In short
- Plan N pays 100% of Part B coinsurance except copays of up to $20 for some office visits and up to $50 for ER visits that don't end in an inpatient admission.
- Plan N doesn't cover the Part B deductible ($283 in 2026) or Part B excess charges, which can run up to 15% above the Medicare-approved amount.
- On October 2, 2026, Medicare.gov starting estimates for Plan N for a 65-year-old in Lincoln ran from $109 to $278 a month, not counting one outlier.
- The size of the premium gap between Plan N and Plan G from the same company matters more than how many times you see a doctor.
- Moving from Plan N to Plan G later usually means health questions in Nebraska, because the state has no birthday rule.
Plan N is the supplement for people who don't mind a small copay now and then if it keeps their premium down. It protects you from the big bills the same way Plan G does. Where it differs is the small stuff, and whether that small stuff costs you more than the premium you save.
How does Plan N work?
Plan N pays the same large costs as Plan G and leaves you three smaller ones: the Part B deductible, office and ER copays, and Part B excess charges. A hospital stay, a surgery or a stretch in skilled nursing costs you about the same on either plan.
| Cost (2026 amounts) | Plan N |
|---|---|
| Part A hospital deductible ($1,736 per benefit period) | Covered |
| Hospital coinsurance and 365 extra days after Medicare's days run out | Covered |
| Skilled nursing coinsurance, days 21 to 100 ($217 a day) | Covered |
| Part B coinsurance (20%) | Covered, except copays of up to $20 for some office visits and up to $50 for ER visits without admission |
| Part B deductible ($283) | You pay it |
| Part B excess charges (up to 15% above the approved amount) | You pay them |
| Foreign travel emergency | 80% after a $250 yearly deductible, up to plan limits |
Like every supplement, Plan N works with any doctor or hospital in the country that accepts Medicare, with no network and no referrals. It doesn't cover prescriptions, so you'd pair it with a Part D plan.
How do Plan N's $20 and $50 copays work?
You pay a copay of up to $20 for some office visits and up to $50 for an emergency room visit that doesn't end in an inpatient admission. If the ER admits you, the $50 copay doesn't apply. The copays start after you've met the Part B deductible for the year.
Three things people miss:
- There's no cap. Plan N copays have no yearly limit. Ten copay visits is $200. Thirty is $600.
- The policy defines which visits count. The rule says "some office visits." Ask the company exactly which visits carry the $20 copay so you know before you buy.
- Specialist visits are office visits too. If you see a specialist regularly, a cardiologist or a dermatologist for example, each visit can carry a copay. Count them all when you estimate your year.
What does a hospital stay cost on Plan N?
About what it costs on Plan G. Say chest pain sends you to the emergency room at CHI Health St. Elizabeth in 2026, and you're admitted for three days. Because you were admitted, the $50 ER copay doesn't apply. Plan N pays the $1,736 Part A deductible and the 20% coinsurance on the doctors' bills once your $283 Part B deductible is met. Where Plan N shows up is afterward: each follow-up office visit with your cardiologist can carry a copay of up to $20. Over a few months of check-ups, that might be $60 to $120, not thousands.
What are excess charges, and how often will you see one?
An excess charge is the extra a doctor who doesn't accept Medicare assignment can bill above the Medicare-approved amount. Medicare caps it, in many cases, at 15% over the approved amount. Plan N doesn't pay it, so you would.
Medicare.gov says most doctors, providers and suppliers accept assignment. So for many people this is a "check once, then relax" item. Here's the size of it. If a doctor who doesn't take assignment has a Medicare-approved amount of $250 for a visit, the excess could be up to $37.50.
How to check: call the billing office of each doctor you see and any specialist you expect to need, and ask "Do you accept Medicare assignment?" That one question tells you whether Plan N's biggest gap applies to you. Snowbirds should ask the same question of doctors in their winter town, and my page on Medicare and travel covers the rest.
How much does Plan N cost in Lincoln?
On October 2, 2026, I ran the Medicare.gov Medigap tool for a 65-year-old in Lincoln ZIP 68508. It returned 30 Plan N listings, with starting estimates from $109 to $278 a month, plus one outlier that started near $745. Across Nebraska, the same tool showed Plan N from $89 to $924 for age 65. These are estimates that span sex and tobacco use, not quotes.
The number that matters more is the gap between a company's Plan G and its own Plan N. For the companies I compared, starting estimates were about $13 to about $70 a month apart. A $13 gap and a $70 gap lead to very different answers, which is why I always price both letters from the same companies.
Who actually saves money with Plan N?
You save with Plan N when the premium you save in a year is more than the copays and excess charges you pay. The size of the premium gap usually decides it. Here are two sample years at two different gaps, using 2026 rules. The Part B deductible is the same on both plans, so it's left out.
| Sample year | Your Plan N costs that Plan G would have paid | Net result with a $15 a month gap ($180 a year) | Net result with a $50 a month gap ($600 a year) |
|---|---|---|---|
| Quiet year: 3 copay visits | Up to $60 | Plan N saves about $120 | Plan N saves about $540 |
| Busy year: 14 copay visits, 2 ER visits without admission, one $45 excess charge | Up to $425 | Plan N costs about $245 more | Plan N saves about $175 |
With a big gap, Plan N can come out ahead even in a busy year. With a small gap, one busy year can wipe out several years of savings. My page on Plan G vs Plan N has a break-even table if you want to plug in your own quotes.
Plan N tends to fit people who:
- See a doctor a handful of times a year and feel good about their health.
- Have doctors who accept Medicare assignment.
- Find a meaningful premium gap between Plan G and Plan N quotes.
- Are comfortable that moving to Plan G later may mean answering health questions.
Should a married couple both pick Plan N?
Not necessarily. Each spouse buys a separate policy, and you don't have to choose the same plan letter, or even the same company. It's common for one spouse to see specialists regularly while the other barely visits a doctor. It can make sense for one to take Plan G and the other Plan N.
Ask about household discounts, which some companies offer to married people or to multiple policies in one household. That can change which company comes out ahead for the pair of you.
What are the risks of choosing Plan N?
The risks are small but real, and they're worth knowing before you sign:
- No cap on copays. Plan N has no out-of-pocket limit for its copays. A year of frequent visits costs more than you might expect.
- Excess charges. If a specialist you need doesn't accept assignment, you pay up to 15% above the approved amount on those bills.
- Getting to Plan G later isn't guaranteed. Nebraska has no birthday rule. After your Medigap open enrollment window, moving from N to G means medical underwriting, and the company can say no.
How does Plan N fit with your other choices?
If Plan N's copays make you nervous, Plan G removes them for a higher premium. If you want an even lower premium and have savings, High-Deductible Plan G is another option. If you're weighing a supplement against a network plan with copays of its own, start with Medigap vs Medicare Advantage. The full picture of supplements in Nebraska is on my Medicare Supplement page. To compare the companies themselves, see Medicare Supplement companies in Nebraska, and if you live in the Omaha area, my Omaha Medicare Supplement page has local details.
For an unbiased check on your numbers, Nebraska SHIP (formerly SHIIP) counsels Nebraskans at 1-800-234-7119. You can also reach 1-800-MEDICARE (1-800-633-4227) 24 hours a day, 7 days a week (TTY 1-877-486-2048). When you want Plan G and Plan N quotes side by side from several companies, talk to me. My help costs you nothing.
Frequently asked questions
Plan N has a copay of up to $20 for some office visits and up to $50 for emergency room visits that don't result in an inpatient admission. Those copays come after you've paid the Part B deductible, which is $283 in 2026. There is no yearly cap on Plan N copays, so a year with many visits adds up. The policy explains exactly which visits carry the copay.
No. Like Plan G, Plan N leaves you the Part B deductible, which is $283 in 2026. The 2027 amount is usually announced in November. Only Plans C and F cover the Part B deductible, and those can only be sold to people who were eligible for Medicare before January 1, 2020.
No. Plan N doesn't pay excess charges, which a doctor who doesn't accept Medicare assignment can bill on top of the Medicare-approved amount. In many cases that extra can't be more than 15% above the approved amount. Most doctors accept assignment, but ask each of your doctors and any specialist you expect to see. Only Plans G and F cover excess charges.
Yes. The ER copay of up to $50 applies only to emergency room visits that don't result in an inpatient admission. If the ER visit leads to an inpatient hospital admission, the copay doesn't apply, and Plan N covers the Part A hospital deductible ($1,736 per benefit period in 2026) and hospital coinsurance like Plan G does.
You can apply at any time, but outside your 6-month Medigap Open Enrollment Period or a guaranteed issue situation, the company can use medical underwriting. That means it can ask health questions, decline you or charge more. Nebraska has no birthday rule that gives a yearly switching window. If you think you'll want Plan G within a few years, it may be worth starting there.
Plan N has no network, so it works with any U.S. provider that accepts Medicare, and it covers 80% of foreign travel emergency care after a $250 yearly deductible, like Plan G. The catch is excess charges. If you see doctors in another state, you may not know whether they accept assignment. Ask before non-emergency visits, or weigh Plan G if that risk bothers you.
Sources
- Medicare.gov: Compare Medigap plan benefits (opens in a new tab)
- Medicare.gov: Choosing a Medigap Policy (CMS Product No. 02110, March 2026) (opens in a new tab)
- Medicare.gov: Does your provider accept Medicare as full payment? (opens in a new tab)
- Medicare.gov: Find a Medigap policy (ZIP 68508, accessed October 2, 2026) (opens in a new tab)
- Nebraska Department of Insurance: Medicare Supplement Fact Sheet 2026 (opens in a new tab)
- CMS: 2026 Medicare Parts A and B premiums and deductibles (opens in a new tab)
We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. 1-800-MEDICARE (1-800-633-4227) is available 24 hours a day, 7 days a week. TTY users can call 1-877-486-2048.
