Medigap Plan G vs. Plan N vs. Medicare Advantage — Full Comparison (2026)
| Feature | Medigap Plan G | Medigap Plan N | Medicare Advantage |
|---|---|---|---|
| Monthly Premium (avg.) | $150–$300/mo | $100–$200/mo | $0–$50/mo (above Part B) |
| Out-of-Pocket Maximum | No limit needed — nearly all costs covered | Very low — only $20/$50 copays | $9,350 in-network (2025) |
| Part B Deductible ($257/yr) | NOT covered (you pay $257) | NOT covered | Varies by plan |
| Doctor Visit Copays | $0 | $20 per visit | Varies (typically $0–$35) |
| Emergency Room Copay | $0 | $50 (waived if admitted) | Typically $90–$120 |
| Provider Network | Any Medicare provider nationwide | Any Medicare provider nationwide | Restricted network; HMO or PPO |
| Prior Authorization Required | No | No | Yes — for many services |
| Dental/Vision/Hearing | Not included | Not included | Often included |
| Part D Drug Coverage | Separate Part D plan needed | Separate Part D plan needed | Usually bundled |
| Best For | Frequent healthcare users; travelers; those wanting zero surprises | Relatively healthy retirees; moderate healthcare use | Healthy retirees; budget-conscious; prefer bundled benefits |
Annual Cost Comparison at Different Healthcare Usage Levels
| Healthcare Usage | Plan G Annual Cost | Plan N Annual Cost | Medicare Advantage Cost |
|---|---|---|---|
| Minimal (2-3 doctor visits/yr, no hospitalizations) | $2,657–$3,857 | $1,457–$2,657 | $600–$1,800 |
| Moderate (6-10 visits, 1 minor procedure) | $2,657–$3,857 | $1,697–$2,897 | $1,200–$4,000 |
| High (multiple specialists, 1 hospitalization) | $2,657–$3,857 | $2,057–$3,257 | $3,000–$9,350+ |
Estimates based on CMS 2025 cost-sharing data. Plan G/N costs include premium + Part B deductible. Medicare Advantage includes premium + copays. Individual plans vary by insurer and state.
💡 The counterintuitive math: Medigap's higher premium can make it cheaper at moderate and high healthcare usage levels than Medicare Advantage, because Medigap's predictable costs replace uncertain out-of-pocket exposure. The break-even point for Plan G vs. Medicare Advantage is typically 2–4 hospitalizations or specialty procedures per year.
Critical Medigap Enrollment Rules — Don't Miss Your Window
⚠️ The most important Medicare decision: You have a one-time 6-month Medigap Open Enrollment Period that begins the month you turn 65 AND are enrolled in Medicare Part B. During this window, insurers MUST offer you any Medigap plan at standard rates regardless of health status. After this window closes, in most states, insurers can use medical underwriting — meaning they can charge you more or deny coverage entirely based on pre-existing conditions.
- Apply for Medicare 3 months before turning 65 — Medicare Part A and Part B eligibility begins at 65
- Choose Medigap plan during the 6-month open enrollment period — guaranteed issue rights; no medical underwriting
- Add a separate Part D drug plan if choosing Medigap (drug coverage not bundled)
- Add dental/vision separately — standalone dental insurance runs $20–$50/month
- Review annually during Medicare Annual Enrollment Period (Oct 15–Dec 7) — can switch Medicare Advantage plans or Part D drug plans
Frequently Asked Questions
- Centers for Medicare & Medicaid Services (CMS), Medicare 2025 Costs and Coverage (Medicare.gov)
- KFF, Medicare at a Glance 2025; KFF Medigap Enrollment Data
- Fidelity Investments, Retiree Health Care Cost Estimate 2024 ($413,000 estimate for couple)
- Genworth/CareScout, Cost of Care Survey 2024
- HHS/ACL, Long-Term Care Statistics
- Plootus Research 2026
