Medigap Plan G vs Plan N in Arizona: which should I choose?

Plan G if you never want to see a bill after a doctor visit. Plan N if you are healthy, see a doctor a handful of times a year, your practices accept Medicare assignment, and you would rather keep the premium difference. Both plans pay what Original Medicare leaves behind, both leave you the $283 Part B deductible, and both work with any provider in any state who takes Medicare. Everything that separates them fits on three lines: an office copay, an ER copay, and Part B excess charges.

What makes this an Arizona question rather than a generic one is the timing. Arizona has no birthday rule, no anniversary rule, and no year-round guaranteed issue. You choose a letter inside your six-month Medigap window with no health questions, and after that most changes go through underwriting. So the decision is cheap once. I walk Peoria households through it most weeks, from the new arrivals in Vistancia who are choosing for the first time in this state to the long-time 85345 residents who have had Plan G for a decade and want to know whether N would have been smarter. Here is the whole comparison, in order.

What actually differs between Plan G and Plan N

Medicare Supplement benefits are standardised by federal law. A Plan G from one carrier pays exactly what a Plan G from another pays, so the comparison is never which company, it is which letter, at what premium. Here is the full picture for 2026.

Source: Medicare.gov, "Compare Medigap plan benefits". Benefits are federal and identical across Maricopa County; only premiums differ by carrier, age and ZIP.

Two things worth saying plainly about that table. First, the Part B deductible is a wash. People sometimes read “Plan N does not cover the Part B deductible” as a point against it, but Plan G does not cover it either, and no plan sold to anyone newly eligible since 2020 does. Second, the top half of the table is where the catastrophic money lives, and the two plans are identical there. A long hospital stay or a run of skilled nursing days costs the same on either letter. Plan N’s exposure is all in the small, frequent, predictable category.

The Arizona wrinkle: excess charges are legal here

A Part B excess charge is the extra a non-participating provider is allowed to bill, up to 15 percent above the Medicare-approved amount, when they do not accept assignment. Eight states ban the practice outright. Arizona is not one of them, so on Plan N the exposure is real rather than theoretical.

It is also, in practice, small. KFF’s analysis of CMS data found that 98 percent of physicians and practitioners billing Medicare were participating providers, meaning they accept assignment on every claim, and only about one percent of non-pediatric physicians have opted out of Medicare altogether. The five percent higher payment Medicare gives participating providers is a strong incentive to stay in that group, and the large physician groups that dominate the west Valley are generally in it.

But “generally” is not “yours”. The way to settle it is not to guess. Ask each practice you rely on one question, phrased exactly this way: “Do you accept Medicare assignment?” Not “do you take Medicare”, which nearly everyone answers yes to. Then confirm it on Medicare.gov’s Care Compare, which lists whether a clinician accepts assignment. If every practice on your list says yes, Plan N’s biggest theoretical drawback is off the table for you. If one specialist you cannot replace says no, that is a genuine point for Plan G, and the Plan G vs Plan N calculator lets you put a number on it.

The arithmetic for a real year

The decision comes down to a subtraction most people never actually do. Take the monthly premium difference between your two quotes, multiply by twelve, and set it against the copays you would realistically pay on Plan N.

An illustration, using your own numbers rather than anyone’s rates: if Plan N is quoted at $30 a month less than Plan G for the same age and carrier, that is $360 a year in your pocket before any care happens. Eight office visits in a year at the full $20 copay is $160. One ER visit that does not end in admission adds up to $50. Plan N finishes that year $150 ahead, and it finishes further ahead in a year with fewer visits. It takes roughly eighteen office visits at the full copay to erase a $30 monthly premium gap, and the gap itself is what varies most by carrier and by ZIP.

Three honest caveats to that sum:

• The copay is “up to” $20, and not every visit triggers it. Lab draws, imaging and many follow-ups are billed without the copay. Your real count is usually lower than your visit count.
• The premium gap is not fixed. Both plans see rate increases over time. Plan N’s history has often been gentler, in part because the copays discourage some low-value visits, but that is a pattern to ask about carrier by carrier, not a promise.
• Excess charges do not show up in a good year. If a provider you use does not accept assignment, a single expensive procedure can put Plan N behind in a way the office copays never would. That is the line in the calculator that matters most and the one most people leave at zero.

Everything above the line, the premium you pay Medicare for Part B and any IRMAA surcharge, is identical whichever letter you choose. A Medicare Supplement premium does not rise with your income; the surcharge lives on the Part B and Part D side of the ledger, and a higher earner pays it on Plan G, on Plan N, or on an Advantage plan alike.

Why the answer changes across Peoria

Peoria runs nearly thirty miles north to south, and this comparison lands differently at each end. The city page has the fuller version, but the parts that bear on G versus N are these.

North Peoria, the 85383 corridor, Vistancia and Trilogy. A large share of these households arrived within the last decade, often carrying a Medicare Supplement chosen under another state’s rules. If you bought Plan N in a state with a birthday rule, you had an annual chance to move to G without questions. Arizona gives you no such thing. A supplement bought elsewhere still works here, because there is no network to lose, but the flexibility you may have been counting on to change letters later does not follow you across the state line. Knowing that, some new arrivals who are otherwise healthy still choose to apply for a change now rather than at seventy-five, while underwriting is easiest to pass.

Seasonal residents. Both plans travel. That is the whole reason a supplement so often beats a network plan for the households in Trilogy at Vistancia and Westbrook Village who spend summers somewhere cooler. The G-versus-N question for a snowbird is only about whether the practices at both ends accept assignment, which is a quick call to each.

Specialist care in Arrowhead and Sun City. North Peoria residents drive to Arrowhead or into Sun City for most of their specialist visits, and Sun City in particular has a concentration of practices built around Medicare patients. Those practices are also, in my experience, the ones most likely to accept assignment, because Medicare is most of what they bill. But a busy specialist patient, someone seeing cardiology, rheumatology and a pain practice on a rotating schedule, is exactly the person whose Plan N copays add up fastest. The more names on your specialist list, the more the arithmetic drifts toward G.

The older 85345 core and Westbrook Village. Households here have often had Plan G, or the closed Plan F before it, for many years. The question I hear is whether to drop to N to trim the premium. That is possible, but it is an underwriting application in Arizona, and the section below is the part to read before you start one.

The timing rule that decides more than the benefits do

Your Medigap open enrollment period is six months long, starts the first month you are 65 or older and enrolled in Part B, and happens once. Inside it, no carrier can refuse you or price you for your health, and you can pick any letter. Outside it, in Arizona, changing from G to N or from N to G is a new application with health questions, and the carrier can decline.

Three details make this sharper than people expect:

1. Arizona has no birthday rule. A handful of states let you move to a plan with equal or lesser benefits each year around your birthday with no underwriting. Arizona does not, and a rule from California or Oregon does not travel with you. Do not let a neighbor’s experience from another state set your expectations here.
2. Guaranteed-issue rights mostly skip Plan N. The federal situations that let you buy a supplement without health questions, such as losing employer coverage or an Advantage plan leaving your county, give you the right to buy Plans A, B, C, D, F, G, K or L. Plan N is not on that list. The one exception is the first-year trial right for someone who joined an Advantage plan at 65, which allows any policy sold in the state. So if you are counting on a future guaranteed-issue event to get you into N, it will generally get you into G instead.
3. You get thirty days to change your mind. When a new Medigap policy is issued, there is a 30-day free look period during which you can cancel it and keep the old one. You pay both premiums for that month. It is the safety net for a G-to-N move that turns out to feel wrong.

Put together, the practical rule is this: choose the letter you expect to want at eighty, not the one that saves the most this year. Moving from N to G later means passing underwriting at an older age with more history. Moving from G to N later means the same, and the premium saving is smaller by then anyway. If you are inside your open enrollment window right now, that window is the one place this decision costs nothing to get right.

One clarification, because the season invites the confusion: the fall Annual Enrollment Period from October 15 to December 7 is for Medicare Advantage and Part D. It does nothing for a Medigap letter change. You can apply to change a supplement in any month, and in Arizona the answer depends on your health, not the calendar. If your real question is whether to leave an Advantage plan for a supplement at all, that is a different decision with its own windows, and the letter comes second.

What about high-deductible Plan G?

There is a third option that suits a particular kind of household. High-deductible Plan G is standard Plan G with a deductible in front of it that CMS resets every January, set at $2,950 for 2026. You pay every Medicare-covered cost, including the Part B deductible, until you reach that amount, and then the plan behaves exactly like Plan G for the rest of the year. The premium is a fraction of the standard version.

For a household with the cash flow to absorb a bad year without noticing, it can be a rational trade: a small, predictable premium in exchange for a capped and known worst case, with no copay bookkeeping and full coverage of excess charges once the deductible is met. For a household that would feel a $2,950 year, it is not. The cost estimator will show you the range, and it belongs in the same conversation as G and N rather than after it.

The short version

• Plan G pays everything Medicare approves after the Part B deductible. Nothing to track, nothing to argue, and it is the plan most guaranteed-issue situations will let you into later.
• Plan N pays everything except an office copay of up to $20, an ER copay of up to $50, and Part B excess charges. It costs less each month, and the saving is real for someone with few visits and providers who accept assignment.
• The difference is small money either way. The catastrophic coverage is identical. Choose on temperament and on your specialist list, not on a headline premium.
• In Arizona, choose once. No birthday rule, underwriting for letter changes, and Plan N excluded from most guaranteed-issue rights. Pick the plan you expect to keep.

What to do before you decide

If you are turning 65 in the next six months, or your Part B is starting for another reason, three things in order:

1. List your practices and call each one with the assignment question. Primary care, every specialist, and the urgent care you actually use. Write down the answers.
2. Count last year’s office visits honestly, then run the calculator with real quotes for both letters from the same carrier at the same age. The breakeven visit count is the number that settles most of these.
3. Decide inside your window. If you are between the two, a short conversation usually resolves it faster than another week of reading, because the deciding fact is nearly always something specific to your doctors rather than to the plans.

And if you already have one letter and are wondering about the other, get the quotes before you get attached to the idea. The Medicare Supplement page explains what underwriting in Arizona actually asks, and a call to (602) 844-6002 will tell you in ten minutes whether a change is worth applying for. No pressure either way; sometimes the honest answer is that the plan you have is the plan you should keep.