictable costs, higher premium
Best if you see doctors often, want to avoid surprise bills, or want one flat monthly cost with almost nothing extra to track.
Plan N: lower premium, small copays
Best if you're generally healthy, don't mind a $20 copay here and there, and want to keep your monthly premium as low as possible.
Do the Math Based on How You Actually Use Care
The comparison usually comes down to simple arithmetic. Take the premium difference between the two plans in your county, often $240 to $600 a year, and compare it to how many office visits and ER trips you typically have. If you see doctors only a handful of times a year, Plan N's copays likely cost you less than the premium savings would erase. If you're managing a chronic condition with frequent visits, Plan G's flat, predictable cost often wins out. Our Medigap in California guide breaks down current premium ranges by region if you want to run your own numbers.
Part B Excess Charges: A California-Specific Wrinkle
Excess charges only matter if your doctor doesn't accept Medicare assignment. Most California providers do accept assignment, which limits how much this factor should weigh in your decision, but it's not universal, especially for some specialists. Before choosing Plan N to save on premium, it's worth a quick call to your regular doctors' offices to ask whether they bill above the Medicare-approved rate.
Before you choose between Plan G and Plan N:
- Get quotes for both plans from at least two or three carriers in your county
- Estimate how many doctor visits and ER trips you had in the past year
- Call your regular doctors to ask if they accept Medicare assignment
- Confirm you have a separate Part D plan lined up, since neither Medigap plan covers drugs
- Check whether you qualify for California's birthday rule to switch without medical underwriting
Switching Between Plan G and Plan N in California
Outside your initial six-month Medigap open enrollment window, switching carriers or plan types typically requires answering health questions, and a carrier can decline coverage or charge more based on your medical history. California is one of the few states with a birthday rule, which lets you switch to an equal or lesser plan within 60 days of your birthday each year without medical underwriting. Our enrollment guide covers the birthday rule timeline and other guaranteed-issue situations in more detail.
Worth knowing: if your household also qualifies for Medi-Cal, a Medigap plan may not be the most cost-effective option. See our dual eligibility guide before comparing Plan G and Plan N premiums.
If you're helping a Spanish-speaking parent or family member compare these same two plans, our sister site Beneficios Medicare covers Plan G and Plan N in Spanish.
Not sure which Medigap plan fits your situation?
A licensed Medicare specialist can pull real quotes for both plans in your county and walk through the numbers with you, at no cost.
Schedule a Free Plan ReviewFrequently Asked Questions
What is the main difference between Medigap Plan G and Plan N?
Plan G covers nearly all out-of-pocket costs except the Part B deductible. Plan N has a lower premium but adds small copays for office and ER visits and doesn't cover Part B excess charges.
What are Part B excess charges and why do they matter for Plan N?
They're the extra amount a doctor can bill, up to 15% above the Medicare-approved rate, if they don't accept assignment. Plan G covers this, Plan N doesn't. Most California providers accept assignment, but it's worth confirming.
Is Plan N cheaper than Plan G overall?
Usually the premium is lower, often by $20 to $50 a month, but whether it's cheaper overall depends on how often you use care, since those visits carry copays under Plan N.
Can I switch from Plan G to Plan N in California, or the other way around?
Yes, though outside your initial enrollment window it typically requires medical underwriting, unless you qualify for California's birthday rule, which allows a guaranteed-issue switch within 60 days of your birthday.
Does Medigap Plan G or Plan N cover prescription drugs?
No. Neither plan includes drug coverage. You'll need a separate stand-alone Part D plan alongside either option.
One More Thought
There's no universally "right" answer between Plan G and Plan N. It's a trade-off between paying a bit more every month for predictability, or paying less every month and covering small copays as they come up. Running the actual numbers for your county and your typical care usage is the only way to know which one truly saves you money over a full year.