Medicare Supplement Plan N is a Medigap policy that pays most of what Original Medicare leaves you, at a lower monthly premium than Plan G. In exchange, you pay up to $20 for some office visits, up to $50 for an emergency room visit when you are not admitted, the Part B deductible ($283 in 2026), and any Part B excess charges. In Iowa's official rate guide (premiums effective October 1, 2026), the middle Plan N price for a 65-year-old man was about $147 a month, and Plan G cost about $59 a month more at the same company. Plan N usually comes out ahead unless you see doctors very often or use providers who charge excess charges.
This page covers Plan N on its own: what it pays, what it costs, and the math for deciding whether it beats Plan G for you. For every Medigap letter side by side, see our Medicare Supplement Plans 2027 comparison chart. For Plan G prices in detail, see our Plan G cost guide.
What Medicare Supplement Plan N Covers
Medigap plans are standardized by federal law. A Plan N from one insurer has exactly the same benefits as a Plan N from any other insurer, in every state except Massachusetts, Minnesota and Wisconsin, which standardize their plans differently. Only the price, the service and the company's rate history differ.
| Cost Original Medicare leaves you | Plan N | Plan G | 2026 amount (CMS) |
|---|
| Part A hospital deductible, per benefit period | Pays 100% | Pays 100% | $1,736 |
| Hospital coinsurance, days 61 to 90 | Pays 100% | Pays 100% | $434 a day |
| 365 extra hospital days after Medicare runs out | Pays 100% | Pays 100% | Not applicable |
| Skilled nursing facility coinsurance, days 21 to 100 | Pays 100% | Pays 100% | $217 a day |
| Part B coinsurance (usually 20%) | Pays 100%, minus the copays below | Pays 100% | Varies |
| Office visit copay | You pay up to $20 | $0 | Not applicable |
| ER copay (waived if admitted as an inpatient) | You pay up to $50 | $0 | Not applicable |
| Part B excess charges (up to 15% over Medicare's rate) | Not covered | Pays 100% | Varies by provider |
| Part B deductible | Not covered | Not covered | $283 |
| Blood (first 3 pints), hospice coinsurance | Pays 100% | Pays 100% | Varies |
| Foreign travel emergency | 80% after $250, up to $50,000 lifetime | Same | Not applicable |
Sources: Medicare.gov "Compare Medigap plan benefits" chart; CMS fact sheet "2026 Medicare Parts A & B Premiums and Deductibles" (November 14, 2025).
Two details on the copays matter. First, each one is "up to": the Iowa Insurance Division's guide describes it as the lesser of $20 (or $50) and the Part B coinsurance you would otherwise owe, so a cheap visit can cost less than $20. Second, the $20 applies to office visits with specialists too, not only your primary doctor.
What Plan N does not cover
Like every Medigap plan sold today, Plan N does not pay for:
- Prescription drugs. You need a separate Part D plan. For 2027, the Part D out-of-pocket cap on covered drugs is $2,400, up from $2,100 in 2026.
- Your Part B premium. You pay Medicare's premium ($202.90 a month in 2026) on top of the Plan N premium.
- Routine dental, vision, hearing aids or long-term custodial care.
Plan N Cost by Age: An Official State Example
National "average Plan N cost" figures vary widely from site to site and rarely show their data. So we used a public source: the Iowa Medicare Supplement & Premium Comparison Guide, published by the Iowa Insurance Division's Senior Health Insurance Information Program (SHIIP), with premiums effective October 1, 2026. Of the 31 insurers it lists, 27 sell Plan N. We pulled the Plan N column for each and found the lowest, middle and highest price at each age.
| Age | Lowest Plan N | Median Plan N | Highest Plan N | Median per year |
|---|
| 65 | $113 a month | $147 a month | $248 a month | $1,762 |
| 70 | $120 a month | $169 a month | $321 a month | $2,028 |
| 75 | $141 a month | $206 a month | $364 a month | $2,468 |
| 80 | $165 a month | $251 a month | $390 a month | $3,009 |
Monthly figures are the guide's annual premiums divided by 12 and rounded.
Read these numbers with care:
- They are rates for men. The guide notes that most insurers charge women less.
- They are best-case rates. They assume you buy during your Medigap open enrollment period or with a guaranteed issue right. Apply later with health problems and you may pay more or be turned down.
- They are Iowa prices. Your state, ZIP code, tobacco use and household discounts all change the number.
- They rise with age. Most Iowa insurers use attained-age pricing, so the median Plan N premium at 80 is about 71% higher than at 65. No insurer can promise your premium will stay the same, whatever its pricing method.
These figures show how Plan N pricing behaves. They are not a quote.
How Much Cheaper Plan N Is Than Plan G
The fairest comparison is the same company's Plan G and Plan N, since that removes differences between insurers. All 27 Iowa companies that sell Plan N also sell Plan G, and Plan N was cheaper at every one of them.
| Age | Median extra cost of Plan G per year | Per month | Smallest gap found | Largest gap found |
|---|
| 65 | $703 | about $59 | $200 a year | $1,511 a year |
| 70 | $719 | about $60 | $228 a year | $1,411 a year |
| 75 | $779 | about $65 | $119 a year | $2,681 a year |
| 80 | $916 | about $76 | $247 a year | $2,022 a year |
Source: our calculation from the Iowa SHIIP guide, premiums effective October 1, 2026.
That gap is the number to beat. Plan N's extra costs (copays and excess charges) have to add up to more than the premium you save before Plan G becomes the better deal. The Part B deductible does not enter the math, because neither plan pays it.
Break-Even Math: When Plan N Beats Plan G
Take a 65-year-old at an insurer with the median gap: Plan G costs $703 more per year. Here is what Plan N's copays add up to in three typical years.
| Your year | Plan N copays and excess charges | Premium saved with Plan N | Better deal |
|---|
| Light use: 4 office visits, no ER | $80 | $703 | Plan N, by about $623 |
| Moderate: 12 office visits, 1 ER visit, not admitted | $290 | $703 | Plan N, by about $413 |
| Heavy: 30 office visits, 2 ER visits, $300 in excess charges | $1,000 | $703 | Plan G, by about $297 |
These are worst-case copay totals. A visit that falls inside your Part B deductible costs you the same under either plan, and a visit whose coinsurance is under $20 costs less than $20.
The simple rule from the median gap:
- Office visits alone: $703 divided by $20 is about 35 copays a year before Plan G pays off. Few people in reasonable health come close.
- At the smallest gap ($200 a year): about 10 office visits gets you to break-even. If your insurer prices Plan G and N close together, Plan G gets more attractive.
- One hospital admission changes nothing. The $50 ER copay is waived when you are admitted as an inpatient, and Plan N pays the Part A deductible in full, same as Plan G.
Run this with your own quotes. Subtract the Plan N premium from the Plan G premium at the same company, then compare that number with your honest estimate of yearly office visits times $20, plus ER visits times $50.
Excess Charges: Plan N's Real Risk
The copays are small and predictable. Excess charges are the part of Plan N that can surprise you.
A doctor who does not accept Medicare assignment can bill you up to 15% more than the Medicare-approved amount for most services. That extra amount is the excess charge. Plan G pays it. Plan N does not.
An example: Medicare approves $1,000 for an outpatient procedure. A non-assigning surgeon bills the maximum, $1,150. Under Plan N, you owe the $150 difference. Under Plan G, you owe nothing beyond the Part B deductible.
How to keep this from costing you:
- Ask before you book: "Do you accept Medicare assignment?" Most doctors do. Doctors who accept assignment cannot bill excess charges.
- Check your state. A few states ban or limit excess charges for their residents. Lists commonly name New York, Pennsylvania, Massachusetts, Connecticut, Ohio, Minnesota, Rhode Island and Vermont. Confirm with your State Health Insurance Assistance Program (SHIP), and know that protection usually stops at the state line.
- Think about where you will get care. If you travel for treatment at a large out-of-state medical center, or your specialists are in a market where non-assigning doctors are common, Plan G's excess charge coverage is worth more.
Who Plan N Fits, and Who Should Lean Toward Plan G
Plan N tends to fit people who:
- See a doctor a handful of times a year and want to keep monthly costs down
- Use doctors who accept Medicare assignment, or live in a state that limits excess charges
- Want full protection against big hospital and surgery bills without paying for first-dollar office coverage
Plan G tends to fit people who:
- Have a chronic condition with frequent specialist visits
- Want no copays at all and the same bill every month
- Live where Plan G costs only slightly more than Plan N at the same company
A third option: high-deductible Plan G has a $3,050 deductible in 2027 (up from $2,950 in 2026), set by CMS, and very low premiums. It suits people who can cover that amount in a bad year and want the lowest premium. Our comparison chart compares it with Plan N.
Medigap is not the only route either. Some people choose a Medicare Advantage plan instead. Our Medicare Advantage vs Medigap guide explains that trade-off.
How to Buy Plan N: Step by Step
- Enroll in Medicare Part A and Part B. You must have both to buy any Medigap plan.
- Mark your Medigap open enrollment period. It lasts 6 months and starts the first month you are 65 or older and have Part B. During it, an insurer must sell you any plan it offers at its best price, even with health problems.
- Get your state's rate guide. Many state insurance departments publish one, like Iowa's. Or use the Medigap tool on Medicare.gov and enter your ZIP code.
- Compare Plan N and Plan G at the same companies. Write down the yearly gap and run the break-even math above.
- Ask each insurer three questions: which pricing method it uses (attained-age, issue-age or community-rated), how much its Plan N rates rose in each of the last three years, and whether it offers a household discount.
- Add a Part D plan if you do not have other drug coverage. Plan N does not cover prescriptions.
- Get free, unbiased help. Your state's SHIP gives free one-on-one counseling and does not sell insurance. Find yours at shiphelp.org.
Timing: why this choice is hard to undo
Outside your open enrollment period or a guaranteed issue right, most states let insurers check your health before selling you a Medigap policy. That means moving from Plan N to Plan G later can cost more, or be refused, if your health changes. Some states give extra switching rights; your SHIP can tell you what applies where you live. Choose as if you will keep the plan for years.
2027 Figures: What Is Official and What Is Not
People buying Medigap now are buying coverage that runs into 2027. Here is the status of each figure on this page as of November 8, 2026.
| Figure | Status |
|---|
| Plan N copays: up to $20 office, up to $50 ER | Set by the federal plan standard, unchanged |
| High-deductible Plan G and F deductible, 2027 | $3,050, published by CMS |
| Part D out-of-pocket cap, 2027 | $2,400, published by CMS |
| 2027 Part B premium and deductible | Not yet published. CMS usually announces them in mid-November. The 2026 figures ($202.90 and $283) apply through December 31, 2026 |
| 2027 Part A deductible | Not yet published. $1,736 is the 2026 figure |
We will not estimate the 2027 Part B numbers before CMS publishes them. For the latest status, see our Medicare costs 2027 page.
CoveredUSA also has a side-by-side Medigap Plan G vs Plan N comparison.
Frequently Asked Questions
How much does Medicare Supplement Plan N cost per month?
It depends on your state, age, sex, tobacco use and insurer. In Iowa's official guide (premiums effective October 1, 2026), Plan N for a 65-year-old man ran from about $113 to $248 a month, with a median of about $147. Prices rise with age at most companies. Get quotes for your own ZIP code before budgeting.
What are the Plan N copays?
Up to $20 for some office visits, including specialist visits, and up to $50 for an emergency room visit that does not lead to an inpatient admission. If you are admitted, the $50 is waived.
Does Plan N cover the Part B deductible?
No. You pay the Part B deductible yourself, which is $283 in 2026. Plan G does not cover it either. Only Plans C and F do, and those are closed to anyone who first became eligible for Medicare on or after January 1, 2020.
Does Plan N cover excess charges?
No. If a doctor does not accept Medicare assignment and bills up to 15% over the Medicare-approved amount, you pay that difference. Plans F and G cover excess charges. Asking whether a doctor accepts assignment avoids most of this risk.
Is Plan N better than Plan G?
For people with light to moderate doctor use, Plan N often costs less overall. In the Iowa data, Plan G cost a median of $703 more per year at 65, which is about 35 office copays. Plan G wins for heavy users, for people who face excess charges, and where the two plans are priced close together.
Can I switch from Plan N to Plan G later?
You can apply, but outside your Medigap open enrollment period or a guaranteed issue right, most insurers can review your health and charge more or decline you. Some states have extra switching rules. Check with your SHIP before you count on switching.
Can I get Plan N if I am under 65 and on disability?
Federal law does not require insurers to sell Medigap to people under 65. Some states do require it, and the price and plan choices vary. Ask your state insurance department or SHIP.
Does Plan N work with any doctor?
Yes. Standard Plan N works with any doctor or hospital in the country that accepts Medicare, with no network. Some insurers sell a Medicare SELECT version with a network at a lower price, so check which version you are buying.
Will Plan N premiums go up in 2027?
Premiums can rise at any time an insurer's new rates are approved, and attained-age policies also go up as you get older. No company can promise your rate will stay the same. Ask each insurer for its rate increase history before you buy.
