Medigap Plan Letters Explained (2026): How to Compare Plans G, N, and the High-Deductible Options

Medigap (Medicare Supplement) plans are standardized by letter, which sounds like it should make shopping easy—every Plan G covers the same benefits regardless of carrier. In practice, premiums for the identical Plan G can vary 30–60% between carriers in the same ZIP code, and the rules around guaranteed-issue rights, attained-age vs community pricing, and household discounts are where buyers leave money on the table. This guide explains the most popular plan letters in 2026 and how to compare them without getting lost in marketing language.

One-line verdict

Most beneficiaries enrolling in 2026 should compare Plan G (full first-dollar except Part B deductible) against Plan N (lower premium, small office-visit copays and no Part B excess charge protection) and at least one high-deductible variant—then choose by long-term premium stability of the carrier, not just the first-year price.

Who this fits (best for)

• New-to-Medicare beneficiaries enrolling during the 6-month Medigap Open Enrollment Period (guaranteed issue, no underwriting).
• Beneficiaries who want predictable out-of-pocket costs and visit any provider that accepts Medicare.
• People who travel often, including out-of-state, and want to avoid Medicare Advantage network limits.
• Households with two enrolling spouses—household discounts of 5–12% are common with many carriers.

Who should look elsewhere (not for)

• Beneficiaries set on Medicare Advantage for $0 premium and bundled drug/dental—Medigap is a different track, not a replacement.
• People in states with strict Medigap underwriting outside the open enrollment window who already have significant pre-existing conditions; switching plans later may be denied.
• Beneficiaries primarily seeking dental, vision, or hearing coverage—Medigap does not cover these; pair with a separate plan.
• Beneficiaries unable to pay both Part B premium and a Medigap premium each month; check Medicare Savings Programs first.

Real scenarios

Scenario 1: Same Plan G, three different carrier prices

Beneficiary turning 65 in California compares Plan G from three carriers: $148/mo, $189/mo, and $215/mo for the identical standardized benefits. The differences are pricing method (community vs issue-age vs attained-age), household discount, and rate history. The cheapest year-one carrier may have the steepest annual increase. Path forward: ask each carrier for the past 5 years of rate increases on the same plan in your ZIP code—this is the single most useful question.

Scenario 2: Switching from Plan F to Plan G after attaining age 70

Long-term Plan F holder (legacy plan, no longer sold to newly eligible after 2020) is paying $310/mo. A current Plan G is $185/mo for the same coverage minus the Part B deductible ($240 in 2026 example). Net annual savings is meaningful, but switching outside open enrollment requires medical underwriting in most states. Path forward: check your state's continuous open enrollment or birthday-rule states (CA, OR, IL, NV, ID, etc.); apply for the new plan first and only cancel the old one after issuance.

Action checklist

• Confirm your Medigap Open Enrollment Period (6 months from Part B effective date)—this is the only window with guaranteed issue and no underwriting in most states.
• Decide between Plan G, Plan N, and a high-deductible variant based on expected annual healthcare use and tolerance for copays.
• Get quotes from at least 3 carriers for the same plan letter and same effective date.
• Ask each carrier for the past 5 years of rate increase history on that specific plan in your ZIP code.
• Confirm pricing method: community-rated, issue-age-rated, or attained-age-rated—each has different long-term implications.
• Apply for household discounts if applicable (often 5–12% when two members enroll with the same carrier).
• Verify whether your state has a 'birthday rule' or continuous open enrollment allowing later switches without underwriting.
• Pair Medigap with a stand-alone Part D drug plan; Medigap does not include drug coverage.

FAQ

Plan G vs Plan N: which is better?

Plan G covers more (Part B excess charges, no office-visit copays) but premium is typically $20–$60/mo higher than Plan N. If you visit doctors frequently or expect to see specialists who charge Medicare excess, Plan G usually wins; if you are a low utilizer, Plan N often wins on total cost of care over multiple years.

What is a high-deductible Plan G?

HD Plan G has a much lower premium (often 50–70% less) but you pay all Medigap-covered costs until you meet the annual deductible (around $2,800 in 2026 example). Best for healthy beneficiaries who can self-fund the deductible and want catastrophic-style supplement coverage.

Can I switch Medigap plans later?

Yes, but in most states it requires medical underwriting outside the initial open enrollment window. Some states (CA, OR, IL, MO, NV, ID, MN, WA among others) have rules allowing switches without full underwriting under specific conditions. Always confirm state rules before assuming you can switch.

Does Medigap work with Medicare Advantage?

No. You cannot use Medigap with a Medicare Advantage plan. You must be enrolled in Original Medicare (Parts A and B) for Medigap to apply.

Sources & methodology

Plan benefit comparisons reflect standardized 2026 Medigap plans regulated by NAIC. Premium examples are illustrative and vary by ZIP code, age, gender (in some states), and pricing method. Always confirm exact premiums and rules with licensed agents and your state insurance department. Medicare and state rules change—verify current year details before enrolling.

• Medicare official annual handbook 'Medicare & You' (current edition).
• State insurance department Medigap rate filings and annual increase histories (state DOI websites).
• NAIC Medigap model regulation and standardized plan benefit charts.
• State-specific birthday rule and continuous open enrollment statutes (varies by state).
• Medicare Rights Center and SHIP (State Health Insurance Assistance Program) free counseling resources.

Bottom line

Medigap looks confusing because of the letters, but the plans themselves are standardized. The decisions that matter are which letter (G, N, or HD-G), which carrier (rate stability over 5 years), and which timing (lock in during open enrollment to avoid later underwriting). Get rate-history data, not just first-year quotes.