Medigap Plans F, G, and N Compared: 2026 Costs & Coverage Guide

If you have Original Medicare — Parts A and B — you already know the coverage has real gaps. There's no cap on out-of-pocket costs, a Part A hospital deductible of $1,676 per benefit period in 2026, and a Part B deductible of $257 per year. Medigap policies, also called Medicare Supplement Insurance, exist specifically to fill those gaps. Among the ten standardized Medigap plan letters sold in most states, Plans F, G, and N together account for the overwhelming majority of enrollees nationwide. Understanding exactly what separates these three plans — in dollars and cents, not insurance-speak — is the most important financial decision many Medicare beneficiaries will make this year.

Plan F has long been considered the gold standard of Medigap coverage because it pays 100% of every Medicare-approved cost that Original Medicare doesn't cover. That means the Part A hospital deductible, the Part B deductible, Part B excess charges (when a doctor bills above Medicare's approved amount), skilled nursing facility coinsurance, foreign travel emergency coverage up to plan limits, and all Part A and Part B coinsurance and copays. You see a doctor, Medicare pays its share, Plan F pays the rest — you owe nothing out of pocket for covered services. The catch: Congress eliminated Plan F for 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 on or after that date, you cannot purchase Plan F. If you were already enrolled before that cutoff, you can keep your existing Plan F or still buy one in 2026.

For everyone who became Medicare-eligible in 2020 or later, Plan G is now the most comprehensive Medigap option available. Plan G covers everything Plan F covers with one single exception: it does not pay the Medicare Part B deductible, which is $257 in 2026. That's it. One difference. So the real question becomes whether the premium savings between Plan F and Plan G in your area exceed $257 per year. In most markets in 2026, Plan G premiums run $30 to $80 per month less than comparable Plan F premiums from the same insurer. At $50 per month in savings, you'd save $600 annually — and since you'd pay the $257 Part B deductible yourself, your net savings would be $343 per year. For most beneficiaries who are newly eligible, Plan G is the financially superior choice, and it's the plan that independent insurance counselors most frequently recommend as a starting point for comprehensive coverage.

Plan N takes a different approach entirely. It keeps premiums significantly lower than both F and G by shifting some cost-sharing back to you in the form of copayments. With Plan N in 2026, you'll pay up to $20 for each office visit and up to $50 for emergency room visits that don't result in an inpatient hospital admission. Plan N also does not cover Part B excess charges — meaning if your doctor doesn't accept Medicare assignment and bills above Medicare's approved rate, you're responsible for that difference, which can be up to 15% above the Medicare-approved amount. Plan N does cover the Part A deductible, skilled nursing facility coinsurance, and Part B coinsurance for most services, but it does not cover the Part B deductible either. The premium savings compared to Plan G can be substantial — often $40 to $100 per month less depending on your age, gender, location, and the insurer — which makes Plan N genuinely attractive for beneficiaries who are relatively healthy, see their primary care doctor a few times a year, and rarely use the emergency room.

Data Snapshot: According to CMS.gov data from the 2024 Medigap Enrollment and Crosswalk Report (the most recent year with complete figures), approximately 14.5 million Americans were enrolled in Medigap policies. Plan G had surpassed Plan F as the most popular Medigap plan by enrollment, reflecting the 2020 eligibility cutoff that has steadily shifted new buyers toward G. Plan N ranked third in total enrollment nationally. CMS data also shows that the average monthly premium for a 65-year-old female non-smoker purchasing Plan G ranged from roughly $100 to $200 per month depending on state and insurer, with significant variation driven by the rating method insurers use — community-rated, issue-age-rated, or attained-age-rated policies can produce dramatically different long-term cost trajectories for the same beneficiary.

That rating method distinction matters enormously and is one of the most overlooked factors when people shop for Medigap. With attained-age rating — the most common method — your premium starts lower but increases as you get older, often rising faster than inflation. With issue-age rating, your premium is based on how old you are when you first buy the policy and increases only for inflation and claims experience, not your age. Community-rated policies charge everyone in a geographic area the same premium regardless of age. If you're 65 and buying a Plan G today, an attained-age policy might look cheapest now but could cost significantly more by the time you're 75 or 80. Asking your insurer or broker which rating method applies to a policy you're considering is not optional — it's essential.

When is the best time to buy a Medigap policy? Your Medigap Open Enrollment Period begins the first month you are both 65 or older and enrolled in Medicare Part B, and it lasts exactly six months. 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 charge you more because of pre-existing conditions, and they cannot deny you coverage. Once that six-month window closes, you lose federal guaranteed issue rights in most states, and insurers can use medical underwriting — meaning they can reject your application or charge you higher premiums based on your health. This makes your initial Medigap Open Enrollment Period the single most important window for locking in coverage, and choosing the right plan letter during that window deserves serious research.

If you missed your initial open enrollment window and want to switch Medigap plans now, your options depend heavily on where you live. Thirteen states have enacted what's commonly called the birthday rule, which gives you a 30-day window each year around your birthday to switch to a Medigap plan with equal or lesser benefits without medical underwriting. Those states are California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, and Oregon. New York and Connecticut go further, requiring insurers to offer guaranteed issue Medigap coverage year-round regardless of health status. If you live in one of these states and have been hesitant to switch plans because you feared being denied, your birthday window may be the opportunity you've been waiting for. If you live outside these states and don't have a qualifying Special Enrollment Period — such as losing employer coverage or your current insurer leaving the market — switching Medigap plans typically requires passing medical underwriting.

Choosing between Plans F, G, and N ultimately comes down to three factors: your eligibility, your health utilization patterns, and your financial risk tolerance. If you became Medicare-eligible before 2020 and currently have Plan F, the question is whether switching to Plan G makes sense. Run the math: take your current Plan F premium, subtract what a Plan G from the same or a competing insurer would cost, and compare that monthly savings to the $257 Part B deductible you'd now pay yourself. If the savings exceed $257 annually — and they often do — switching to Plan G may reduce your total annual spending. If you're newly eligible and want maximum coverage with no copays or surprise bills, Plan G is the clear choice. If you're in good health, see doctors infrequently, and want to keep monthly premiums as low as possible while still having solid hospital coverage, Plan N deserves serious consideration — just make sure your doctors accept Medicare assignment so you're not exposed to excess charges.

One practical step that many beneficiaries skip: use Medicare's official Plan Finder tool at Medicare.gov to compare Medigap premiums from multiple insurers in your ZIP code. Premiums for identical plan letters can vary by 40% or more between insurers for the same beneficiary, because the benefits are standardized by law but the prices are not. A Plan G from Insurer A and a Plan G from Insurer B cover exactly the same services — the only difference is price, financial stability of the insurer, and customer service reputation. Your State Health Insurance Assistance Program, known as SHIP, offers free, unbiased counseling from trained volunteers who can walk you through plan comparisons without trying to sell you anything. You can find your local SHIP contact through Medicare.gov or by calling 1-800-MEDICARE. These counselors can also help you understand whether your state has any additional Medigap protections beyond federal minimums, which can significantly affect your options if you're considering switching plans outside of your initial open enrollment window.