Guide · Medigap

Medigap Plan G vs Plan N in New York

Almost everyone who chooses a Medicare Supplement in New York ends up deciding between Plan G and Plan N. They cover nearly the same things. The difference is a handful of small copays in exchange for a meaningfully lower premium — and in New York, one of the usual reasons to avoid Plan N doesn't apply.

In short

Plan G and Plan N cover nearly the same things. Plan N costs less in exchange for a copay of up to $20 at office visits and up to $50 at the emergency room, and it doesn't cover Part B excess charges. In New York that last gap barely matters, because state law caps what doctors can bill above the Medicare-approved amount at 5% for most services. So the choice usually comes down to how often you see doctors against the premium difference; heavy users tend to prefer G, light users N, and New York lets you switch between them in any month with no health questions.

What the two plans cover

BenefitPlan GPlan N
Part A hospital deductible & coinsuranceCoveredCovered
Skilled nursing facility coinsuranceCoveredCovered
Part B 20% coinsuranceCoveredCovered, except copays below
Office visit$0Up to $20 copay
Emergency room (not admitted)$0Up to $50 copay
Part B deductibleYou payYou pay
Part B excess chargesCoveredNot covered
Foreign travel emergency80% after a $250 deductible, first 60 days of a trip, $50,000 lifetime limitSame: 80% after $250, first 60 days, $50,000 lifetime

That's the whole difference: two small copays and excess charges. Everything else — the hospital, the surgery, the chemotherapy, the rehab stay — is covered identically.

Why the answer is different in New York

1. Excess charges are capped at 5% here

Nationally, the argument against Plan N is "what if a specialist doesn't accept assignment and bills 15% more?" New York is one of a handful of states that restricts excess charges: Public Health Law §19 limits physicians to 5% above the Medicare-approved amount for most services, against the federal 15%. Unless you regularly see doctors out of state, the excess-charge risk that scares people off Plan N elsewhere is, in New York, small and capped.

2. Community rating makes the premium gap matter more

New York Medigap premiums are community-rated — everyone on a plan pays the same regardless of age. That pushes premiums at 65 higher than in age-rated states, so the dollar gap between G and N is larger here, and the savings from choosing N are correspondingly bigger.

3. You can change your mind

New York's year-round guaranteed issue means you're never stuck. If you pick N and find yourself at the doctor every two weeks, you can move to G next month. In most states that door closes after your first six months on Part B.

Rule of thumb

Count your office visits

Divide the annual premium difference between G and N by $20. If you have fewer office visits than that number in a typical year, Plan N is cheaper for you — often by a wide margin. If you have more, or you'd rather have as few bills as possible, Plan G.

Who tends to pick which

  • Plan G — people with a chronic condition and frequent specialist visits; people who split time in states that allow excess charges; people who want the fewest possible bills and are happy to pay for it.
  • Plan N — people in good health who see a doctor a few times a year; budget-conscious buyers who still want provider freedom; couples where the lower earner's premium matters.
  • High-deductible G — the financially comfortable who want catastrophic cover at the lowest premium and can absorb the deductible.

What both plans don't do

  • Cover prescription drugs — you need a separate Part D plan.
  • Cover routine dental, vision or hearing.
  • Cover the Part B deductible (Plan F does, but only for people eligible before 2020).

Getting quotes

Because the plans are standardised (Medigap plans in New York lays out every letter side by side), shopping is about premium and the carrier's rate history. I compare the carriers I'm appointed with for both G and N at your ZIP code, alongside a Part D comparison for your actual prescriptions. Request Medigap quotes — and if you're weighing a Supplement against Medicare Advantage, the Medigap in New York page covers that decision.

We do not offer every plan available in your area. Currently we represent 10 organizations which offer 81 products in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (TTY 1-877-486-2048) is available 24 hours a day, 7 days a week. Insurers' legal names and home offices: carriers page.

Questions

Common questions

Short answers to what people ask before they call.

Still have a question? Call (518) 902-8822 or book a call.

What's the actual difference between Plan G and Plan N?

Both cover the Part A deductible, hospital and skilled-nursing coinsurance, the Part B 20% coinsurance, blood and foreign travel emergencies. Plan N adds a copay of up to $20 at office visits and up to $50 at the emergency room (waived if you're admitted), and does not cover Part B excess charges. Neither covers the Part B deductible.

What are Part B excess charges, and do they exist in New York?

An excess charge is the extra up to 15% a doctor who doesn't accept Medicare assignment can bill above Medicare's approved amount. New York Public Health Law §19 caps what physicians may charge Medicare patients at 5% above the Medicare-approved amount for most services (a few office and home visits may go to the federal 15%), so the excess-charge risk Plan N carries in other states is small here — not zero. Out-of-state care is the exception.

How much cheaper is Plan N?

It varies by carrier. In the DFS table in effect October 1, 2026 for the Albany region, the gap between a company's Plan G and its Plan N runs from under $10 a month to about $250, and at one carrier Plan N costs slightly more than Plan G (for example $384.00 against $375.00 at one carrier, $601.17 against $426.20 at another). When the gap is small, Plan N saves little; when it is large, a year of savings is usually more than you'd pay in office-visit copays unless you see doctors very frequently. I'll quote both side by side for your ZIP code.

Can I switch from G to N, or N to G, later?

In New York, yes — any month, with no health questions, because Medigap is guaranteed-issue year-round here. Start with the one that fits your budget and expected usage; you're not locked in.

What about high-deductible Plan G?

It's Plan G with a yearly deductible ($2,950 in 2026, indexed annually) before the plan pays, in exchange for a much lower premium. Medicare still pays its share first; you cover the cost-sharing until the deductible is met. It suits people who want catastrophic protection and can absorb a couple of thousand dollars in a bad year. Not everyone offers it in New York; I'll tell you who does.

Get Plan G and Plan N quoted for your ZIP

Same standardized plans, different premiums by carrier. I'll show both from the carriers I represent, with their rate history.

Quick replyUsually within 30 minutes during office hours

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