Medigap Plans F, G and N: Which One Actually Fits Your Budget?

If you are enrolled in Original Medicare — Parts A and B — and you have ever faced a hospital bill, you already know that Medicare does not pay 100% of your costs. The program leaves beneficiaries responsible for a Part A deductible of $1,676 per benefit period in 2025, a Part B deductible of $257 per year, and 20% coinsurance on most outpatient services with no annual cap. That unlimited 20% exposure is the reason most financial advisors recommend a Medicare Supplement, or Medigap, policy. Among the ten standardized Medigap plan types sold in most states, Plans F, G, and N account for the overwhelming majority of enrollees — and choosing among them is one of the most consequential financial decisions a Medicare beneficiary can make.

Plan F is the most comprehensive Medigap policy ever designed. It covers the Part A deductible, the Part B deductible, Part A coinsurance and hospital costs, Part B coinsurance and copays, the first three pints of blood, Part A hospice coinsurance, skilled nursing facility coinsurance, and 80% of foreign travel emergency costs (after a $250 deductible, up to a $50,000 lifetime limit). In practical terms, a beneficiary on Plan F typically pays nothing out of pocket beyond the monthly premium for Medicare-covered services. That near-zero cost-sharing is enormously appealing, but Congress closed Plan F to new enrollees as part of the Medicare Access and CHIP Reauthorization Act of 2015. Anyone whose Medicare Part B eligibility began on or after January 1, 2020 cannot purchase Plan F. If you turned 65 before 2020 or had Medicare due to disability before that date, you may still be able to enroll — but you will pay a premium that reflects an older, sicker risk pool, since no younger beneficiaries are entering the plan. Average Plan F premiums nationally ran between $180 and $280 per month in 2025 depending on age, gender, tobacco use, and state of residence, though rates in high-cost states like New York or Florida can exceed $350 for beneficiaries in their mid-70s.

Plan G has effectively replaced Plan F as the gold-standard comprehensive option for the majority of new Medigap shoppers. The only difference between G and F is that Plan G does not cover the annual Part B deductible — $257 in 2025. Once you pay that deductible yourself each January, Plan G covers everything else that Plan F covers. The math is straightforward: if the premium difference between a Plan F and a Plan G policy from the same insurer is more than $257 per year (roughly $21.42 per month), Plan G saves you money. In most markets, that spread is considerably larger than $21 per month, which is why Plan G has grown into the most widely sold comprehensive Medigap plan. Average Plan G premiums nationally ranged from roughly $120 to $200 per month in 2025 for a 65-year-old non-tobacco user, though rates vary significantly by insurer pricing method. Insurers use one of three approaches: community rating (everyone pays the same regardless of age), issue-age rating (your premium is locked to your age at enrollment and rises only with inflation), or attained-age rating (premiums increase as you get older). Over a 20-year retirement, the pricing method can matter as much as the initial premium — an attained-age policy that looks cheap at 65 may cost far more at 80.

Plan N occupies a different position in the market. It covers the same hospital and skilled nursing benefits as Plan G, but it does not cover the Part B deductible, it does not cover Part B excess charges (the amount a doctor who does not accept Medicare assignment can charge above the Medicare-approved rate, up to 15%), and it requires cost-sharing at the point of service: up to a $20 copay for office visits and up to a $50 copay for emergency room visits that do not result in an inpatient admission. In exchange for accepting that cost-sharing, beneficiaries typically pay premiums that are $30 to $60 per month lower than comparable Plan G policies. For a healthy 65-year-old who sees a primary care physician a few times a year and rarely visits specialists, Plan N can produce meaningful annual savings. But for someone managing multiple chronic conditions who sees several specialists monthly, those $20 copays can accumulate quickly — 20 specialist visits per year at $20 each equals $400 in copays, which may erase much of the premium savings. The excess charge exposure is also worth taking seriously: if you live in a state that does not ban excess charges and you value seeing any doctor you choose, Plan G's broader protection may be worth the higher premium.

The enrollment timing for Medigap is as important as the plan choice itself. Your Medigap Open Enrollment Period — the six-month window that begins the month you are both 65 or older and enrolled in Medicare Part B — is the single most valuable consumer protection in the Medigap market. During this window, insurers must sell you any plan they offer at standard rates regardless of your health history. Pre-existing conditions cannot be used to deny coverage or raise your premium. Once that window closes, most states allow insurers to use medical underwriting, meaning a history of heart disease, diabetes, cancer, or even sleep apnea can result in a higher premium or an outright denial. If you missed your open enrollment window, you may still have guaranteed issue rights in specific circumstances — for example, if your Medicare Advantage plan is leaving your area, if you lose employer coverage, or if you move out of your plan's service area. These Special Enrollment Periods are narrow and time-sensitive, typically lasting 63 days from the triggering event.

A smaller group of states have enacted additional consumer protections worth knowing. Thirteen states — California, Idaho, Illinois, Kentucky, Louisiana, Maine, Maryland, Missouri, Nevada, New Jersey, New York, Oklahoma, and Oregon — have a birthday rule that gives Medigap enrollees a 30-day window each year around their birthday to switch to an equal or lesser plan from any insurer without medical underwriting. New York and Connecticut go further, requiring guaranteed issue year-round regardless of health status, which means residents of those states have far more flexibility to switch plans at any age. If you live in one of these states, you have options that beneficiaries in other states simply do not.

When comparing specific policies, do not rely on premium alone. Ask each insurer which pricing method they use — community, issue-age, or attained-age. Request the insurer's rate increase history for the past five years; a company with a pattern of 8% to 12% annual increases may look cheap today but become unaffordable by your mid-70s. Check the insurer's financial strength rating through AM Best or Standard & Poor's — you want a company rated A or better, since Medigap policies are long-term commitments. Your State Health Insurance Assistance Program, known as SHIP, offers free, unbiased counseling from trained volunteers who can pull side-by-side premium comparisons for every insurer licensed in your state. To find your local SHIP office, visit shiphelp.org or call 1-800-MEDICARE. The Medicare Plan Finder tool at medicare.gov also allows you to compare Medigap premiums by zip code, though it does not display rate increase history, which is why speaking with a SHIP counselor adds real value.

One final consideration: if you are currently enrolled in Medicare Advantage and thinking about switching to Original Medicare plus a Medigap plan, be aware that the transition carries underwriting risk in most states. Leaving Medicare Advantage during the Annual Enrollment Period (October 15 through December 7) or the Medicare Advantage Open Enrollment Period (January 1 through March 31) does not automatically grant you guaranteed issue rights for Medigap in most states. You would need to pass medical underwriting unless a specific guaranteed issue trigger applies to your situation. For beneficiaries in their late 60s or early 70s who are still in good health, making the switch while underwriting is favorable — and locking in an issue-age or community-rated Plan G — can provide decades of predictable, comprehensive coverage. Waiting until a serious diagnosis forces the issue may leave you with limited or expensive options.