Medicare Supplement

Plan G vs. N vs. K vs. L: What Each Medigap Letter Actually Pays

In North Royalton, one of the most common questions retirees ask about Medicare Supplement insurance — often called Medigap — is why the same letter shows up at insurer after insurer. The short answer: federal rules require it. Since 1992, Medigap plans have been standardized by letter, meaning a Plan G sold by one company covers the same core benefits as a Plan G sold by another. What changes from company to company is the price, the customer service, and sometimes small extras — not the underlying benefits set by federal law.

North Royalton is in Cuyahoga County, where Ohio residents choose from the standardized plans the federal government defines. Here is a plain-language look at what Plans G, N, K, L, and high-deductible G do and do not cover, and why the letter — not the logo — is what matters.

Why the letter matters more than the brand

Medigap policies work alongside Original Medicare (Parts A and B). They help pay some of the out-of-pocket costs Original Medicare leaves behind — things like coinsurance, copays, and hospital deductibles. The federal government sets what each lettered plan must cover. So a Plan G is a Plan G, whether it's sold by a national household name or a smaller regional insurer.

That standardization is why so many guides tell shoppers to first pick the letter that fits their needs, then compare insurers on price and service.

What Plan G covers — and doesn't

Plan G is one of the most comprehensive Medigap options available to people newly eligible today. It covers the Part A hospital deductible, Part A and Part B coinsurance, the first three pints of blood, skilled nursing facility coinsurance, hospice coinsurance, and foreign travel emergency care up to plan limits.

What Plan G does not cover is the Part B deductible. Under federal law, that deductible must be paid by the beneficiary before Plan G kicks in for outpatient services. Plan G also does not cover prescription drugs — that's what Part D is for — and it does not cover routine dental, vision, or hearing.

High-deductible Plan G: same benefits, different math

High-deductible Plan G covers the same benefits as standard Plan G, but only after you meet a yearly deductible set by Medicare. The deductible amount is adjusted each year. Until you reach it, you pay out of pocket for the costs Plan G would normally cover. Once you meet it, the plan pays as usual for the rest of the calendar year.

It's the same coverage on paper — just structured so more of the risk sits with you upfront in exchange for a typically lower monthly premium.

Plan N: lower premium, small copays at the door

Plan N covers most of what Plan G covers, with two key differences. First, Plan N can charge 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. 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.

Like Plan G, Plan N does not cover the Part B deductible.

Plans K and L: cost-sharing plans with a safety net

Plans K and L work a little differently. Instead of covering most gaps in full, they pay a percentage of certain costs and require you to pay the rest.

• Plan K generally pays 50% of many covered services (like Part B coinsurance, the first three pints of blood, Part A hospice coinsurance, and skilled nursing coinsurance), and covers the Part A hospital deductible at 50%.
• Plan L pays 75% of those same categories.

Both plans include an important feature: a yearly out-of-pocket limit. Once you hit that limit — and once you've also paid the Part B deductible — the plan pays 100% of covered services for the rest of the year. Medicare sets and updates the out-of-pocket limits annually.

The plans that are closed to newer enrollees

Plans C and F used to be popular because they covered the Part B deductible. Federal law changed that. If you became eligible for Medicare on or after January 1, 2020, you cannot buy Plan C or Plan F (including high-deductible F). People who were already eligible before that date may still be able to purchase them, depending on availability.

Three states that play by different rules

Most of the country uses the letter system described above. But Massachusetts, Minnesota, and Wisconsin standardize their Medigap plans differently. If you move to or from one of those states, the plan choices — and the way benefits are labeled — will not look the same.

How to think about the decision

There's no universally "right" Medigap letter. The federal standardization means the comparison comes down to how you'd rather handle costs: predictable monthly premiums with fewer surprises (Plan G), a lower premium with small copays (Plan N), a high-deductible option that trades upfront risk for a lower monthly bill, or a cost-sharing plan with an annual safety net (K or L).

For a personalized look, the Ohio Senior Health Insurance Information Program (OSHIIP) — the state's SHIP — offers free, unbiased counseling to Cuyahoga County residents.