Medicare Supplement Plans Explained: 2026 Medigap Comparison

Original Medicare (Part A and Part B) covers a significant portion of your medical bills, but it leaves beneficiaries responsible for substantial out-of-pocket expenses. There is no annual cap on what you pay, and you must cover the 20% outpatient coinsurance, hospital deductibles, and doctor copayments yourself. To protect their retirement budgets, many seniors purchase a private Medicare Supplement Insurance policy, commonly known as a Medigap plan.

We looked into the official standardization guidelines and regulations from the Centers for Medicare & Medicaid Services (CMS) to provide a clear comparison of the available plans for 2026. Below, we explain how standardized plans are structured, compare the two most popular options for new retirees—Plan G and Plan N—and explain the rules surrounding enrollment windows and pre-existing conditions.

What This Article Covers

• How the federal government standardizes Medigap benefits across lettered plans.
• Plan G vs. Plan N: A detailed breakdown of premiums, copayments, and coverage.
• The history of the Plan F phase-out and what it means for new retirees in 2026.
• How the 6-month Medigap Open Enrollment window protects you from medical underwriting.
• State-specific rules that offer continuous enrollment or higher consumer protections.

Understanding Medicare Supplement Plans: What the Official Rules Actually Say

Medigap plans are private health insurance policies, but they are strictly regulated by federal and state laws. Under the Omnibus Budget Reconciliation Act of 1990, the federal government standardized Medigap plans into ten lettered options (Plans A, B, C, D, F, G, K, L, M, and N).

Standardization means that a Plan G offered by one insurance company has the exact same medical benefits as a Plan G offered by another company. The only differences are the monthly premium price, the company's financial rating, and their customer service reputation.

Because these plans work to supplement Original Medicare, they do not replace government-administered coverage. When you visit a doctor or hospital, Medicare processes the claim first, paying its 80% share. The remaining 20% portion is automatically billed to your private Medigap insurer, leaving you with little to no out-of-pocket costs.

The Plain English Version

• Medigap plans are private insurance policies standardized by lettered benefit packages.
• All plans of the same letter offer identical medical coverage, regardless of the insurer.
• They only supplement Original Medicare and cannot be paired with Medicare Advantage.
• Plan G is the de facto full-coverage plan for individuals turning 65 in 2026.
• Plan N offers lower premiums but introduces small copayments and excess charge risks.

Who This Applies To: Choosing Your Plan

Selecting a Medigap plan depends on your health needs, budget, and when you first became eligible for Medicare:

Are you turning 65 on or after January 1, 2020?

Yes. If you are a new enrollee, you are prohibited by federal law from purchasing Plan F or Plan C. These plans covered the Part B deductible ($283 in 2026). Congress phased out these plans for new enrollees to ensure beneficiaries share in initial outpatient costs, which they believe discourages overutilization of services. As a result, **Plan G** is now the highest-coverage plan available to you.

Are you looking for the most predictable medical expenses?

Yes. If you want to visit any doctor nationwide without worrying about co-pays or deductibles at the time of service, Plan G is the recommended option. Once you meet the annual Part B deductible, Plan G pays 100% of your remaining Medicare-covered costs, including doctor bills, hospital stays, and foreign travel emergency care.

Are you looking for a lower monthly premium?

It depends. Plan N is an excellent alternative if you are willing to pay small copayments in exchange for lower monthly premiums. Under Plan N, you must pay up to $20 for office visits and up to $50 for emergency room visits. Additionally, Plan N does not cover Part B "excess charges"—surcharges that doctors who do not accept "Medicare assignment" are legally allowed to charge you (up to 15% above the Medicare-approved rate).

Real-Life Scenario: Comparing Plan G and Plan N

Robert, a 65-year-old retiring teacher in Pennsylvania, enrolls in Original Medicare and wants to supplement it. He compares Plan G and Plan N. An insurer offers him Plan G for $150 a month and Plan N for $110 a month. Robert knows that with either plan, he will pay the 2026 Part B deductible of $283 out of pocket. If he chooses Plan G, his monthly premium is $150, but he will have zero co-pays for doctor visits thereafter. If he chooses Plan N, he saves $480 a year on premiums ($40 a month savings) but must pay up to $20 for each office visit. Since Robert visits his cardiologist and primary doctor only four times a year, his total office copayments under Plan N would be at most $80. Therefore, Robert chooses Plan N, saving $400 over the course of the year.

The Numbers: Standardized Medigap Plans Compared

The table below compares the benefit packages for the most popular Medigap plans available to new retirees in 2026:

In 2026, standard Plan G premiums typically range from $100 to $250+ per month depending on your age, location, gender, and tobacco status. Plan N premiums are usually 20% to 30% cheaper, averaging $80 to $180 per month, making it an attractive choice for healthy seniors who do not visit the doctor frequently.

What Most Sources Don't Tell You: The Excess Charge Trap and Assigned Risk

Most websites that compare Plan G and Plan N scare readers about Part B excess charges, warning them that Plan N does not cover them. However, they fail to explain what an excess charge actually is and how rare they are in the real world.

An excess charge occurs when a doctor who does not participate in the Medicare program charges more than the official Medicare-approved amount for a service. Federal law limits this surcharge to a maximum of 15% above the approved rate.

However, approximately **96% of primary care physicians and specialists nationwide accept Medicare "assignment."** This means they legally agree to accept the Medicare-approved rate as payment in full and cannot charge excess fees. Additionally, states like **New York, Ohio, Pennsylvania, Massachusetts, Connecticut, Maine, Minnesota, and Vermont** have banned Part B excess charges entirely. In these states, it is illegal for a doctor to charge you an excess fee, making Plan N’s lack of excess charge coverage completely irrelevant.

Common Pitfall to Avoid: Delaying Enrollment and Facing Underwriting

Many seniors wait until they get sick to buy a Medigap plan, believing they can sign up during the annual autumn Open Enrollment Period (October 15 – December 7). However, that annual window only applies to Medicare Advantage and Part D plans, not Medigap. If you miss your initial six-month Medigap Open Enrollment Period (which starts when you are both 65 and enrolled in Part B), private insurers in most states can review your medical history, charge you significantly higher premiums, or deny you coverage entirely due to pre-existing conditions. Secure your plan during your initial window to guarantee coverage at standard rates.

What You Can Do: Action Steps to Buy a Supplement Plan

If you are preparing to transition to Medicare and want to purchase a Medigap supplement, follow these steps to secure the best rates:

1. Mark your 6-month Medigap enrollment window: This window starts the first day of the month you are 65 or older and enrolled in Part B. It is a one-time window that cannot be extended or restarted.
2. Decide between Plan G and Plan N: Review your budget and your tolerance for copayments. If you want maximum predictability, choose Plan G. If you want lower monthly premiums and don't mind co-pays, select Plan N.
3. Compare rates across multiple insurers: Because the benefits are identical, obtain premium quotes from multiple insurance companies in your zip code. Make sure to ask if they use "community-rated," "issue-age-rated," or "attained-age-rated" pricing methods, as this determines how your premiums will rise as you age.
4. Enroll in a stand-alone Part D plan: Medigap plans sold today do not include prescription drug coverage. You must purchase a separate, stand-alone Part D drug plan during your Initial Enrollment Period to avoid late signup penalties.
5. Contact your local SHIP office: For unbiased, localized assistance in comparing Medigap policies and rates, contact your State Health Insurance Assistance Program (SHIP) at shiphelp.org or call 1-877-839-2675.

Common Questions: Frequently Asked Questions