Medicare Supplement Guide · PA · DE · NJ

Why Plan N Is the Smarter Medicare Supplement Choice

Plan N can save you $720–$960 per year over Plan G — and most people would have to visit the doctor 36 to 48 times a year for Plan G to make more financial sense.

The Numbers Speak for Themselves

Plan N typically costs $60–$80 less per month than Plan G for the same core Medicare Supplement coverage. That adds up fast.

$60–$80
Monthly Premium Savings
Plan N vs Plan G
$720–$960
Annual Savings
Real money back in your pocket

Let's Do the Math

The main difference? Plan N has a $20 copay for doctor office visits. So how many visits would it take for Plan G to actually save you money?

$720–$960
Annual Savings
÷
$20
Office Visit Copay
=
36–48
Visits Per Year

You would need to visit the doctor 36 to 48 times per year — roughly once a week — for Plan G to break even. Most Medicare beneficiaries visit their doctor 6 to 12 times per year. For the vast majority, Plan N is the clear winner financially.

Plan G vs Plan N: Side-by-Side Comparison

Both plans are standardized by the federal government — meaning the benefits are identical from carrier to carrier. The only differences between G and N are listed below.

Coverage Feature ✦ Plan N Plan G
Part A Hospital Coinsurance & 365 Extra Days
Part B Coinsurance / Copayment (up to $20 copay) (100%)
Blood — First 3 Pints
Part A Hospice Care Coinsurance
Skilled Nursing Facility Coinsurance
Part A Deductible ($1,736 in 2026)
Foreign Travel Emergency (80%)
Part B Excess Charges (see notes below — rarely an issue)
ER Copay (if not admitted) Up to $50 $0
Office Visit Copay Up to $20 $0
Typical Monthly Premium Lower Higher
Expected Rate Increases Over Time Lower Higher

Note: Neither Plan G nor Plan N covers the annual Medicare Part B deductible ($283 in 2026), prescription drugs, dental, vision, or hearing.

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Great News for Pennsylvania Residents

Pennsylvania is one of only 8 states that prohibits Part B excess charges entirely. That means the main coverage difference between Plan G and Plan N — excess charge protection — simply doesn't apply if you see doctors in PA. This makes Plan N an even stronger value in our state. (The other states: CT, MA, MN, NY, OH, RI, VT.)

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What About New Jersey and Delaware?

NJ and DE do allow excess charges — but here's what most people don't realize: approximately 98% of physicians billing Medicare are participating providers who accept assignment, meaning they agree to accept the Medicare-approved amount as full payment. Of the small percentage who don't participate, nearly half are mental health professionals. According to KFF research, over 99% of claims submitted by physicians do not include an excess charge.

The bottom line: even in states that allow excess charges, the real-world probability of actually being billed one is extremely low. You can always confirm your doctor accepts assignment by asking their office or using Medicare's provider lookup tool at Medicare.gov/care-compare. For the vast majority of Plan N enrollees in NJ and DE, excess charges are simply not a concern.

Two Big Reasons to Choose Plan N

1

The Premium Savings Are Substantial — and the Math Favors Plan N

Plan N premiums are typically $60 to $80 per month lower than Plan G. Over a year, that's $720 to $960 in savings that stays in your pocket. The only additional cost with Plan N is a small copay of up to $20 for some office visits, and up to $50 for emergency room visits that don't result in hospital admission.

When you divide the annual savings by that $20 copay, you'd need to go to the doctor 36 to 48 times per year before Plan G would start saving you money. The average Medicare beneficiary sees their doctor about 6 to 12 times a year. That means Plan N saves most people hundreds of dollars every year.

And that's just the first year. As you'll see below, the savings compound over time because Plan N also tends to have lower rate increases year after year.

2

Plan G's Guaranteed Issue Status Drives Higher Rate Increases

Here's something most people don't know: since 2020, federal law requires insurance carriers to offer guaranteed issue enrollment into Plan G for certain individuals leaving group coverage or Medicare Advantage plans. This means carriers must accept these applicants into Plan G regardless of their health status — no medical underwriting allowed.

While guaranteed issue is an important consumer protection, it has a side effect: Plan G attracts a disproportionate number of enrollees with significant health challenges. These enrollees tend to file more claims, which drives up the overall cost of the Plan G risk pool. Insurance carriers pass those higher costs along to all Plan G policyholders through higher rate increases.

Plan N, by contrast, is generally not a guaranteed issue plan. New enrollees who choose Plan N typically go through medical underwriting (outside of their initial open enrollment), which results in a healthier risk pool, lower claims, and more stable premiums over time.

Industry data suggests Plan G rate increases tend to run 1% to 4% higher annually than Plan N increases. Over 10 or 15 years, that difference compounds significantly.

Plan G — Typical Annual Increase

5–8%
Higher
Fueled by guaranteed issue enrollees

Plan N — Typical Annual Increase

3–5%
Lower
Healthier risk pool, more stable

15-Year Premium Projection: Plan G vs Plan N

Example starting at age 65, illustrative rates. Assumes 6% average annual increase for Plan G and 4% for Plan N.

Age Plan G Monthly Plan N Monthly Monthly Difference Cumulative Savings
65$155$95$60$720
67$174$103$71$2,304
70$207$116$91$5,256
73$247$130$117$9,588
75$277$141$136$13,164
80$371$171$200$25,344

*Illustrative projections based on typical market data. Actual premiums vary by carrier, location, age, and gender. Individual results will differ.

Is Plan N Right for You?

Plan N is an excellent fit for most Medicare beneficiaries — especially those who value both strong coverage and smart savings.

Plan N May Be Ideal If You:

  • Visit the doctor fewer than 3 times per month
  • Want comprehensive hospital coverage with lower premiums
  • Live in PA, where excess charges are prohibited by law
  • Prefer more stable, predictable rate increases over time
  • Are comfortable with a small $20 office visit copay
  • Want to keep more money in your pocket each month

Plan G May Be Better If You:

  • Visit the doctor very frequently (3+ times per month)
  • Prefer zero out-of-pocket costs after your Part B deductible
  • Travel often to states that allow excess charges
  • Value maximum coverage over monthly savings
  • Qualify for guaranteed issue and have significant health needs

Let's Find the Right Plan for You

Every situation is different. I'll compare Plan G and Plan N rates from multiple carriers for your specific zip code, age, and health profile — and help you choose the plan that makes the most financial sense. There's never a cost for my help.

Serving Medicare beneficiaries in Pennsylvania, Delaware, and New Jersey