Back when I started as an agent the question I’d get from those wanting to buy a Medicare Supplement (aka Medigap) was: should I get a Plan F or a Plan G? Plan F, back then, offered the most comprehensive coverage, but what did that actually mean?

In actuality, the only difference between a Plan F & G was F covered the Part B deductible and G didn’t. Back then, the Part B deductible was around $140 and an annual deductible, which means once someone met the deductible Plan G was the same as an F plan.

The premiums between an F and G would usually be $25-30 a month difference for most companies at the time. Furthermore, once the annual rate increases (say 8% annually to be conservative) began to be applied, over time, the disparity would grow. Say for instance you had a 65-year-old woman have a $140 Plan F per month or a $110 Plan G monthly offered, here’s what you could expect the monthly premiums to mature to if they had an 8% annual rate increase:

                           Plan F            Plan G

65                          $140                    $115

70                          $205.71               $168.98

75                          $302.25               $248.28

Granted, the Part B premium does go up every year (in 2026 it’s at $283), you’re paying far more annually (at least double) than it would pay to have that covered.

Eventually though, in 2020, Plan F was removed for those who’ve aged into Medicare since 2020. Now, Plan G is the most comprehensive plan available to folks turning 65 and I’d just been selling it blindly since.

Then a client named Tim came to see me in December and he said he wanted a plan N. While N has been available since 2010, I’d only sold a few of them since it had a $20 doctor co-pay per visit and didn’t cover Part B excess charges. So, I got on my quote machine and gave him quotes for a 65-year-old male for a plan N. Much to my surprise the difference in price was stark! Much more so than I remember it being.

The most competitive Plan G was $140 monthly and on the same company it was $90 a month for a plan N! So, I asked him where he went to the doctor and all his docs took Medicare assignment (you can look this up on the Medicare.gov website).

The reason this is important is if a doctor or facility takes Medicare assignment, that means they can’t charge Medicare Part B excess charges. In fact, to even charge excess charges (the limit is up to 15% more than the Medicare allowable amount in my state, Tennessee), a doctor or facility must opt out of Medicare assignment, and only 3% of all physicians and facilities have even done that. Many of the ones who do opt out are in the mental health field and are usually psychiatrists or psychologists. So that took the sting off of Plan N not covering excess charges, since it’s exceedingly rare it would ever be an issue.

Beyond that, Plan N could charge a $20 co-pay to see the doctor whereas Plan G won’t. Unless you go to the doctor on a constant basis this isn’t that big a deal either. Furthermore, neither plan covers the Part B deductible, so until you meet the deductible, you’ll still be paying 20% of the doctor visit until you’ve met the deductible on N or G. The $20 co-pay only really matters once the Part B deductible has been met for the year!

To drive home the point, let’s look at the long-term difference between G & N from Tim’s perspective, if there was an 8% annual increase:

                          Plan G                 Plan N

65                          $140                         $90

70                          $205.71                    $132.24

75                          $302.25                    $194.30

It’s the law of compound interest in reverse! Tim had me convinced that Plan N was an extremely viable option. And, suffice-it-to-say, that’s what he went with.

In summary, Plan G may be the most comprehensive plan, just like Plan F was back-in-the-day, but it wasn’t usually the one that made the most sense from an overall cost perspective. Now Plan N seems positioned to be the one that stands out nowadays as the most cost-efficient. Granted both are excellent coverage for the price, but I won’t be sleeping on N as a good choice anymore!