Medicare Supplement

Same Plan G in Paterson: what the Medigap letter guarantees, and what it doesn't

PATERSON, N.J. — If you have been comparing Medigap options and wondering why the same "Plan G" seems to show up at insurer after insurer, you are reading the chart correctly. Under federal rules, Medigap plans are standardized by letter — so a Plan G at one company covers the same medical costs as a Plan G at another. What changes from company to company is the price and the service, not the benefits on the chart.

That standardization is what makes the Medigap letters comparable in the first place. Here is how Plans G, N, K, L and high-deductible G line up, and what the chart does — and does not — promise.

Why "the letter is the letter"

Medigap — also called Medicare Supplement Insurance — is sold by private insurers, but the federal government defines what each lettered plan has to cover. According to CMS, a company selling Plan G in New Jersey must include the same set of benefits as any other company's Plan G. The insurer picks the price and the customer service; the benefit grid is not theirs to change.

That is why shopping Medigap is mostly a price-and-service comparison once you have chosen a letter. Paterson is in Passaic County, and the letter you pick will behave the same way whether you buy from a national carrier or a regional one licensed in New Jersey.

Three states are the exception. Massachusetts, Minnesota and Wisconsin standardize their Medigap plans on their own systems, so the letter descriptions below do not apply the same way there.

What Plan G covers

Plan G is one of the more comprehensive letters still open to new enrollees. It covers Part A coinsurance and hospital costs, Part B coinsurance or copays, the first three pints of blood, Part A hospice coinsurance, skilled nursing facility coinsurance, the Part A deductible, and foreign travel emergency care up to plan limits.

What Plan G does not cover: the annual Part B deductible. You pay that yourself before Plan G's Part B coverage kicks in. It also does not cover prescription drugs — that is Part D — and it does not cover routine dental, vision, hearing aids or long-term care.

What Plan N covers — and the two catches

Plan N covers the same major categories as Plan G, with one built-in cost-sharing feature: you may owe a copay of up to $20 for some office visits and up to $50 for emergency room visits that do not result in admission. Like Plan G, Plan N does not cover the Part B deductible.

There is a second catch that trips people up. Plan N does not cover Part B "excess charges" — the extra amount a provider can bill when they do not accept Medicare assignment. Plan G does cover excess charges. Whether that matters depends on whether the doctors you see accept assignment.

High-deductible Plan G

High-deductible Plan G covers the same benefits as regular Plan G, but you must first pay an annual deductible set by Medicare before the plan begins to pay. After you meet that deductible, coverage works like standard Plan G.

The trade-off is straightforward: a lower monthly premium in exchange for more up-front cost-sharing during the year. It is the same benefit chart — just with a deductible sitting in front of it.

Plans K and L: the cost-sharing plans

Plans K and L are structured differently. Instead of paying most Part A and Part B cost-sharing in full, they pay a percentage:

• Plan K pays 50% of many cost-sharing items (including the Part A deductible, Part B coinsurance, and skilled nursing facility coinsurance), and you pay the other 50% until you hit an annual out-of-pocket limit set by Medicare. After that limit, and after you meet the Part B deductible, the plan pays 100% of covered services for the rest of the year.
• Plan L works the same way but pays 75% and has a lower out-of-pocket limit.

Neither K nor L covers the Part B deductible, foreign travel emergency, or Part B excess charges. They are designed for people who want a lower premium and are willing to share more of the cost until the annual cap is reached.

What Plans C and F used to do — and why the chart looks different now

Plans C and F used to be popular because they covered the Part B deductible. Under federal law, plans that cover the Part B deductible are closed to people who became eligible for Medicare on or after January 1, 2020. If you were eligible before that date, you may still be able to buy them; if you became eligible later, they are not on your menu.

That is why current shoppers most often compare G, N and high-deductible G — and why Plan F rarely appears in a new enrollee's comparison at all.

How Medigap fits with the rest of Medicare

Medigap only works with Original Medicare (Part A and Part B). It does not work with Medicare Advantage. And Medigap does not include prescription drug coverage — you would add a separate Part D plan for that.

A few Part D program-level figures for 2026 are worth keeping in mind while you plan: the Part D out-of-pocket cap is $2,100, the maximum Part D deductible is $615, and the coverage gap has been eliminated as of 2025, leaving three phases. The Medicare Prescription Payment Plan lets you spread drug costs across the year in monthly amounts if you choose. IRMAA income-related surcharges begin above $109,000 for a single filer in 2026.

Enrollment dates to remember: the Annual Enrollment Period runs October 15 through December 7, and the Medicare Advantage Open Enrollment Period runs January 1 through March 31. Medigap has its own enrollment rules, including a one-time six-month Open Enrollment Period that begins when you are 65 or older and enrolled in Part B.