Medicare Supplement

Same Letter, Same Coverage: What Medigap G, N, K and L Actually Do

In Toms River, one of the most common questions from people turning 65 is also one of the most misunderstood: if two insurers both sell "Plan G," is the coverage really the same? Under federal rules, the answer is yes. Medicare Supplement Insurance — better known as Medigap — is standardized by letter, which means the benefits inside Plan G, Plan N, Plan K, Plan L, and high-deductible Plan G are set by law, not by the insurance company.

That's a helpful thing to know before you shop, because it changes what you're really comparing.

Why the "letter" is what matters

The federal government sets what each Medigap letter must cover. An insurer can decide whether to sell a particular letter, what to charge, and how to handle customer service — but it cannot change the benefits inside the plan. So when you compare Plan G across companies, you're really comparing price, service, and stability, not coverage.

That's the single biggest source of confusion we hear from readers: assuming that a cheaper Plan G is somehow a "worse" Plan G. The benefits are identical by law.

What Plan G covers (and one thing it doesn't)

Plan G is the most comprehensive Medigap plan available to people newly eligible for Medicare today. It covers the Part A hospital deductible, coinsurance for hospital and skilled nursing stays, Part B coinsurance, the first three pints of blood, hospice cost-sharing, and a share of foreign travel emergency care.

The one thing Plan G does not cover is the annual Part B deductible. You pay that yourself before the plan begins paying its share of outpatient costs.

How Plan N is different

Plan N covers most of the same things Plan G does, with two notable differences. First, you may owe a copay of up to $20 for some office visits and up to $50 for emergency room visits that don't lead to an inpatient admission. Second, Plan N does not cover Part B "excess charges" — the extra amount a doctor can bill if they don't accept Medicare's approved amount as full payment. Plan G does cover those.

For many people, those trade-offs mean a lower monthly premium in exchange for a little more cost-sharing at the point of care.

Plans K and L: cost-sharing with a yearly cap

Plans K and L work differently from G and N. Instead of covering most costs in full, they pay a percentage — K pays 50% of many benefits, and L pays 75%. You pay the rest.

In exchange, both plans include an annual out-of-pocket limit. Once you hit that limit and pay the Part B deductible, the plan pays 100% of covered services for the rest of the calendar year. Plan G and Plan N don't have that yearly cap because they cover more of your costs from the start.

High-deductible Plan G

High-deductible Plan G covers the same benefits as regular Plan G, but only after you meet a yearly deductible set by federal rule. Premiums are typically lower, but you're responsible for more out of pocket before the coverage kicks in. It's the same letter, just structured around a higher deductible.

Plans C and F are closed to newer enrollees

If you became eligible for Medicare on or after January 1, 2020, you cannot buy Plan C or Plan F. Those two plans covered the Part B deductible, and federal law closed them to newly eligible enrollees. People who were already eligible before that date can still buy or keep them where available.

A note for readers in a few states

Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans under a different system. If you live in one of those states — or move to one — the letter comparisons in this article don't apply the same way. Ocean County, New Jersey follows the federal standardization used in most states.

Where to get answers you can trust

Medigap rules, enrollment protections, and the standardized benefit chart are all published at medicare.gov. You can also call 1-800-MEDICARE, 24 hours a day, or reach New Jersey's State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling to Toms River residents.