Medicare Supplement Plan N vs. Plan F: Which One Could Be a Fit for You?

Note: Medicare Supplement (Medigap) Plan F is no longer available for people who became eligible for Medicare on or after January 1, 2020. You may want to read our Medicare Supplement Plan N vs G article instead since Medigap Plan G is the most similar to Medicare Supplement Plan F. But if you’re eligible for Medicare Supplement Plan F, read below!

Medicare can be confusing. 

Not only do Medicare Supplement plans have confusing names like A, B, C, but it’s very hard to understand the differences on paper. 

You might be looking at charts with checks and exes, but how are those going to affect you in real life?

That’s why we’re here to help.

As the founder of Nuvo Health and The Medicare Store, and the CEO of PlanFit, my team and I have helped tens of thousands of people find the right Medicare plans for their specific needs for over a decade now.

In this article, I’m going to give you a comprehensive look at two Medicare Supplement plans: Medicare Supplement Plan N vs Plan F. 

We’ll tell you exactly what they are, what they cover (and how that affects you), and then compare them side-by-side to show you which might be a better fit for you. 

We’ll also talk about how Medigap Plan F is only available for people who were eligible for Medicare before January 1, 2020, and why it might not be worth enrolling in despite its coverage.

Quick Answer: Medicare Supplement Plan N and F Are common With…

We usually see Medigap Plan N used by people who want lower premiums and aren’t expecting many visits to medical offices or the ER.

Medicare Supplement Plan N covers most Medicare Part B services (Medicare Part B is the medical insurance portion of Original Medicare), but it does typically have small copays for office and ER visits. This is why, if you visit doctors often, it can offset the money you save from the lower premiums. Medigap Plan N also doesn’t typically cover Medicare Part B excess charges.

Medigap Plan F was a common option for people who were eligible for Medicare before January 1, 2020, who wanted what they considered to be comprehensive coverage.

Premiums are higher on a Medigap Plan F than on Plan N. Because Plan F is no longer sold to people newly eligible for Medicare, its pool of enrollees is aging without new members to help balance costs, which can put upward pressure on premiums over time (more on this later). However, this plan has a lot of features compared to the other nine Medicare Supplement Plans currently available.

What are Medicare Supplement Plans (Medigap)?

Both Medigap Plan N and Plan F are Medicare Supplement Plans (also known as Medigap).

Not sure what exactly these are?

Let’s take a quick look at this before heading into the comparison!

Original Medicare (Parts A and B) is the most basic form of Medicare. Medicare Part A covers your hospital expenses, while Medicare Part B covers your medical expenses.

However, Original Medicare doesn’t cover all of your healthcare costs. Part B generally pays 80% of the Medicare-approved amount for covered services after you meet the Part B deductible, and you’re typically responsible for the remaining 20% (plus the Part A deductible and any coinsurance for extended hospital stays). Original Medicare also doesn’t cover every healthcare service, such as most routine dental, vision, and hearing care.

Medicare Supplement Plans are provided by private insurance companies to help cover these out-of-pocket expenses. Essentially, they fill in the gap of coverage left by Original Medicare.

There are 10 Medigap plans you can choose from: Plan A, B, C, D, F, G, K, L, M, and N.

These Medicare Supplement plans are standardized. This means that it doesn’t matter which company you get your Medigap Plan N from, it’ll provide largely the same coverage as all the other providers selling Medicare Supplement Plan N.

The main exception is Massachusetts, Minnesota, and Wisconsin. These three states standardize their Medigap policies differently, so residents should review the plans and benefits available in their state.

Of all these plans, Medigap Plan F and N are two of the more common ones.

One thing to remember: Medigap policies sold after 2005 do not include outpatient prescription drug coverage. If you want drug coverage, you can enroll in a separate Medicare Part D plan, which may have its own premium and cost sharing.

Let’s take a thorough look at these two Medicare Supplement plans to see if they could be a good fit for you.

Note! “Medigap” Plan N, “Medicare Supplement” Plan N, and “Med Supp” Plan N are all referring to the same thing. Some people call it “Medicare Plan N” as well.

Medigap Plan N vs Plan F — The Full Comparison

Here’s the most important information you need to know about Medicare Supplement Plan N and F, to determine which one is better for your unique situation.

Medigap Plan N and Plan F Comparison Chart

	Plan N	Plan F
Average cost	$80 – $250/month	$150 – $350/month*
Part A coinsurance and hospital costs (up to 365 days after Medicare benefits are used)	✅	✅
Part B coinsurance and copayments	✅ except up to $20 for some office visits and up to $50 for ER visits without inpatient admission	✅
Blood transfusion (first 3 pints)	✅	✅
Part A hospice care coinsurance and copayments	✅	✅
Skilled nursing facility care coinsurance	✅	✅
Part A deductible	✅	✅
Part B deductible	❌	✅
Part B excess charge	❌	✅
Foreign travel emergencies	80% after $250 deductible	80% after $250 deductible
Out-of-pocket limit	❌	❌

*Approximate average premiums today; actual costs vary by insurer, location, age, and health status, and change over time.

Medigap Plan N

Medicare Supplement Plan N has a reputation as a commonpopular alternative to Medigap Plans F and G.

Medigap Plan N has lower monthly payments and provides many areas of coverage. Compared to Medigap Plan F, which some people might see as unnecessary, it only lacks three coverage areas.

Before enrolling in Medigap Plan N, it’s a good idea to do some calculations to see if the lower monthly payments are worth it.

Provider Access and Prior Authorization

Standard Medicare Supplement Plan N does not use a provider network. You can generally see any doctor or hospital in the United States that accepts Original Medicare. It is also worth asking whether the provider accepts Medicare Assignment, because Plan N does not cover Part B excess charges. Medicare SELECT policies are an exception and may require you to use certain hospitals or doctors to receive full benefits. Original Medicare usually does not require prior authorization, although limited services and medical equipment may still be subject to Medicare authorization requirements.

A Note on Premiums

Plan N often begins with a lower premium than Plan F, but future increases are not guaranteed to be lower or more gradual. Premium changes depend on factors such as the insurance company, location, policy rating method, age, and the claims experience of that particular group of policyholders. When comparing policies, ask each insurer about its rate increases over the past several years.

What Medigap Plan N Covers

• Medicare Part A Coinsurance and Hospital Costs — Part A doesn’t typically completely cover your hospital costs after 60 days. There are still several copays you’ll have to pay. The good news is that Medigap plans will cover this for you, including Plan N.
• Medicare Part B Coinsurance and Copayments (except office and ER visits) — Medicare Part B covers your outpatient needs. However, most items and services covered by Medicare Part B come with a 20% coinsurance that you’re responsible for paying out-of-pocket. Medigap Plan N covers most of these, but it does charge you small copays for office and ER visits, which other Medicare Supplement Plans don’t have. These copays are one of the most notable differences between Medigap Plan N and other Medicare Supplement plans.
• Blood Transfusion — If you need to buy blood for transfusion, Original Medicare won’t cover the cost for the first three units. But if you’re enrolled in a Medicare Supplement Plan N, your insurance company will typically take care of this for you.
• Hospice Care and Skilled Nursing Facility Coinsurance and Copayments — If you stay at a hospice or get treatment in a skilled nursing facility, Medicare Part A will usually take care of some of the costs. You will have to pay coinsurance and copayments, though. However, with a Medicare Supplement Plan N, you don’t have to worry about these costs!
• Part A Deductible — You have to hit your deductible for inpatient costs before Medicare Part A begins to cover you. With Medigap Plan N, your insurance company will cover this deductible, so you don’t have to spend out-of-pocket before Medicare Part A kicks in.
• Foreign Travel Medical Emergencies — If you’re traveling outside the country and you have a medical emergency, Medicare Supplement Plan N will usually cover 80% of your costs after a $250 annual deductible, up to a lifetime limit of $50,000.

What Medicare Supplement (Medigap) Plan N Doesn’t Cover

There are three things that Medicare Supplement Plan F covers that Medicare Supplement Plan N doesn’t. These are:

• Medicare Part B Office and ER Visit Copayments — Most items and services covered by Medicare Part B (medical coverage) come with a 20% coinsurance. Medicare Supplement Plan N covers most of this, but it has copays for doctor’s office visits (up to $20), and ER visits (up to $50 unless you’re admitted to the hospital). This is one of the most notable coverage gaps of Medicare Supplement Plan N, and something you may want to calculate before enrolling in this plan.
• Medicare Part B Deductible — Medigap Plan N covers the Medicare Part A deductible but not the Medicare Part B deductible.
• Medicare Part B Excess Charge — Healthcare providers who accept Medicare but don’t follow the Medicare-approved amount for items could charge 15% more than the Medicare-approved amount. When this happens, you’re usually responsible for paying the excess amount. Unlike Medigap Plan F, Medigap Plan N doesn’t normally cover this excess charge.

A Part B excess charge may apply when a nonparticipating clinician who accepts Medicare does not accept Assignment for a particular claim. Federal rules generally limit the charge to 15% above the Medicare-approved amount, although state rules can provide additional protection. 

Excess charges are uncommon: MedPAC has found that about 98% of clinicians billing under the Medicare Physician Fee Schedule are participating providers, and roughly 99.7% of Physician Fee Schedule claims are paid at Medicare’s standard rate. That said, you may not always know in advance whether a provider accepts Assignment, so it is worth asking before you receive care.

• Out-of-Pocket Limit — Some Medigap Plans have a yearly out-of-pocket spending limit. Once your out-of-pocket expenses reach this number, your insurance company will generally cover all other expenses for the year. Medigap Plan N and most other Medigap plans with broad coverage don’t have a set maximum out-of-pocket limit.

Who is Medigap Plan N For?

Medigap Plan N is typically for people who may want to save on premiums and who usually feel like they won’t go to the doctor or ER very often.

Here’s one way you can calculate to see if Medigap Plan N might be the right fit for you:

1. Get a quote to see how much a Medigap Plan F would cost you. Then, see how much a Medigap Plan N would cost you. Subtract the Medigap Plan N amount from the Medigap Plan F amount.

This number will show you how much you could save every year by choosing Medigap Plan N.

2. Take this new number and subtract the Medicare Part B deductible ($283). The remaining amount is how much you would have to spend on the doctor’s office and ER copays (and Medicare Part B excess charges). Estimate how many times you’d go to the doctor and ER, and subtract that amount. If you still have money left over, you might still be saving money by choosing a Medigap Plan N over a Plan F.

For example:

Let’s say you live in Connecticut, and you’re quoted $200/month for Medigap Plan N, and $300/month for Medigap Plan F. This would mean that by choosing the Medigap Plan N instead of the Medigap Plan F, you would save $1,200/year on premiums.

$200 x 12 = $2,400

$300 x 12 = $3,600

$3,600 − $2,400 = $1,200

Now subtract the Medicare Part B deductible:

$1,200 − $283 = $917

In this example, you would have to spend $917/year on office and ER copays, and Medicare Part B excess charges before Medigap Plan N wouldn’t save you money (if you’re healthy, you might not even need to pay the Medicare Part B deductible).

That’s at least 45 office visits ($917 / $20 = 45.85) or about 18 ER visits ($917 / $50 = 18.34)! (Note: the $20 copay for office visits and $50 for ER visits are maximum amounts. Some insurance companies may charge less.)

The only kicker is the Medicare Part B excess charges. But if you choose doctors and facilities that accept the Medicare-approved amount (this is called “Medicare Assignment”), you won’t have to worry about Medicare Part B excess charges at all.

Doctors and facilities that accept “Medicare Assignment” charge prices set by Medicare. However, facilities and doctors that accept Medicare but don’t take Medicare Assignment are allowed to charge 15% more than the Medicare set prices, which is the Part B excess charge.

Note: This is an example only. Make sure to do your own calculation with the quotes you receive for both plans!

Look at Total Yearly Cost, Not Just the Premium

When you run your own numbers, it helps to compare the total yearly cost of each plan rather than just the monthly premium. Start with 12 months of premiums and add the out-of-pocket costs you reasonably expect. 

For Plan N, those costs may include the Part B deductible, copayments of up to $20 for some office visits, copayments of up to $50 for emergency room visits that don’t result in an inpatient admission, and possible excess charges. 

Then, separately, consider how comfortable you are with some uncertainty in your yearly costs in exchange for a lower premium. Looking at the numbers and your own comfort level together gives you a clearer picture than the premium alone.

Medigap Plan F

Medigap Plan F was one of the most common Medicare Supplement Plans until it stopped being offered to new Medicare enrollees on January 1, 2020.

Again, people who were eligible for Medicare before January 1, 2020 can still get this plan.

Here’s what Medigap Plan F covers and why many people don’t normally enroll in this plan:

What Medigap Plan F Covers

Medigap Plan F covers most of the “gaps” of Original Medicare (Part A deductible, Part B deductible, Part A copays, Part B coinsurance, skilled nursing facility copays, and Part B excess charges). This means that you’ll typically have coverage for most of your healthcare expenses.

However, Medigap Plan F usually costs more than other Medicare Supplement Plans.

Once Medigap Plan F was made unavailable for new Medicare beneficiaries, monthly costs for this plan rose significantly.

Some states also offer a high-deductible version of Plan F. It works like the standard Plan F, but you pay a set amount out of pocket each year before the plan starts covering costs, in exchange for a lower monthly premium. In 2026, that deductible is $2,950, and it changes annually (a separate $250 deductible applies to the foreign-travel emergency benefit). Like the standard version, the high-deductible Plan F is only available to people who were eligible for Medicare before January 1, 2020.

Here’s a rundown of what Medigap Plan F covers:

• Medicare Part A Coinsurance and Hospital Costs — If you’re in a hospital for longer than 60 days, Medicare will start to charge you copays. Both Medigap Plan N and Medigap Plan F cover this for you.
• Medicare Part B Coinsurance and Copayments — Unlike Medigap Plan N, you won’t have to pay a $20 copayment for office visits and $50 for ER visits if you have a Medigap Plan F. You won’t have any Medicare Part B coinsurance or copayments at all with a Medigap Plan F.
• Blood Transfusion — Like with Medigap Plan N, you won’t have to pay for the first three pints of blood if you have to purchase it. Medigap Plan F usually takes care of the first three pints, while Medicare will typically take care of the rest.
• Hospice Care and Skilled Nursing Facility Coinsurance and Copayments — Like Medigap Plan N, Medigap Plan F will generally handle any coinsurance or copayments you need to pay for hospice or skilled nursing facility care.
• Medicare Part A and Part B Deductible — Medigap Plan F is one of the only Medigap plans that usually covers both the Medicare Part A and Part B deductibles. Due to the fact that your Medigap Plan F covers the Medicare Part A and Medicare Part B deductibles, your monthly payments are essentially the only healthcare cost you’ll have to make for services Original Medicare covers.
• Medicare Part B Excess Charge — If your healthcare provider charges above the Medicare-approved maximum, you generally don’t have to worry about paying the excess charge. Medigap Plan F is one of only two Medicare Supplement plans that will typically pay this (Plan G is the other).
• Foreign Travel Medical Emergencies — Like Medigap Plan N, Medigap Plan F will normally also cover 80% of your medical emergencies abroad after a $250 annual deductible. Medigap Plan F has a $50,000 lifetime cap, just like Medigap Plan N.

What Medigap Plan F Doesn’t Cover

Something Medigap Plan F doesn’t typically have is a yearly out-of-pocket maximum.

On the other hand, Medigap Plan F covers most of Medicare’s gaps, so an out-of-pocket maximum isn’t as necessary for this plan as it might be for others. Keep in mind that Plan F doesn’t cover your Part B premium, outpatient prescription drug costs, most services Original Medicare doesn’t cover, or foreign travel emergency costs beyond the plan’s 80%/$50,000 lifetime limit.

Who is Medigap Plan F For?

Medigap Plan F was typically for people who were eligible for Medicare before January 1, 2020, and who wanted to fill in most of the gaps left by Medicare. It was also preferred by people who were okay with spending significantly more money on premiums to ensure their costs would be more predictable throughout the year.

If you have Medigap Plan F coverage, you generally don’t have to worry about most deductibles, coinsurances, or copays for Medicare-covered services.

You will, however, typically have a higher monthly premium cost!

On average, Medigap Plan F is one of the more expensive Medigap plans. Because people newly eligible for Medicare can no longer enroll in Plan F, its pool of enrollees will continue to age, which can put upward pressure on premiums over time.

Why Many People Don’t Choose a Medigap Plan F

From Medicare’s perspective, Medicare costs are based on a group of people on a plan. The premiums of healthy people who don’t need medical attention help offset the spending Medicare pays for people who need a lot of medical attention.

This same principle is applied to private insurance companies that offer Medicare Supplement plans. Healthy people on Medigap Plan F help offset the costs of sick people on Medigap Plan F. 

However, now that Medigap Plan F is no longer available to new people turning 65, everyone on this plan is eventually going to age, potentially get sick, and need more medical attention. 

With no new enrollees to help offset the costs of Medigap Plan F, insurance companies selling this plan may have to raise the premiums for existing enrollees. 

That’s why the costs for Medigap Plan F could rise in the coming years. 

This is a phenomenon known as an insurance death spiral. 

No one knows for sure if Medigap Plan F will go into a death spiral but if you’re still healthy, 

you may want to consider switching from a Medigap Plan F to another Plan.

The Key Differences Between Medigap Plan N and Plan F

	Medigap Plan N	Medigap Plan F
Premiums	Plan N has a lower premium range, with an average of $80 – $250/month	Plan F has the highest premium range, with an average of $150 – $350/monthBecause Plan F is closed to new enrollees, its enrollee pool is aging, which can put upward pressure on premiums over time
Coverage	Many people believe Plan N provides comprehensive coverage but notably has copays for office ($20) and ER visits ($50). Plan N also excludes the Part B deductible and Part B excess charges	Plan F covers the gaps of Original Medicare that it’s designed to cover (Part A/B deductibles, Part A/B coinsurance, and Part B excess charges). It doesn’t cover the Part B premium, prescription drugs, or services Original Medicare excludes
Companies with policies in force	70% of Medicare insurance companies had Plan N policies in force (2023 data)	86% of Medicare insurance companies had Plan F policies in force (2023 data)
Share of Medigap enrollment	About 10% of all standardized Medigap enrollees are in Plan N (2023 data)	About 36% of all standardized Medigap enrollees are in Plan F (2023 data)
Enrollment rank	#3. Plan N is the third most common Medigap plan thanks to its lower premiums and decent coverage	#2. Plan G overtook Plan F as the most common Medigap plan in 2023 (39% vs. 36% of enrollment), making Plan F the second most common. Because Plan F is no longer available to people newly eligible for Medicare, its enrollment share has been declining.
People who often choose it	Budget-conscious people who are anticipating few office and ER visits	People who were eligible for Medicare before January 1, 2020, who want extensive coverage and don’t mind paying higher premiums

Wondering exactly how common each plan type is? In AHIP’s analysis of 2023 NAIC data, Plan G ranked first with 39% of Medigap enrollment, Plan F ranked second with 36%, and Plan N ranked third with 10%. Plan F’s enrollment share declined from 46% in 2020 to 36% in 2023. These figures don’t include the small share of Medigap enrollees reported separately through the California Department of Managed Health Care.

Frequently Asked Questions About Medicare Supplement Plan N vs Plan F

Can I Switch From Medigap Plan F to Plan N?

Yes, you can switch from Plan F to Plan N. However, if you do this after the Medigap Open Enrollment Period (the six-month period that begins the first month you’re 65 or older and enrolled in Medicare Part B), there will likely be a medical underwriting process before you can switch your plan. If you have a preexisting medical condition, insurance companies might decline your application.

What Is The Medigap Open Enrollment Period?

Once you sign up for Medicare Part B, there’s a six-month window when you can sign up for any Medigap plan with no medical underwriting. During this window (called the Medigap Open Enrollment Period), insurance companies are not allowed to deny your application or decide your price based on your health status.

Insurance companies may still ask health questions on the application, but during this period they cannot use your answers to deny your application or charge you a higher premium. They can’t charge you more because of your health. (rates typically differ between companies, but within one insurance company, nobody of the same age should be paying more because of their health).

However, after the six-month Medigap Open Enrollment Period, you normally lose that government protection. At that point, insurance companies are typically permitted to have a medical underwriting process, and they may decline your application based on your health unless you have a guaranteed issue right or other protection.

Even if they do accept your application, you’re likely to pay higher premiums if you have a medical condition. Again, after the Medigap Open Enrollment Period, companies can now charge you higher premiums based on your health.

Sometimes, we see people who are still healthy switching from Medigap Plan F to Medigap Plan N, even if they’re outside the Medigap Open Enrollment Period, since Plan N’s typically lower starting premium could be worth exploring.

Can I Switch From Medigap Plan N to Medigap Plan F?

You can switch from Plan N to Plan F if you were eligible for Medicare before January 1, 2020. Otherwise, you’re no longer eligible for Plan F.

If you’re unhappy with the coverage of your Medigap Plan N, you can also consider switching to Medigap Plan G. Medigap Plan G covers most of the items covered by Medigap Plan F. The only coverage difference between these two Medigap Plans is that Medigap Plan G doesn’t cover the Medicare Part B deductible.

When Can I Switch From Medigap Plan F to Medigap Plan N?

You can switch from Medicare Supplement Plan F to Plan N at any time. It may be a good idea to do this during the Medigap Open Enrollment Period, but it’s not the only time you can do this.

Unlike Medicare Advantage plans, you don’t have to wait for any period to switch Medigap plans.

However, if you’re outside the Open Enrollment Period, insurance companies are not obligated to accept your application. There will usually be a medical underwriting process.

That’s why if you’re going to switch, it’s best to do this while still in the Medigap Open Enrollment Period.

What’s an Alternative to Medigap Plan F?

One common alternative to Medigap Plan F is Medigap Plan G. Medigap Plan G covers everything covered by Medigap Plan F except the Medicare Part B deductible. It typically also costs less than Plan F.

The Medicare Part B deductible is the amount you have to spend for medical services before Medicare starts covering you. This amount slightly changes every year.

If you’re attracted to Medigap Plan F for its coverage, you might like Medigap Plan G as well. Many people see Medigap Plan G as an option with extensive coverage.

What’s an Alternative to Medigap Plan N?

The Medigap plan that generally has the lowest average monthly payments is Plan K. So if you like Plan N for the low premiums, you may want to look into Plan K.

However, it typically offers significantly less coverage than other plans. It doesn’t cover the Medicare Part B deductible and excess charges, and only covers 50% of your:

• Medicare Part B coinsurance and copayments,
• First three pints of blood,
• Medicare Part A hospice care coinsurance and copayments,
• Skilled nursing facility coinsurance, and
• Medicare Part A deductible.

If you’re healthy, you might be satisfied with this level of coverage but if you have constant healthcare expenses, your out-of-pocket spending can get very high with a Medigap Plan K.

Does Medigap Plan N or Plan F Cover Prescription Drugs?

No. Current Plan N and Plan F policies do not include outpatient prescription drug coverage. You can enroll in a separate Medicare Part D plan if you want that coverage. When comparing your overall expenses, include any Part D premium, deductible, and medication cost sharing that may apply. (A small number of Medigap policies sold before 2006 included drug coverage and are an exception, but they are no longer sold.)

Do Part B Excess Charges Apply in Every State?

Not in exactly the same way. Some states restrict or stop providers from charging more than the Medicare-approved amount, while others follow the federal default. Rules vary by state, so check with your State Health Insurance Assistance Program or state insurance department rather than assuming excess charges are or aren’t allowed where you live. Nationwide, excess charges are uncommon: MedPAC has found that about 98% of clinicians billing under the Medicare Physician Fee Schedule are participating providers, and that roughly 99.7% of Physician Fee Schedule claims are paid at Medicare’s standard rate.

Need Help Deciding Between Medigap Plan N and Plan F?

Still can’t decide?

A licensed insurance agent could lay out your options and help you make your decision. 

Because the truth is, the right plan for YOU depends on your specific situation. 

If you’d like to discuss your options, we have a team of licensed insurance agents ready to help you out!

(Licensed Insurance Brokers are paid a commission by insurance companies – but the commission amount is the same no matter which plan you choose, so our agents can be unbiased, and you don’t pay them to help you, the insurance company does.)

So give us a call today to find out if Medigap Plan F or Medigap Plan N is the right fit for your exact situation!