Medicare Supplement Plan Selection Guide 2026: G vs N vs High-Deductible
Quick Answer
For most new Medicare beneficiaries in 2026, Plan G is the best value — it covers everything except the $257 Part B deductible. Plan N costs less monthly but adds copays ($20 office visits, $50 ER) and doesn't cover Part B excess charges. High-Deductible Plan G has the lowest premiums but requires you to pay $2,870 out-of-pocket before coverage kicks in — best for healthy, wealthy beneficiaries who can self-insure the gap.
The 2026 Medicare Cost Landscape
Before choosing a supplement, understand what Medicare itself covers (and what it doesn't):
| Medicare Component | 2026 Cost | What It Covers |
|---|---|---|
| Part A (hospital) | $0 premium for most | Hospital stays, skilled nursing |
| Part B (medical) | $185/month | Doctor visits, outpatient |
| Part A deductible | $1,676 per benefit period | Hospital admission |
| Part B deductible | $257/year | Medical services |
| Part A coinsurance (day 61–90) | $419/day | Extended hospital stays |
| Skilled nursing coinsurance (day 21–100) | $209.50/day | Post-hospital rehab |
Without a supplement, a single serious hospitalization can cost $5,000–$15,000+ out of pocket. This is the gap Medigap fills.
Medigap Plan Comparison: G vs N vs HD-G
| Feature | Plan G | Plan N | HD Plan G |
|---|---|---|---|
| Part B deductible | NOT covered ($257) | NOT covered ($257) | NOT covered ($257) |
| Part A deductible | Covered | Covered | After deductible |
| Part B excess charges | Covered | NOT covered | After deductible |
| Office visit copay | $0 | Up to $20 | After deductible |
| ER copay | $0 | $50 (waived if admitted) | After deductible |
| Typical monthly premium (age 65) | $120–$180 | $90–$140 | $40–$70 |
| Annual deductible | None | None | $2,870 |
Plan G is best for: People who want comprehensive coverage and predictable out-of-pocket costs. The slight premium increase over N is usually worth eliminating copays for frequent healthcare users.
Plan N is best for: Relatively healthy beneficiaries who don't see specialists often and want lower monthly premiums. Risk: Part B excess charges if your doctors don't accept Medicare assignment.
High-Deductible G is best for: Healthy beneficiaries with significant savings who can absorb $2,870/year if needed. The premium savings ($80–$140/month) may exceed the expected annual claims for healthy individuals.
Common Mistakes (Do This, Not That)
❌ Mistake 1: Choosing Medicare Advantage instead of traditional Medicare + supplement without comparing all costs ✅ Fix: Medicare Advantage has lower premiums but higher out-of-pocket maximums ($8,850 in-network, $13,300 out-of-network for 2026). For people with significant health needs, Medigap often costs less total. Run the numbers for your specific situation.
❌ Mistake 2: Buying during open enrollment and choosing the cheapest plan without comparing insurer rate histories ✅ Fix: Premiums increase annually. Check an insurer's historical rate increases — some companies raise rates aggressively after year 1. Choose insurers with stable rate histories even if the initial premium is slightly higher.
❌ Mistake 3: Delaying enrollment past the 6-month Medigap open enrollment window ✅ Fix: For 6 months after enrolling in Part B, insurers must accept you regardless of health history (guaranteed issue). After this window, insurers can medically underwrite and deny coverage in most states.
❌ Mistake 4: Assuming Plan F is still available ✅ Fix: Plan F (which covers the Part B deductible) was eliminated for new Medicare enrollees after January 1, 2020. Plan G is now the most comprehensive plan available to new enrollees.
Step-by-Step Checklist
- Determine your Medicare start date (generally age 65, or earlier if disabled)
- Enroll in Part B on time to start your 6-month guaranteed issue window
- Estimate your likely annual healthcare utilization (healthy vs. complex needs)
- Get quotes from at least 5 Medigap insurers (use Medicare.gov plan finder)
- Check insurer AM Best financial rating (A- or better)
- Review the insurer's rate increase history (ask the agent or check state insurance filings)
- Choose Plan G unless HD-G premium savings exceed expected claims
- Enroll before the 6-month open enrollment window closes
FAQ
Q: Can I switch Medigap plans later if I change my mind? A: In most states, you can switch at any time but insurers can medically underwrite you (charge more or deny based on health). California, Connecticut, Maine, Massachusetts, New York, and Washington have additional guaranteed issue protections. Check your state's rules.
Q: Does Medigap cover prescription drugs? A: No. Medigap plans sold after 2006 do not include drug coverage. You need a separate Part D plan for prescription drugs.
Q: Is Medigap the same as Medicare Advantage? A: No. Medigap is a supplement to original Medicare (Parts A and B). Medicare Advantage replaces original Medicare with a private insurance plan. You cannot have both simultaneously.
Q: What's the best age to enroll in Medigap? A: Enroll during your 6-month guaranteed issue window after Part B enrollment (usually when you turn 65). Don't wait — health issues later can make you uninsurable for Medigap in most states.
Q: My parent is turning 65 in a foreign country — do they need Medigap? A: Standard Medigap plans cover emergency care in foreign countries (80% after $250 deductible, up to $50,000 lifetime). But if living abroad, Medicare doesn't cover routine care outside the US, so international health insurance is also needed.
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