Medigap Plan N: The Copays and Costs Plan N Leaves With You

Plan N is a Medigap plan. It pays toward costs that Original Medicare leaves behind. For many people, it pays almost all of them. But a short list stays with you. This guide is about that list.

People often set Plan N next to Plan G. Plan G pays one cost that Plan N does not. That cost is Part B excess charges. Plan N also has small copays. Plan G does not have those. In return, Plan N premiums are often lower. That is true when both plans come from the same company. No premium figure is given here. Companies set Medigap premiums. CMS does not. You can find our other Medigap guides in our Medicare Supplement section.

The costs Plan N leaves with you, one by one

First, the Part B premium. Each person with Part B pays the standard premium. It is $202.90 a month in 2026 (Ledger A1). Income can change that amount for some people. Plan N pays none of it. Your Medigap premium is a second bill. It is separate. You pay that one to the insurance company.

Second, the Part B deductible. In 2026 the deductible is $283 for the year (Ledger A2). You pay for Part B care yourself at first. Once you reach that amount, other cover can start. Plan N does not pay the deductible. Plan G does not pay it either. No Medigap plan sold today pays it. That holds for people new to Medicare.

Third, the office visit copay. Plan N pays 100% of the Part B coinsurance. Still, you must pay a copayment of up to $20 for some office visits. The copay is per visit. See a doctor often, and these copays add up over a year.

Fourth, the emergency room copay. You must pay up to $50 for an emergency room visit. That is when you are not admitted as an inpatient. The visit leads to admission? Then this copay does not apply.

Fifth, excess charges. Some doctors do not accept assignment. They can charge above the Medicare-approved amount. There is a set limit on how far above they can go. That extra amount is called an excess charge. Plan N does not pay it. Plan G pays it in full. You can dodge this cost in most cases. Just use doctors who accept assignment.

What Plan N pays

Plan N pays the Part A deductible. It pays Part A hospital coinsurance. It also pays hospital costs for an added 365 days. Those days start after Medicare benefits run out. It pays the first three pints of blood. It pays Part A hospice care coinsurance. It pays skilled nursing facility care coinsurance. It pays 80% of foreign travel emergency care. Plan limits apply there. And it pays your Part B coinsurance in full. The copays named above still apply.

That is a lot of cover. Still, the gaps are real. They are just small. Picture a year with many office visits. Add one doctor who bills excess charges. That year can cost more on Plan N. It can cost more than the premium gap with Plan G saves you.

Who pays for what

• Medicare pays first. Original Medicare pays its share of covered care. For Part B care, that is usually 80% of the approved amount. That is after the deductible.
• Medigap pays toward the Original Medicare benefit. Plan N is a Medigap plan. It does not cover a service on its own. It pays the cost sharing listed above. The copays and gaps in this guide still apply.
• Medicaid: some people have Medicare and Medicaid at the same time. They may get help with premiums. They may get help with cost sharing too. State programs give that help. Plan N is a private policy. It is not a Medicaid benefit.
• Private pay: some costs come from your own funds. You pay the Plan N premium that way. You also pay the Part B premium. You pay the Part B deductible. You pay the Plan N copays. And you pay any excess charges. Other cover you hold may help.

A note on the Plan K and Plan L limits in the Ledger

Our Ledger lists CMS amounts for other plans too. They are there so you do not mix them up with Plan N. Plan N has no yearly out-of-pocket limit. That is how the plan is built. Plan K limit: $8,000 in 2026, and $8,360 in 2027 (Ledger L2; 2027 amount takes effect on 2027-01-01). Plan L has a limit of $4,000 in 2026, and $4,180 in 2027 (Ledger L3; 2027 amount effective 2027-01-01). Some plans come in a high-deductible form. Those are Plans F, G, and J. Their deductible is $2,950 in 2026 and $3,050 in 2027 (Ledger L1; 2027 amount effective 2027-01-01). None of those three amounts is a Plan N cost.

Sample situation

Frank is 72 and holds Plan N. In March he has paid his Part B deductible of $283 for the year (Ledger A2). In April he sees his heart doctor four times. Each visit is an office visit with a copay. He pays up to $20 per visit, so up to $80 for the month. His Plan N pays the rest of the Part B coinsurance for those visits.

In May, Frank goes to the emergency room with chest pain. Tests show he is fine, and he goes home the same night. Since he was not admitted, he pays the emergency room copay of up to $50. Frank adds up his spring costs: $283 plus $80 plus $50 is $413, on top of his two monthly premiums. He decides Plan N still fits him, since his premium saving over Plan G is larger than $413 a year. A person who sees doctors far more often could reach the other answer.

Questions to ask before you buy Plan N

Our guide on Plan G vs Plan N sets the two plans side by side. Our guide on high-deductible Plan G covers that form of Plan G.

• What is the monthly premium? How has it risen over the past few years?
• Do my regular doctors accept assignment? Say one does not. What excess charges might I face then?
• How many office visits do I make in a normal year? What would the copays add up to?
• How does the total cost compare? Compare it with Plan G from the same company.

Sources

• https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits