The plan letter sets your coverage, the carrier sets your price, and your health usage decides which plan actually costs less. This calculator totals premiums plus the copays, deductibles, and coinsurance each plan leaves to you, then shows the exact usage level where the ranking flips.
Medigap policies are standardized by federal law. A Plan G sold by a national carrier covers exactly what a Plan G from a regional insurer covers, so shopping between companies changes your premium and little else. The decision that actually moves money is the letter: G, N, or the high-deductible version of G for anyone who became Medicare-eligible in 2020 or later. Those three dominate new enrollment, and they differ in small, precise ways that small numbers can settle.
The 2026 numbers that drive everything below come from the Centers for Medicare and Medicaid Services. Original Medicare leaves you a $1,736 Part A deductible for every hospital benefit period, a $283 Part B deductible each year, and 20 percent coinsurance on most Part B services with no annual cap. A hospital stay costs $434 per day on days 61 through 90 and $868 per day for reserve days, and skilled nursing care runs $217 per day on days 21 through 100. Medigap exists to absorb those gaps, and each letter absorbs a different slice of them.
Plan G covers every Medicare cost-sharing amount except the $283 Part B deductible. After you pay that once each year, your covered medical bills are done. There is no out-of-pocket maximum because there is essentially nothing left to share.
Plan N is the same policy with two holes punched in it. You pay up to $20 per office visit and up to $50 per emergency room visit that does not lead to admission, and the plan does not cover Part B excess charges, the extra 15 percent a non-participating doctor may bill above the approved amount. In exchange, carriers price N meaningfully below G.
High-Deductible Plan G has identical coverage to standard G, but you pay all Medicare cost sharing yourself until you hit a deductible set by CMS at $2,950 for 2026, up from $2,870 in 2025. After that, it pays like standard G for the rest of the year. The premium is a fraction of the standard plan's, which is the entire trade: hundreds of dollars a month saved against a few thousand dollars of risk.
Two other letters exist but rarely win. Plan K covers 50 percent of most cost sharing under an $8,000 annual out-of-pocket cap, and Plan L covers 75 percent under a $4,000 cap. Both leave too much of the 20 percent coinsurance with you to justify their modest premium discount for most buyers.
Because coverage is standardized, the premium is the only variable worth shopping. Kaiser Family Foundation's analysis of national enrollment data put the average Plan G premium at $164 per month, with state averages running from about $140 in Hawaii to $236 in New York, and noted Plan N typically prices 15 to 30 percent below G. More recent 2026 plan-year data from MoneyGeek, drawn from 16,954 quotes on Medicare.gov collected in November 2025, showed Plan G averaging $220 per month at age 65, Plan N at $171, and High-Deductible Plan G at $61. The calculator defaults sit between those two sources: $200 for G, $150 for N, $55 for the high-deductible version. The gap between the two G variants, roughly $145 a month at the defaults, is the budget that has to absorb your bad health years.
Variables in plain terms. Premiums are the monthly quotes you collect from carriers; they vary by state, age, gender, and tobacco use, which is why the calculator takes yours as input rather than assuming a national average. Office and ER visit counts should reflect a typical year, not your worst one. Approved costs are the Medicare-approved amounts, which run below billed charges. The premium increase rate compounds across the 10-year projection, and out-of-pocket usage is held constant, so treat the long-run totals as a planning shape rather than a forecast.
At $200, $150, and $55 monthly premiums with 12 office visits, one non-admission ER visit, and no hospital stays, Plan G costs $2,683 for the year: $2,400 of premium plus the $283 deductible. Plan N costs $2,373, since the $600 of premium savings gives back $240 in office copays and $50 at the ER. High-Deductible G is the cheapest at $1,493: its $833 of cost sharing, made up of the $283 deductible plus 20 percent of $2,750 in approved charges, sits far below the $2,950 deductible it would need to reach.
The breakeven points tell you where each advantage ends. Plan N stays ahead of Plan G until your office visits reach 27.5 per year at these premiums, which is more doctor contact than most beneficiaries have. High-Deductible G stays ahead of standard G until your annual Medicare cost sharing passes $2,023, the gap between the two plans' annual costs excluding the high-deductible premium. In the default usage that figure is $833, so the cheap plan wins comfortably.
| Plan | Annual premium | Annual out-of-pocket | Year-1 total | 10-year total |
|---|---|---|---|---|
| Plan G | $2,400.00 | $283.00 | $2,683.00 | $33,016.94 |
| Plan N | $1,800.00 | $573.00 | $2,373.00 | $28,370.21 |
| High-Deductible G | $660.00 | $833.00 | $1,493.00 | $16,631.41 |
The 10-year totals compound premiums at the default 5 percent annual increase and hold usage constant. Health does not stay constant, so the more useful exercise is the stress test below.
Add a single hospital admission to the default year. Medicare's $1,736 Part A deductible lands on you under the high-deductible plan, pushing its cost sharing to $2,569 and its annual total to $3,229. Standard G still costs $2,683 that year, so the premium savings did not cover one ordinary hospitalization. Plan N, which also covers the Part A deductible in full, costs $2,373 and becomes the cheapest option the moment hospital risk shows up.
The worst case is the clearer boundary. If a year is bad enough that High-Deductible G hits its full $2,950 deductible, that plan costs $3,610 at the default premiums, and standard G at $2,683 wins by $927. Run the same comparison with the MoneyGeek national averages, $220 against $61, and the result holds: the standard plan's worst case is cheaper than the cheap plan's worst case. The high-deductible version only pays off across years, and even then it needs restraint from hospital risk. Holding premiums at the defaults, it stays cheapest over a decade unless you hit its deductible cap in roughly 8 of those 10 years.
That is the honest summary of the three-way choice. Plan N is the default for people in average health, because its copays rarely outrun its premium discount. Plan G costs more and buys certainty, which is worth real money to anyone who cannot absorb a surprise bill. High-Deductible G is the strongest wealth move for genuinely healthy years, and the one that turns a diagnosis into a budget line. Premiums themselves sit on top of Medicare's own charges, including the income-based Part B surcharge covered in the Medicare IRMAA calculator. Funding either premium from an HSA works only for balances built before enrollment, which the HSA calculator can size. And healthcare is one of retirement's least flexible spending lines, so it belongs in the withdrawal plan modeled by the retirement withdrawal calculator.
The benefits differ in exactly two places. Plan N leaves you up to $20 per office visit and up to $50 per emergency room visit that does not result in admission, and it does not cover Part B excess charges, where a doctor bills more than the Medicare-approved amount. Plan G covers both. Everything else, including the $283 Part B deductible you pay under either plan in 2026, is identical. Whether N wins is a premium question: at the calculator defaults, N saves $600 per year in premium and gives back $290 in copays, so it wins by $310 until your office visits reach about 27.5 per year.
It depends on how much Medicare cost sharing you would rack up in a year. At the calculator defaults, High-Deductible G costs $1,493 per year against $2,683 for standard G, and it stays ahead unless your annual cost sharing passes $2,023. Even in the worst possible year, where you pay the full $2,950 deductible, it costs $3,610 against $2,683 for standard G. With these premiums the standard plan wins even in the worst year, which is the honest way to frame the choice: the high-deductible version is a bet that premium savings accumulate faster than bad health years arrive.
Kaiser Family Foundation analysis of national data put the average Plan G premium at $164 per month, with state averages running from about $140 in Hawaii to $236 in New York. Newer 2026 plan-year quotes collected from Medicare.gov by MoneyGeek show Plan G averaging $220 per month at age 65, Plan N at $171, and High-Deductible Plan G at $61. The same standardized letter plan can vary by $50 or more per month between carriers in the same ZIP code, so quotes matter more than averages.
Your one-time Medigap Open Enrollment Period lasts six months, starts the month you are 65 and enrolled in Part B, and during it any insurer must sell you any plan at the standard price regardless of health. Outside that window, switching plans generally requires medical underwriting unless your state has a rule like a birthday switching window. The October 15 to December 7 Annual Enrollment Period applies to Medicare Advantage and Part D, and does not create a guaranteed right to switch Medigap plans.
A 2015 federal law barred insurers from selling plans that cover the Part B deductible to people who became eligible for Medicare on or after January 1, 2020, which closed Plan C and Plan F to new enrollees. People already eligible before that date can still buy or keep Plan F. For everyone else, Plan G is the same policy minus one item: it leaves you the $283 Part B deductible, which is almost always cheaper than the extra premium Plan F charges.
No, on all three. Policies sold after 2005 contain no drug coverage, so you need a separate Part D plan. Routine dental, vision, and hearing care are excluded, and custodial long-term care is never covered by Medigap. What Medigap does cover is the cost sharing of Medicare itself: hospital deductibles and coinsurance, the 20 percent Part B coinsurance, and, on most plans, foreign travel emergency care at 80 percent.