Plan G. Plan N. Plan F. Medigap supplement letter plans are standardized by Medicare. In all, there are 10 different letter plans, some of which are not even available in most states. Some of the letter plans such as the very popular Plan G are everywhere, like Toyotas. Other letter plans are like Peugeots. Basically, not worth talking about it.
Plan F used to be the most popular, but as of 2020 it was discontinued other than for people who turned 65 prior to 2020. Because everyone who has Plan F is now at least 71 years old and aging, the premium costs of plan F have skyrocketed and will continue to go up even more as the Plan F pools age further. I recommend for those in Plan F, if you can pass underwriting and get out, to make the switch over to Plan G.
Plan F covers both the Part A and Part B deductibles 100% so you have no deductible or any other co-payment costs. Plan G, which is by far the most popular plan, covers the Part A deductible but not the Part B deductible which is set by the government each year. This year the Part B deductible is $283 so that is your only deductible expense for the year. Around 80% of people with Medigap supplements have either Plan F, if they have been on Medicare for a while, or Plan G, if they are more recent to Medicare.
The other two plans we will discuss is Plan N which is the second most popular plan although Plan G is more popular than N by around 4 to 1. We will also discuss a hybrid of Plan G, called a High-deductible Plan G, though I do not recommend what we refer to as a High G.
Letter plans are standardized by the government. So, a carrier cannot decide let’s make our deductible half-price, only $141 for your Part B deductible, creating a bargain. Or, for each Plan G we sell we will give away a free Plan G to someone needy. It would be nice, but it’s not allowed.
With a Plan G Medigap supplement between what Medicare contributes, and what your supplement contributes, 100% of both your Part A hospital costs and Part B doctor and other medical costs are covered. But you do pay the first $283 in 2026, as a deductible, yourself. If all your medical expenses in a year our preventative, you wouldn’t even pay the $283 deductible as there is no deductible charged for preventative health costs.
Plan G also picks up the 15% excess costs that some medical facilities and doctors can charge, often referred to as balanced billing. In 8 states there is no balanced billing, as state law prohibits it. To better understand excess charges: Some medical facilities do not accept what Medicare is willing to pay them for medical procedures, called assignment. But they do accept Medicare patients with an extra fee of 15% above the Medicare payment amount. A well-known example is Mayo Clinic. Plan G picks up this excess charge amount often giving people further peace of mind of knowing with their Medicare plan they can use the maximum number of facilities.
Because Plan G gives you more benefits than Plan N does, the premiums will be around 20% more than those for Plan N. Plan N, however, does not cover excess charges. The other big difference Plan N has is that with Plan N you pay a $20 copayment for most doctor visits and $50 for emergency room visits. You do not have this copayment with Plan G.
High-Deductible Plan G, or High G as we call it, has a substantially lower monthly premium. In fact, it’s less than half the cost. But there is a catch. Instead of paying a $283 deductible you pay a much higher deductible with a High G. In 2026 it’s $2,950 and is reset higher by Medicare each year. The reason I don’t recommend High G is that you may, with good luck, save for instance $1,000 in premiums this year, but if you have any medical expenses at all to speak of, and it doesn’t take much to be billed $2,950, one small medical incident could end up costing you the full $2,950 deductible, costing you three times more than you saved.
Worse though, once you are in a High-Deductible G Plan you can’t change to a regular Plan G down the round unless you can pass underwriting. So, to maybe save $1,000 this year, if you don’t have medical issues, you could end up paying triple that amount every year for 30 years to come. Some bargain that would be!
Plan G provides you with the most flexibility and cost certainty. That’s why it’s so popular. Popularity tends to come with good reasons.
