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An older couple at a wooden table at home going through insurance paperwork with a pen and a phone calculator, the kind of side-by-side comparison of Medigap Plan G and Plan N premiums and copays that people in Delta, Cedaredge, Paonia and Hotchkiss work through

Medigap comparison · Delta County, Colorado · Plan year 2026

Medigap Plan G vs. Plan N in 2026: three real differences, and how they play out in Delta County

Plan G and Plan N pay the same hospital bills. They part ways on office copays, on excess charges, and on which one an insurer must sell you when you have a guaranteed right to buy. Here is what each difference is worth, with the federal data for Delta County doctors.

The bottom line

  • Seven of nine benefit lines are identical. Both plans pay the Part A hospital deductible ($1,736 in 2026), hospital and skilled nursing coinsurance, and 80% of foreign travel emergencies. Neither pays the $283 Part B deductible.
  • Plan N adds copays. Up to $20 for some office visits and up to $50 for an emergency room visit that does not end in an admission.
  • Plan N does not pay Part B excess charges. Those can run up to 15% above the Medicare-approved amount from a provider who does not accept assignment.
  • Locally, excess charges look rare. All 70 Delta County practitioners in CMS's 2024 physician file were flagged as participating in Medicare or accepting assignment.
  • The quiet difference is your right to buy. In several guaranteed-issue situations Colorado requires insurers to sell you Plan G. Plan N is not on that list.
  • You may not be able to switch later. Outside your protected windows, a company can ask health questions and decline.

The short answer

Medigap Plan G and Plan N cover the same hospital and skilled nursing costs; Plan N differs by charging a copay of up to $20 for some office visits and up to $50 for some emergency room visits, and by not paying Part B excess charges. In exchange, Plan N usually carries a lower monthly premium from the same company.

A Medigap policy, also called Medicare Supplement Insurance, is private insurance that pays some of the costs Original Medicare leaves to you. The plans are standardized by letter. Medicare's guide is blunt about what that means: "Price is the only difference between policies with the same letter sold by different companies." So the decision has two layers. First pick the letter. Then pick the company.

This article is about the letter. For most people who became eligible for Medicare in 2020 or later, G and N are the two plans that get compared, because plans that pay the Part B deductible are no longer sold to people new to Medicare.

Sources: Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections · Medicare & You 2027 (official handbook), pages 32, 63–64 and 80: Part B costs, assignment and the Medigap chart. Retrieved October 2026.

$20 / $50
Maximum Plan N copay for an office visit and for an emergency room visit without admission, 2026 (Medicare.gov, Choosing a Medigap Policy)
15%
Most a non-participating provider can generally charge above the Medicare-approved amount (Medicare.gov)
70 of 70
Delta County practitioners flagged as participating in Medicare or accepting assignment, 2024 (CMS physician file)
5,556
Delta County residents in Original Medicare, 2025 — the group a Medigap policy is built for (CMS Medicare Monthly Enrollment)

Sources: Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections · Medicare.gov — Does your provider accept Medicare as full payment? (assignment, the limiting charge, opt-out providers) · CMS — Medicare Physician & Other Practitioners, by Provider (calendar year 2024 data) · CMS — Medicare Monthly Enrollment (data.cms.gov).

What does each plan cover?

This is the 2026 benefit chart from Medicare's Medigap guide, cut down to the two columns that matter here. The rows where the plans differ are in bold.

BenefitPlan GPlan N
Part A coinsurance and hospital costs (up to 365 extra days after Medicare's benefits are used) Covered 100% Covered 100%
Part A hospital deductible ($1,736 per benefit period in 2026) Covered 100% Covered 100%
Skilled nursing facility coinsurance Covered 100% Covered 100%
Part A hospice coinsurance or copayment Covered 100% Covered 100%
Blood (first 3 pints) Covered 100% Covered 100%
Foreign travel emergency care 80%, up to plan limits 80%, up to plan limits
Part B deductible ($283 in 2026) Not covered — you pay it Not covered — you pay it
Part B coinsurance (the 20% you owe on most outpatient care) Covered 100% Covered 100%, except a copay of up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to an inpatient admission
Part B excess charges Covered 100% Not covered — you pay them

Source: Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections, Section 2, "Medicare Supplement Insurance (Medigap) Plans" chart for 2026. Dollar amounts for the Part A and Part B deductibles are from Medicare.gov — Medicare costs (plan year 2026).

Two things are worth saying plainly.

  • The expensive events are covered the same way. A hospital stay, a stretch in a skilled nursing facility, a long run of chemotherapy or dialysis billed under Part B — both plans pay Medicare's coinsurance on all of it. Plan N is not a "catastrophic only" plan.
  • Neither plan covers what Medicare does not cover. Medigap fills gaps in Medicare-covered services. It does not add prescription drugs, routine dental, vision or hearing care, or long-term care. Drug coverage is a separate Part D plan.

How do Plan N's copays work?

Medicare's chart says Plan N "pays 100% of the Part B coinsurance" but that you "must pay a copayment of up to $20 for some office visits and up to a $50 copayment for emergency room visits that don't result in an inpatient admission."

The words "up to" and "some" come from the regulation behind the chart. Colorado's Regulation 4-3-1, which mirrors the national standard, defines the Plan N copays this way:

  • Office visits: "the lesser of twenty dollars ($20) or the Medicare Part B coinsurance or copayment for each covered health care provider office visit (including visits to medical specialists)."
  • Emergency room: "the lesser of fifty dollars ($50) or the Medicare Part B coinsurance or copayment for each covered emergency room visit," and the copay is "waived if the insured is admitted to any hospital and the emergency visit is subsequently covered as a Medicare Part A expense."

Read that wording closely and three practical points follow.

  • The copay cannot exceed your coinsurance. If Medicare's 20% share on a short visit works out to $14, the copay is $14, not $20.
  • No coinsurance, no copay. Medicare charges nothing for most covered preventive services when the provider accepts assignment. Under the "lesser of" wording there is nothing for Plan N to collect on those. We cover what counts as preventive in our guide to Medicare preventive services and the annual wellness visit.
  • The copay is per office visit, not per service. It attaches to the visit. Lab work, imaging, physical therapy sessions and outpatient procedures are separate questions, and how a particular claim is treated is something to ask the insurer before you buy.

The Part B deductible sits in front of both plans. In 2026 you pay the first $283 of Medicare-approved Part B costs yourself on Plan G and on Plan N alike. The copays above are what Plan N adds after that.

Sources: Colorado Secretary of State — 3 CCR 702-4, Division of Insurance Regulation 4-3-1, Minimum Standards for Medicare Supplement Policies (Sections 9.1, 10 and 11), Section 9.1.E.11 · Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections · Medicare & You 2027 (official handbook), pages 32, 63–64 and 80: Part B costs, assignment and the Medigap chart.

How many visits before Plan G costs less?

Because the copay is capped at $20, the most Plan N's office copays can add in a year is simple multiplication.

Maximum Plan N office-visit copays in a year: visits × the $20 ceiling. Arithmetic from the copay in Choosing a Medigap Policy (2026). Actual copays can be lower, and emergency room copays are separate.

Now set that against the premium. We are not publishing premiums here, because they differ by company, age, tobacco use and ZIP code, and a number on a blog is stale the day a company files a new rate. What does not change is the arithmetic.

If Plan N's premium is lower than Plan G's by…That is this much a yearWhich equals this many office visits at the full $20 copay
$10 a month$1206 visits
$20 a month$24012 visits
$30 a month$36018 visits
$40 a month$48024 visits

Illustration only. The monthly differences in the first column are round numbers chosen to show the arithmetic; they are not quotes and not a prediction of what any company charges in Delta County. Get current prices for your age and ZIP code from Medicare's Medigap tool, from the insurer, or from a licensed agent.

If you see doctors fewer times than the number in the last column, Plan N's copays cost you less than the premium you saved. If you see them more often, Plan G comes out ahead on that line alone. Add up to $50 for each emergency room visit that does not lead to admission.

Two cautions keep this honest. A premium gap is not fixed: each plan's rate changes over time, and nothing guarantees the gap you see at 65 is the gap at 78. And your visit count is not fixed either. The year you need a specialist every three weeks is not a year you get to choose.

What are excess charges, and do Delta County doctors bill them?

Most providers "accept assignment," which means they take the Medicare-approved amount as full payment. A provider who does not is called non-participating, and Medicare.gov explains what that can mean for you: "They can charge you more than the Medicare-approved amount. In many cases, the charge can't be more than 15% above the Medicare-approved amount for non-participating healthcare providers. This amount is called 'the limiting charge.'"

That extra amount is the Part B excess charge. Plan G pays it. Plan N does not. On a service with a $1,000 Medicare-approved amount, a 15% excess charge would be up to $150 out of your pocket on Plan N and nothing on Plan G. On a $150 office visit it would be up to $22.50.

How often does that happen here? We checked two federal files.

AreaPractitioners in CMS's 2024 Medicare physician fileFlagged as never participating or accepting assignmentProviders who have opted out of Medicare (August 2026)
Delta County (Delta, Cedaredge, Paonia, Hotchkiss and neighboring ZIP codes)7000
Montrose210011
Grand Junction625130
Colorado, statewide23,031351,362

Sources: CMS — Medicare Physician & Other Practitioners, by Provider (calendar year 2024 data), Medicare participation indicator, by practice city or ZIP code · CMS — Opt Out Affidavits (August 2026 file), by city. The physician file lists practitioners who billed Original Medicare Part B for more than 10 beneficiaries in 2024. CMS sets the indicator to "Y" for any provider with at least one claim as a participating provider or with assignment accepted, and notes that a non-participating provider may accept the Medicare amount for some services and not others. Counts are our tabulation of those files.

The picture is consistent. In Delta County, and in the two nearest larger medical hubs, almost no practitioner in the file was flagged as outside assignment altogether. Statewide it was 35 of 23,031, and most of those were chiropractors.

That is good news for Plan N, with three limits you should know about.

  • The flag is generous. A "Y" means at least one assigned or participating claim that year. A non-participating provider who accepts assignment on some services and not others still shows as "Y." The only way to know about your doctor is to ask the office or look the provider up in Care Compare.
  • Status can change, and so can where you get care. A new specialist, a referral to the Front Range, or a winter out of state all bring different providers. Our guide to Medicare for snowbirds and travelers covers how a Medigap policy travels with you.
  • Opt-out providers are a different matter entirely. A provider who has opted out does not bill Medicare at all. Medicare.gov says Medicare will not pay for services from an opted-out provider except in emergencies, and a Medigap policy only pays where Medicare does. Neither Plan G nor Plan N helps there. Colorado's opt-out list is mostly mental health counselors, psychologists, psychiatrists, dentists and some family practice physicians.

Want the two plans priced side by side for your age? Bring your birth date, your ZIP code and a rough count of how often you see doctors. We will show Plan G and Plan N from the companies we represent, how each is priced as you get older, and where you stand on guaranteed-issue rights. No charge, no obligation, and no pressure to choose either one.

Compare Plan G and Plan N →

Which plan can you always get?

This is the difference most comparison charts leave out, and for some people it decides the question.

A Medigap company does not always have to sell you a policy. It must when you are in your Medigap Open Enrollment Period or when you have a "guaranteed issue right" — a situation where the law says the company cannot turn you down or charge more for your health. But the law also says which plans are guaranteed in each situation, and the list is not always every plan.

Your situationMust an insurer sell you Plan G?Must an insurer sell you Plan N?What the rule says
Your 6-month Medigap Open Enrollment Period (starts when you are 65 or older and enrolled in Part B)YesYesAny Medigap policy the company sells, with no health questions.
Colorado's 6-month window for people under 65, starting when they become enrolled in Part BYesYesColorado requires insurers to make all of their Medigap plans available.
Trial right: you joined a Medicare Advantage plan when you were first eligible for Part A at 65 and leave within 12 monthsYesYesAny Medigap policy sold by any insurer in the state.
Your Medicare Advantage plan leaves Medicare, stops serving your area, or you move out of its service areaYesNot requiredThe guaranteed list is Plan A, B, D, G (including high-deductible G), K or L for people first eligible for Medicare in 2020 or later.
Employer, retiree or union coverage that pays after Medicare is endingYesNot requiredSame guaranteed list. An insurer may still choose to offer Plan N, but may ask health questions.
Any other timeNot requiredNot requiredNo federal right to buy or switch. The insurer may use medical underwriting.

Sources: Colorado Secretary of State — 3 CCR 702-4, Division of Insurance Regulation 4-3-1, Minimum Standards for Medicare Supplement Policies (Sections 9.1, 10 and 11), Sections 10, 11.B and 11.E · Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections, Section 3. The table is a summary for people first eligible for Medicare on or after January 1, 2020; the guaranteed list differs for people eligible earlier. Each situation has its own application deadline. Regulation text as retrieved October 2026 — confirm your own rights with the Colorado Division of Insurance or SHIP.

Here is why that matters this fall. Some of this year's Medicare Advantage plan IDs on the Western Slope do not appear in CMS's 2027 file, and anyone whose plan is not being renewed should already have a letter saying so. A person whose plan is ending and who returns to Original Medicare has a guaranteed right to a Medigap policy — and Plan G is on the guaranteed list. Plan N is not. Someone in that position with a health history that would not pass underwriting may find that Plan G is the plan they can be sure of getting. We walk through those rights in our guide to what a Medicare Advantage non-renewal letter means.

During your first six months with Part B at 65, none of this applies: every plan a company sells is open to you. That window is covered in detail in our guide to Medigap open enrollment and guaranteed issue.

Can you switch later?

Many people plan to start with Plan N while they are healthy and move to Plan G if their health changes. Be careful with that plan. It runs straight into the rule above.

Medicare.gov puts it this way: "In most cases, you won't have a right under federal law to switch Medigap policies," unless you are within your 6-month Medigap Open Enrollment Period or you qualify under a specific situation or guaranteed issue right. Outside those windows, Medicare's guide says, "There's no guarantee that an insurance company will sell you a Medigap policy if you don't meet their medical underwriting requirements."

Medical underwriting means the company asks about your health and can decline your application or charge more. The moment you most want richer coverage is usually the moment you are least likely to pass.

Some states have added an annual window to change Medigap plans without health questions. We did not find a provision like that in Colorado's Regulation 4-3-1 when we retrieved it in October 2026. The Colorado Division of Insurance is the authority on what state rules apply to you.

None of this means you can never change. People who pass underwriting do move between companies and plans. It means you should not count on it. Medicare's guide says the same thing plainly: "you might not be able to switch policies later."

Sources: Medicare.gov — Can I change my Medigap policy? · Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections, Sections 2 and 4.

What about high-deductible Plan G?

There is a third option that often gets left out. Plan G also comes in a high-deductible version in some states. Medicare's guide describes it: "you must pay the first $2,950 (in 2026) of deductibles, copayments, and coinsurance for covered services not paid by Medicare before the Medigap policy pays anything."

Think of the three as a ladder.

  • Plan G. Highest premium of the three. After the $283 Part B deductible, you generally owe nothing on Medicare-covered care.
  • Plan N. Lower premium. Small, capped copays as you go, and no coverage of excess charges.
  • High-deductible Plan G. Typically the lowest premium. You pay Medicare's cost sharing yourself until you reach $2,950 in the year, then the policy pays like Plan G. Colorado's regulation includes it on the guaranteed-issue list alongside standard Plan G.

Not every company sells the high-deductible version, and the deductible amount is updated each year. If the choice you are really making is "how much risk do I keep in exchange for a lower premium," it belongs in the comparison.

Why does this matter in Delta County?

Because about half of the county is in the group a Medigap policy is designed for.

CMS counted 10,535 Medicare beneficiaries in Delta County in 2025. 5,556 of them — about 53% — were in Original Medicare, and 4,980 were in a Medicare Advantage or other health plan. A Medigap policy works only with Original Medicare, so those 5,556 people are the ones for whom the G-or-N question is live.

Source: CMS — Medicare Monthly Enrollment (data.cms.gov), calendar year 2025 county totals. Original Medicare enrollees as a share of all Medicare beneficiaries: Pitkin County 2,949 of 3,343; Garfield County 7,871 of 10,764; Ouray County 1,227 of 1,694; Montrose County 7,323 of 13,032; Mesa County 21,837 of 41,023; Delta County 5,556 of 10,535.

The health picture bears on the copay question. CDC's PLACES estimates say 74.1% of Delta County adults had a routine checkup in the past year. They also estimate that 33.5% have arthritis, 37.5% have high blood pressure, 12.4% have diagnosed diabetes and 8.8% have coronary heart disease. Those are estimates for all adults, not only people on Medicare. They describe the conditions that turn two visits a year into ten.

Source: CDC PLACES — Local Data for Better Health, county data, 2025 release, Delta County, Colorado, crude prevalence among adults 18 and older, 2023 data.

And geography bears on the excess-charge question. People in Delta, Cedaredge, Paonia and Hotchkiss who need a specialist often look to the nearest larger medical hubs, Montrose and Grand Junction. The federal files above show those markets look the same as Delta County on assignment. Where the picture is less certain is care farther from home, which is exactly the care you cannot plan in advance.

If you are still deciding between a Medigap policy and a Medicare Advantage plan in the first place, start with our comparison of Medigap and Medicare Advantage in Montrose and Delta counties. And if you are new to all of it, our turning 65 roadmap puts the deadlines in order.

Six questions to answer before you choose

QuestionWhy it matters
1. Are you inside a window where the company must accept you?Your Medigap Open Enrollment Period or a guaranteed-issue right decides whether health questions apply at all — and, outside open enrollment, whether Plan N is on the guaranteed list.
2. What does each plan cost at your age, from the same company?Compare G and N from the same insurer first. Then compare across insurers, because the same letter plan is the same coverage at different prices.
3. How is the premium priced?Community-rated, issue-age-rated or attained-age-rated. Medicare's guide warns that attained-age policies can start as the lowest price and become the highest.
4. How many office visits do you really have in a year?Count primary care, specialists, and follow-ups. Multiply by $20 for the upper limit of what Plan N's copay could add.
5. Do all of your doctors accept assignment?Ask each office, or look them up in Medicare's Care Compare. If every one does, Plan G's excess-charge benefit has nothing to pay.
6. Could you change your mind later?Maybe not. Outside your protected windows, a company can ask health questions and decline. Choose as if the choice may be permanent.

On pricing, Medicare's guide lists the questions to put to any company, and two of them are worth asking word for word: "Do you price this Medigap policy by using community-rating, issue-age-rating, or attained-age-rating?" and "Has the premium for this Medigap policy increased in the last 3 years due to inflation or other reasons?"

You can see which companies sell Medigap policies in your ZIP code in Medicare's Medigap tool. Colorado's State Health Insurance Assistance Program offers free, unbiased counseling, and a licensed agent can show you the plans that agent represents.

Sources: Medicare.gov — Choosing a Medigap Policy: A Guide to Health Insurance for People with Medicare (CMS Product No. 02110), 2026 benefit chart, pricing and guaranteed-issue sections, Section 4 · Colorado Division of Insurance — Senior health care and Medicare (SHIP).

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, 1-800-MEDICARE, or your local State Health Insurance Assistance Program (SHIP) to get information on all of your options. Bemis Insurance is a licensed independent insurance agency. Not connected with or endorsed by the United States government or the federal Medicare program. Medicare Supplement Insurance (Medigap) policies are sold by private insurance companies. This article is education, not advice — confirm your own costs, eligibility, guaranteed-issue rights, policy terms and deadlines with Medicare.gov, with the Colorado Division of Insurance, with the insurer, or with a licensed agent before you act. Benefit descriptions are from the CMS publication Choosing a Medigap Policy and describe plan year 2026; the Plan N copayment wording and guaranteed-issue lists are from Colorado Division of Insurance Regulation 4-3-1 as retrieved October 2026; provider counts are our tabulation of the CMS Medicare Physician & Other Practitioners file for calendar year 2024 and the CMS Opt Out Affidavits file for August 2026; enrollment counts are CMS figures for calendar year 2025; health estimates are from the CDC PLACES 2025 release. The premium differences shown are arithmetic illustrations, not quotes. Premiums, deductibles and plan availability change each year, and a provider's Medicare participation status can change at any time.

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Questions people actually ask

What is the difference between Medigap Plan G and Plan N?

Three things. First, Plan N has copays that Plan G does not: up to $20 for some office visits and up to $50 for an emergency room visit that does not lead to an inpatient admission. Second, Plan G pays Part B excess charges and Plan N does not. Third, in several guaranteed-issue situations an insurer must sell you Plan G but is not required to sell you Plan N. Everything else on Medicare's 2026 benefit chart is the same, including the Part A hospital deductible, skilled nursing coinsurance and foreign travel emergency care. Neither plan pays the Part B deductible, which is $283 in 2026.

Does Plan N charge a copay for every doctor visit?

Not necessarily. Colorado's regulation, which follows the national standard, sets the copay at the lesser of $20 or the Medicare Part B coinsurance for each covered office visit, including specialists. Under that wording, a visit where Medicare charges you no coinsurance has no Plan N copay, and a low-cost visit can carry less than $20. The emergency room copay is the lesser of $50 or the coinsurance, and it is waived if you are admitted to a hospital and the visit is covered under Part A. Ask the insurer how it applies the copay to the kinds of visits you have.

What is a Part B excess charge, and do Delta County doctors bill them?

An excess charge is the amount a provider who does not accept assignment may bill above the Medicare-approved amount. Medicare.gov says that in many cases it cannot be more than 15% above the approved amount for non-participating providers. In CMS's calendar year 2024 physician file, all 70 practitioners with a Delta County practice address were flagged as participating in Medicare or accepting assignment. That is a reassuring snapshot, not a guarantee: it covers only practitioners in that file, a provider's status can change, and care you receive elsewhere is billed under that provider's status. Ask each office whether it accepts assignment.

Can I switch from Plan G to Plan N, or from N to G, later?

You can apply at any time, but the company may not have to accept you. Medicare.gov says that in most cases you will not have a right under federal law to switch Medigap policies unless you are within your 6-month Medigap Open Enrollment Period or have a guaranteed-issue right. Outside those windows an insurer can use medical underwriting, which means it can ask health questions and may decline you or charge more. We did not find an annual switching provision in Colorado's Regulation 4-3-1 when we retrieved it in October 2026; the Colorado Division of Insurance can confirm what applies to you.

Is Plan N always less expensive than Plan G?

Plan N generally carries a lower premium than Plan G from the same company because you take on the copays and the excess-charge risk, but each insurer sets its own prices and the gap varies by company, age, tobacco use and ZIP code. The useful comparison is arithmetic: every $10 a month of premium difference is $120 a year, which equals six office visits at the full $20 copay. Compare actual quotes for your age in your ZIP code in Medicare's Medigap tool or with a licensed agent, and ask how each policy is priced as you get older.

What is high-deductible Plan G?

It is Plan G with a yearly deductible in front of it. Medicare's guide says that with the high-deductible option you pay the first $2,950 in 2026 of deductibles, copayments and coinsurance for covered services before the policy pays anything. In exchange the premium is typically lower than standard Plan G. It suits people who can absorb a bad year's costs and want protection above that point. Not every company sells it.

Is Bemis Insurance part of Medicare or the government?

No. Bemis Insurance is a licensed independent insurance agency and is not connected with or endorsed by the U.S. government or the federal Medicare program. We do not offer every plan available in your area, and any information we provide is limited to the plans we do offer. To review every option available to you, contact Medicare.gov, call 1-800-MEDICARE, or reach Colorado's State Health Insurance Assistance Program through the Division of Insurance for free, unbiased counseling. This article is education, not advice — confirm your own costs, eligibility, plan rules and deadlines with Medicare, with the insurer, or with a licensed agent before you act.

Sources

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