Medigap Plan F vs. Plan G: Which One Saves You More?

If you've been comparing Medigap plans and keep landing on the same two options — Plan F and Plan G — you're not alone. These are the two most comprehensive Medicare Supplement plans available, and for good reason: both cover nearly everything Medicare doesn't, leaving you with very little out-of-pocket exposure when you need medical care. But the choice between them isn't as simple as picking the one with more coverage. For most people shopping today, the math actually favors Plan G, and understanding why requires looking at both the premium difference and a key eligibility rule that took effect in 2020.

Let's start with who can even choose Plan F. Congress passed the Medicare Access and CHIP Reauthorization Act (MACRA) back in 2015, and one of its provisions banned the sale of first-dollar coverage Medigap plans — meaning plans that pay your Medicare Part B deductible — to newly eligible Medicare beneficiaries starting January 1, 2020. If you turned 65 on or after that date, or became eligible for Medicare due to disability after that date, Plan F is simply not available to you. Insurance companies are legally prohibited from selling it to you. Plan G becomes your most comprehensive option, and for the vast majority of people enrolling in Medicare today, that's where the comparison ends — Plan G wins by default.

However, if you became eligible for Medicare before January 1, 2020, you may still be able to purchase Plan F, and you may already have it. Millions of beneficiaries are currently enrolled in Plan F, and if it's working for them financially, there's no automatic reason to switch. But here's the concern that financial advisors and Medicare counselors raise repeatedly: because Plan F is a closed risk pool — no new, younger, healthier enrollees are joining — premiums for Plan F have been rising faster than those for Plan G in many states. Insurers are covering an aging, higher-utilization group, and those costs get passed along. That trend is expected to continue, which is why even current Plan F holders are increasingly being advised to run the numbers on switching to Plan G.

So what exactly is the difference in coverage? It comes down to one single item: the Medicare Part B deductible. In 2025, that deductible is $257 per year. Plan F pays that $257 for you. Plan G does not — you pay it yourself, once per calendar year, before Plan G kicks in for outpatient services. That's it. Everything else these two plans cover is identical. Both cover Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted. Both cover Part A deductible (which is $1,676 per benefit period in 2025). Both cover Part A hospice care coinsurance or copayments. Both cover skilled nursing facility care coinsurance. Both cover Part B coinsurance or copayments after that deductible. Both cover the first three pints of blood. And both cover foreign travel emergency care up to plan limits, typically 80% after a $250 deductible up to a $50,000 lifetime maximum.

Now here's where the math gets interesting. If Plan F costs you $180 per month and a comparable Plan G from the same insurer costs $130 per month, you're paying $600 more per year for Plan F. But Plan F only saves you $257 — the Part B deductible. That means you're paying $343 more per year than you need to. Even if you use outpatient services every single month of the year, you only owe that $257 deductible once. After that, Plan G covers everything Plan F covers. The premium savings from Plan G typically outweigh the deductible cost in most real-world scenarios, particularly for beneficiaries in good to moderate health. The break-even point only shifts if Plan G premiums in your area are priced unusually close to Plan F premiums — which does happen in some markets — so it's worth getting actual quotes side by side.

Premium differences between Plan F and Plan G vary significantly by state, insurer, age, and tobacco use status. In states like Florida and Texas, the monthly premium gap between Plan F and Plan G from the same carrier can be $80 to $120 or more for a 70-year-old non-smoker. In states with more regulated Medigap markets, like New York and Massachusetts, the gap may be smaller, but the direction of the math usually still favors Plan G. Massachusetts and Minnesota use their own standardized Medigap plan structures rather than the federal lettered system, so beneficiaries in those states should compare their state's equivalent plans directly. Wisconsin also has its own Medigap structure. In all other states, the federal standardized plans apply, and Plan G is the top-tier option for anyone who aged into Medicare after 2020.

One important nuance: there is also a high-deductible version of both Plan F and Plan G. High-deductible Plan G, in particular, has grown in popularity. In 2025, the high-deductible Plan G requires you to pay the first $2,870 in Medicare-covered costs before the plan begins paying. In exchange, monthly premiums can be dramatically lower — sometimes $40 to $70 per month compared to $130 to $200 or more for standard Plan G, depending on your state and age. High-deductible Plan G can make sense for beneficiaries who are relatively healthy, want catastrophic protection against a major illness or hospitalization, and are comfortable managing smaller out-of-pocket costs throughout the year. It functions somewhat like a high-deductible health plan in the employer market — lower monthly cost, higher exposure before coverage kicks in.

Enrollment timing matters enormously with Medigap. Unlike Medicare Advantage, Medigap plans don't have a universal annual enrollment window. Your most protected window is the six-month Medigap Open Enrollment Period that begins the month you turn 65 and are enrolled in Medicare Part B. During this window, insurers must sell you any Medigap plan they offer in your state at standard rates, regardless of your health history. They cannot deny you coverage or charge you more because of pre-existing conditions. Once that window closes, you're subject to medical underwriting in most states — meaning insurers can review your health history, charge you higher premiums, or deny coverage altogether based on conditions like diabetes, heart disease, or prior cancer treatment.

If you missed your initial open enrollment window, you may still have options through a Special Enrollment Period. Qualifying events include losing employer-sponsored coverage, your Medicare Advantage plan leaving your service area, or moving out of your plan's coverage area. These SEPs give you a guaranteed-issue right to purchase a Medigap plan without underwriting, but they're time-limited — typically 63 days from the triggering event — so acting quickly is essential.

For beneficiaries in certain states, there's an additional protection worth knowing: the birthday rule. If you live in California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, or Oregon, you have a 30-day window each year around your birthday to switch to a Medigap plan with equal or lesser benefits without medical underwriting. This means if you're currently on Plan F and want to switch to Plan G to capture the premium savings, your birthday window may give you a guaranteed path to do so — even if you have health conditions that would otherwise disqualify you under standard underwriting. New York goes further, offering guaranteed issue rights year-round. If you're in one of these states and haven't taken advantage of this protection, it's worth marking your calendar.

When comparing specific Plan G quotes, make sure you're comparing plans with the same pricing methodology. Medigap insurers use three different approaches: community-rated (everyone pays the same premium regardless of age), issue-age-rated (premium is based on your age when you buy the plan and doesn't increase as you age), and attained-age-rated (premium increases as you get older). Attained-age-rated plans often have the lowest initial premiums but can become significantly more expensive over time. Community-rated plans, available in states like New York and Connecticut, tend to be more expensive upfront but more predictable long-term. Understanding which pricing model applies to the plan you're considering is just as important as the current monthly premium.

If you're currently enrolled in Plan F and wondering whether to switch to Plan G, the calculation is straightforward: find out what Plan G costs from your current insurer and from competitors in your state, subtract the annual premium difference from $257, and see whether you come out ahead. If you're in a birthday rule state, check whether your birthday window gives you a guaranteed path to switch without underwriting. If you're subject to medical underwriting, weigh your current health status against the potential long-term premium trajectory of Plan F as its risk pool continues to age. A State Health Insurance Assistance Program (SHIP) counselor can walk you through this comparison at no cost — find your local SHIP office through the Medicare.gov website or by calling 1-800-MEDICARE. These counselors are not insurance agents and have no financial stake in which plan you choose, making them one of the most valuable and underused resources available to Medicare beneficiaries.