Medicare Plan F vs Plan G vs Plan N: Which Medigap Plan Fits? 

Plan G covers everything Plan F covers except the annual Part B deductible. Plan N covers slightly less than Plan G — you pay small copays at some visits and it does not cover Part B excess charges — but the premium is usually lower.

The complication is that Plan F is closed to most people. If you became eligible for Medicare on or after 1 January 2020, you cannot buy Plan F at all, which makes the real decision for most Texans today a choice between Plan G and Plan N.

Plan F was the most comprehensive Medigap policy ever standardised. It covered the Part A deductible, the Part B deductible, coinsurance and copays, hospital costs beyond what Medicare pays, skilled nursing coinsurance, Part B excess charges and foreign travel emergency care. With Plan F in place, a covered Medicare service generally left you with nothing to pay.

Because it covered the Part B deductible, federal law closed it to newly eligible beneficiaries. If you were eligible for Medicare before 1 January 2020 you may keep Plan F or still buy it. If you became eligible on or after that date, it is not available to you.

One consequence worth knowing: the Plan F risk pool is now closed and ages over time, with no younger enrollees joining. That tends to put upward pressure on Plan F premiums in the years ahead, which is why some long-time Plan F holders end up comparing a switch to Plan G.

Plan G is the most comprehensive Medigap plan available to people newly eligible today, and it is the one we place most often. It covers the same list as Plan F with a single exception: you pay the annual Part B deductible yourself. After that deductible is met, covered Part B services are generally paid in full between Medicare and the plan.

Plan G does cover Part B excess charges, which matters in Texas. An excess charge is what a provider who does not accept Medicare assignment may bill above the Medicare-approved amount. Some states prohibit them outright; Texas does not, so that protection is not merely theoretical here.

Plan N covers the same core benefits as Plan G with three differences. You pay the annual Part B deductible. You may pay a copay of up to twenty dollars for some office visits and up to fifty dollars for an emergency room visit that does not result in admission. And Plan N does not cover Part B excess charges.

In exchange the premium is normally meaningfully lower than Plan G. For someone who sees a doctor a handful of times a year and uses providers who accept assignment, Plan N can be the better economic answer. For someone with frequent specialist visits, the copays erode the saving.

Every standardised Medigap plan with the same letter covers exactly the same benefits, no matter which company sells it. A Plan G from one carrier and a Plan G from another are identical in what they pay. What differs is the premium, the rating method and how the carrier has historically raised rates.

That makes this decision much less about the letter than people expect, and much more about these factors.

Shopping on first-year premium alone. Because the benefits are standardised, a carrier can win your business with a low introductory rate and recover it through steep increases later — and by then switching may require medical underwriting.

That underwriting point is the one most people miss. During your Medigap Open Enrollment Period — the six months beginning when you are 65 and enrolled in Part B — you can buy any Medigap policy sold in Texas regardless of health. Outside that window, and outside a guaranteed-issue situation, a carrier can decline you or charge more. The plan you choose in that six-month window is therefore worth more thought than the premium difference suggests.