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Medigap Plan G vs. Plan N vs. Medicare Advantage (MAPD) — Which Is Best to Switch to in 2026
🎉 Turning 65 or already on Medicare? You’re not alone in wondering which plan to choose in 2026. For most seniors, the real decision comes down to Medigap Plan G, Medigap Plan N, or a Medicare Advantage plan (MAPD).
- Plan G gives you the strongest Medigap protection, covering nearly every gap in Original Medicare.
- Plan N trims the premium a bit lower, but you’ll have small copays along the way.
- MAPD plans (Medicare Advantage with drug coverage) bundle hospital, doctor, and prescriptions together — sometimes with extras like dental, vision, or gym memberships — but you’re tied to networks and yearly out-of-pocket limits.
At Palmetto Mutual, we walk Carolina seniors through these choices every day. The right plan depends on your health, your budget, and your ZIP code. This guide will compare each option side by side so you can switch with confidence and avoid costly surprises.
Why So Many Seniors Consider Switching Medicare Plans in 2026
Switching Medicare plans can be confusing, especially when you’re comparing different timelines, premiums, and coverage rules. Many seniors in 2026 are re-evaluating their options as they weigh the differences between Medigap Plan G, Medigap Plan N, and Medicare Advantage (MAPD). Understanding how these plans compare helps make the decision clearer and prevents costly mistakes.
📅 Understanding Your Medicare Timeline After Enrollment
Your Medicare timeline works like a series of checkpoints on a winding road.
- At 65, you start with your Initial Enrollment Period.
- Each October–December, you hit the Annual Enrollment Period (AEP), where you can make changes for the next year.
- Along the way, Special Enrollment Periods (like moving ZIP codes or losing employer coverage) act like detours.
💬 Marjorie’s Story
“I budgeted as if Medicare was free, like I’d heard people say. When the Part B premium hit, it shook up my retirement plans. I looked at switching to a MAPD to balance my monthly costs, but I also compared Plan G and Plan N for better long-term protection. It taught me: don’t wait until the bill comes to figure it out.”
✅ Common Reasons Seniors Switch Plans
- Lowering monthly premiums without giving up too much coverage
- Finding a plan that includes prescription drug coverage
- Frustration with doctor networks or prior authorizations in MAPDs
- Wanting predictable out-of-pocket costs with Medigap (especially Plan G)
- Taking advantage of new 2026 plan extras like dental or OTC cards
💡 Quick Refresher on Your Three Main Options
MAPD (Medicare Advantage) → $0 or low premiums, bundled drug coverage, extras like dental or gym memberships — but comes with networks and annual out-of-pocket limits.
Medigap Plan G → Highest monthly premium, but almost all gaps are covered.
Medigap Plan N → Lower premiums than Plan G, but has copays ($20 for doctor visits, $50 for ER visits).
What Medigap Plan G Covers — Benefits and Costs
Medigap Plan G is designed to minimize out-of-pocket medical costs under Original Medicare. After you pay the annual Part B deductible, Plan G covers most remaining Medicare-approved expenses, including coinsurance and copays. This makes it one of the most comprehensive supplemental options for people who want predictable costs and fewer coverage gaps.
🛡️ Complete Coverage Like Bumper Rails at a Bowling Alley
With Plan G, you get peace of mind knowing:
- Hospital stays are fully covered after your deductible.
- Skilled nursing, lab tests, outpatient visits — all taken care of.
- No surprise “excess charges” if your doctor bills above Medicare’s standard.
It’s like rolling the ball straight down the lane — you’re protected from unexpected gutter balls.
💰 Understanding Plan G Premiums in 2026
Premiums for Plan G depend on your ZIP code, age, and carrier.
- In some South Carolina ZIPs, like 29582 (North Myrtle Beach), Plan G averages around $145/month.
- Just across the border in 28401 (Wilmington, NC), rates may be closer to $130/month.
- Discounts, like household savings, can drop the cost further if two people in the same home enroll.
📍 That’s why checking your exact ZIP code is key — premiums can change even between towns.
✅ What’s Included vs. What You Still Pay
Here’s a simple side-by-side look at Plan G vs. Plan N vs. MAPD in 2026:
| Feature | Plan G | Plan N | MAPD (Medicare Advantage) |
|---|---|---|---|
| 💵 Part B Deductible | You Pay | You Pay | Varies |
| 📈 Part B Excess Charges | ✅ Covered | ❌ Not Covered | N/A |
| 🌍 Foreign Travel Emergency | 80% (to plan limits) | 80% (to plan limits) | Varies |
| 🏥 Network Restrictions | 🚫 None | 🚫 None | ✅ Yes |
💬 Real Voices from Seniors
“I didn’t think I could afford it, but I qualified for Extra Help.”
“Nobody told me my doctor was out-of-network.”
Plan G makes things simple: you pay a bit more each month, but you rarely get caught off guard later.
What Medigap Plan N Covers — Benefits and Trade-Offs
Medigap Plan N balances lower monthly premiums with some cost-sharing. Many seniors choose Plan N because it typically costs less each month than Plan G. In exchange, enrollees may pay certain copays for doctor and emergency room visits, and some expenses are not covered. Understanding these trade-offs helps determine whether the savings align with your healthcare usage and budget.
🔍 Peeling Back the Layers of Plan N Coverage
Plan N covers the big-ticket items that could derail your budget, such as:
- Hospital stays 🏥
- Skilled nursing care
- 80% of foreign travel emergencies ✈️
But when you peel another layer back, you’ll see:
- A $20 copay at the doctor’s office
- A $50 copay if you go to the ER (unless admitted)
- No coverage for Part B excess charges if your provider bills more than Medicare’s approved rate
💵 Monthly Premiums vs. Out-of-Pocket Costs Explained
- In ZIP 29505 (Florence, SC), Plan N averages $115/month, compared to $140/month for Plan G.
- Over in ZIP 28358 (Lumberton, NC), seniors may see Plan N for $110/month, saving about $25 compared to Plan G.
- These savings add up month after month — but remember, you’ll spend more at the doctor’s office through small copays.
Plan N works best if you’re healthy, see the doctor less often, and don’t mind the occasional copay.
⚖️ When Plan N Makes Financial Sense
Plan N may be the better choice if:
✅ You want to save money upfront with lower premiums
✅ You don’t mind paying small copays along the way
✅ Your doctors don’t charge Part B excess fees (many in the Carolinas do not)
✅ You’re looking for a plan that balances protection and affordability
💬 Eleanor’s Story
Eleanor thought saving money with a $0 premium Medicare Advantage plan was the smartest move. But when she learned her longtime doctor wasn’t in-network, she felt like she’d lost a trusted friend. During her review, she switched to Medigap Plan G, which let her keep all her providers.
“It costs a little more,” she says, “but peace of mind is worth it.”
How Medicare Advantage (MAPD) Works Compared to Medigap
Medicare Advantage (MAPD) plans can offer low or even $0 premiums and added benefits, but they also come with trade-offs. Provider networks, prior authorization rules, and out-of-pocket costs can vary by plan and location, sometimes changing from year to year.
Unlike Medigap Plans G and N, which provide predictable, nationwide coverage alongside Original Medicare, MAPD plans are more localized and subject to plan-specific rules. Understanding these differences is essential when deciding which option best fits your healthcare needs and budget.
🌤️ MAPD Coverage: Like Checking the Weather Forecast Daily
- MAPDs bundle doctor, hospital, and prescription coverage into one plan.
- Many include extras like dental, vision, hearing, or even gym memberships 🏋️♂️.
- Premiums can start as low as $0/month, but you’ll still pay your Part B premium.
Just like checking the daily weather, you need to review the details every year — coverage and networks can change each January.
🏥 Network Requirements and Prior Authorizations
Unlike Medigap (where you can see any doctor that takes Medicare), MAPD plans use networks:
- HMOs may require you to pick doctors in-town.
- PPOs give more freedom but often at higher costs.
- Many services need prior authorization, which means the plan must approve it before you can move forward.
📍 For example, in Charleston, SC (ZIP 29407), one MAPD might cover Roper Hospital doctors, while another limits you to Trident facilities.
💡 Understanding ZIP Code Impact on Your Coverage
Where you live plays a big role in your MAPD options:
- In ZIP 29706 (Chester, SC), some carriers offer household discounts up to 12%, lowering a Plan G premium from about $128 down to $112.
- A few miles over in ZIP 29710 (Clover, SC), those discounts don’t apply — seniors there pay the higher rate.
- MAPDs also vary: one ZIP may have 40+ MAPD choices, while another may have only 12 plans available.
This is why two neighbors in different ZIPs can face very different Medicare decisions — even when their health needs are the same.
Monthly Premiums: Comparing Plan G, Plan N, and MAPD
Building your Medicare budget starts with understanding your monthly costs. Some expenses are fixed and predictable, while others can vary depending on the plan you choose and how you use care. Whether you select Medigap Plan G, Medigap Plan N, or a Medicare Advantage (MAPD) plan, your monthly premium is the starting point for planning and managing your healthcare expenses.
💰 Building Your Medicare Budget Block by Block
- Plan G → Higher monthly premium (often $130–$160 in South Carolina ZIPs like 29582 – North Myrtle Beach).
- Plan N → Mid-range premium (about $110–$125 in the same ZIP), with copays on visits.
- MAPD → Can start at $0 premium in places like 28401 – Wilmington, NC, but costs show up in copays, coinsurance, and yearly out-of-pocket maximums.
Just like building a tower, the more stable your base, the less chance of it toppling later when big medical bills arrive.
🏥 Doctor and Hospital Access Differences in 2026
- Plan G and Plan N → Any doctor or hospital that accepts Medicare across the U.S. ✅
- MAPD → Network restrictions. Example: in ZIP 29464 (Mount Pleasant, SC), some MAPDs include MUSC Health, while others don’t — making hospital choice a deciding factor.
✅ Real Premium Examples Across the Country
| Location & ZIP | Plan G (avg) | Plan N (avg) | MAPD (avg) |
|---|---|---|---|
| Florence, SC – 29501 | $142 | $118 | $0–$40 |
| Wilmington, NC – 28403 | $135 | $112 | $0–$35 |
| Charleston, SC – 29412 | $148 | $122 | $0–$50 |
💬 Martha’s Story
“A phone rep told me it was my ‘last chance’ to grab a MAPD plan, so I signed up without asking enough questions. Later, I realized Plan N would’ve been a better fit. Now, whenever I review my coverage, I slow down, get advice, and make sure the plan name matches what I really want.”
Out-of-Pocket Costs and Deductibles for Each Option
Different Medicare plans manage costs in different ways. Medigap and Medicare Advantage plans each place limits on what you may pay, but those limits work differently depending on the plan type. Understanding where costs can arise—and how each plan handles them—helps you prepare for real expenses and choose coverage that fits your budget and risk tolerance.
⚡ Your Coverage Fuse Box: What Trips the Circuit
- Plan G → Covers almost every expense except the small Part B deductible. Once you pay that, your “circuits” rarely trip.
- Plan N → Adds small copays and leaves Part B excess charges uncovered, so the breaker may flip occasionally.
- MAPD → Works like a panel with many switches. Premiums can be $0, but ER visits, hospital stays, and prior authorizations may flip your costs higher.
⚖️ Medicare Plan Comparison — Pros & Cons
| Aspect | Plan G ✅ Pros | Plan G ❌ Cons | Plan N ✅ Pros | Plan N ❌ Cons | MAPD ✅ Pros | MAPD ❌ Cons |
|---|---|---|---|---|---|---|
| 💵 Costs | Predictable | Higher premiums | Lower premiums | Copays apply | $0 premiums available | High max out-of-pocket |
| 🏥 Access | Any doctor | No extra benefits | Any doctor | ER copays | Extra benefits (dental, vision, etc.) | Network limits |
| 📋 Coverage | Most comprehensive | Part B deductible | Good coverage | Excess charges not covered | All-in-one coverage | Prior authorizations required |
🚫 Hidden Costs Nobody Mentions
Plan G looks pricey upfront but prevents financial “short circuits” later by covering nearly everything.
MAPDs may advertise $0 premiums, but annual out-of-pocket maximums can reach $8,850 in 2026.
Plan N copays may add up quickly if you see specialists often.
Provider Access: Nationwide Coverage vs. Network Restrictions
When it comes to seeing doctors, Medicare plans differ like night and day. Some let you go anywhere in the country, while others limit you to local networks. Here’s a fact file 📁 breakdown so you know exactly what to expect.
📁 Fact File: Provider Network Realities
- Medigap Plan G & Plan N → Work with any doctor or hospital in the U.S. that accepts Medicare ✅. No referrals, no networks.
- Medicare Advantage (MAPD) → Uses networks.
- HMOs = lower premiums but local-only doctors.
- PPOs = wider choice but still restricted.
- Prior authorization is often required for MRIs, surgeries, or specialty treatments under MAPD.
📍 Example: In Florence, SC (ZIP 29505), McLeod Regional Medical Center may be covered by some MAPDs but not others. With Medigap, no such worry — if they take Medicare, you’re in.
💊 Prescription Drug Coverage Differences Explained
- Medigap (Plan G & N) → Do not include drug coverage. You must buy a separate Part D plan.
- MAPD → Includes built-in drug coverage but ties you to its formulary (drug list).
- Formularies change each year — so the drug covered today may cost more next year.
✅ Keeping Your Current Doctors: What Each Plan Allows
- Plan G → Best for seniors who want long-term stability with providers.
- Plan N → Same freedom as Plan G, with small copays.
- MAPD → Best only if your current doctors and preferred hospital are in-network.
💬 Elizabeth’s Story
Elizabeth loved her weekly bridge games ♣️ but hated the surprise bill after an ER visit. She had chosen Plan N, not realizing it came with ER copays. Frustrated, she switched to Medigap Plan G, saying, “Now I know exactly what’s covered and what isn’t.”
Prescription Drug Coverage: Built-In with MAPD vs. Add-On for Medigap
Choosing prescription coverage requires understanding how it’s included with different Medicare options. Medicare Advantage (MAPD) plans include drug coverage as part of the plan. Medigap plans such as Plan G or Plan N do not include prescriptions, so a separate Part D plan is required. Knowing this difference helps ensure your medications are covered correctly and avoids unexpected costs.
🔧 Using the Right Wrench: Matching Drug Coverage to Your Needs
- MAPD Plans → Drug coverage is included. You don’t pay an extra premium, but you must use that plan’s pharmacy network and drug list (formulary).
- Medigap Plans G & N → Require a separate Part D plan. This means another monthly premium but often gives you more freedom to pick a plan that covers your prescriptions best.
📍 Example: In ZIP 29588 (Myrtle Beach, SC), MAPDs may include Walmart and CVS as preferred pharmacies, but a standalone Part D plan may also allow Walgreens or local independents.
💰 Understanding Edge ZIP Premium Penalties
Where you live can increase your drug and Medigap costs.
- In ZIP 29712 (Chesterfield, SC), Plan N averages $128/month.
- Just one town over in ZIP 29520 (Cheraw, SC), the same plan averages $116/month.
- These “edge ZIP penalties” make MAPD plans look more attractive in certain towns, even if Medigap offers stronger coverage.
📋 Part D Formulary Changes and Your Options
- MAPDs → Formularies are set by the plan. Your drug may be covered today, but it could be moved to a higher-cost tier next year.
- Part D Add-On → Lets you shop around annually for the plan that best matches your prescriptions.
💡 That’s why Palmetto Mutual often recommends seniors review drug lists every fall before sticking with the same plan.
Pros and Cons of Plan G, Plan N, and MAPD Side by Side
There are plenty of brochures that highlight the positives, but here’s what no one tells you 🤫 when you’re comparing Plan G, Plan N, and MAPD. These are the real-world trade-offs seniors in the Carolinas run into every year.
🤫 What No One Tells You About Each Plan Type
- Plan G → Feels expensive each month, but when you need major care, it saves you from huge bills.
- Plan N → Looks like a deal upfront, but those $20 and $50 copays can sneak up if you see doctors often.
- MAPD → “$0 premium” sounds wonderful — until you learn your doctor or hospital isn’t in-network.
📍 For example: In ZIP 29440 (Georgetown, SC), many MAPDs don’t include Tidelands Georgetown Memorial Hospital, forcing seniors to travel for care. With Plan G or N, that’s never an issue.
🎁 Extra Benefits to Consider Beyond Medical Coverage
- MAPDs often include perks like dental cleanings, hearing aids, gym memberships, or OTC cards 🛒.
- Medigap Plans G & N stick to medical coverage only, but give you the freedom to pick any doctor nationwide.
- The question is: Do you value extras now, or unlimited provider choice long-term?
⚖️ Making the Trade-Off Decision
Think of it like weighing two baskets on a scale ⚖️:
- Basket 1 = Freedom & predictability → Medigap Plan G or N
- Basket 2 = Extras & lower monthly premium → MAPD
💬 Paul’s Story
“What if you pick a $0 premium plan and then find out your doctors aren’t included? That’s what happened to me. I had to drive far out of town just to get care. Now I’m weighing Plan G versus Plan N, because I want predictable access to doctors without surprises.”
How to Decide Which Medicare Plan Fits Your Needs in 2026
Deciding on a Medicare plan can feel complicated because there are several valid options to compare. The key is having clear guidance so you understand the differences between Medigap Plan G, Medigap Plan N, and Medicare Advantage (MAPD). With the right information, you can compare these plans accurately and choose the one that best fits your healthcare needs and budget.
🧩 Navigating the Medicare Maze: Your Personal Roadmap
Here’s how to think about your decision:
- Plan G → Best if you want peace of mind and predictable costs.
- Plan N → Good if you’re healthy, want to save money monthly, and don’t mind small copays.
- MAPD → Works well if you like bundled coverage (hospital, doctors, and drugs together) and don’t mind network rules.
📅 Switching Rules and Timing in 2026
- Annual Enrollment Period (AEP): Oct 15 – Dec 7 → Change or join MAPD and Part D plans.
- Medigap Switching: Rules vary by state. In most cases, switching later may require health questions (medical underwriting).
- Special Enrollment Periods: Triggered by moving ZIP codes, losing employer coverage, or other life changes.
📍 Example: If you move from ZIP 29582 (North Myrtle Beach, SC) to ZIP 28403 (Wilmington, NC), your MAPD options will change, but Medigap Plan G or N will continue working anywhere doctors accept Medicare.
✅ Step-by-Step Decision Checklist
- List your monthly budget 🧾
- Write down your current doctors & preferred hospitals 🏥
- Check your prescriptions against formularies 💊
- Decide if you want extras (dental, vision, gym) 🎁
- Compare premiums in your ZIP code 📍
- Talk with a licensed Medicare agent for a side-by-side review 🤝
🧭 Choosing the Best Medicare Plan for Your Situation
| Your Situation | Best Option | Why |
|---|---|---|
| ✈️ Travel frequently | Plan G or N | Nationwide coverage |
| 💵 Fixed income, healthy | Plan N | Lower premiums, manageable copays |
| 💊 Multiple medications | MAPD | Built-in Part D drug coverage |
| 📊 Want predictability | Plan G | Most comprehensive coverage |
| 🎁 Like extra benefits | MAPD | Dental, vision, hearing included |
❓ Frequently Asked Questions
📊 Compare Timelines, Claims Help, and Plan Matching — Side by Side
| Feature | Plan G | Plan N | MAPD |
|---|---|---|---|
| Monthly Premiums | Higher, predictable | Lower, with more copays | Often lowest upfront |
| Provider Choice | Any doctor accepting Medicare | Any doctor accepting Medicare | In-network only |
| Claims & Billing | Streamlined | Streamlined | Managed through the plan |
| Added Benefits | Medical only | Medical only | May include dental, vision, hearing |
✅ At Palmetto Mutual, we don’t just show you numbers — we explain how each plan affects your budget, coverage, and peace of mind in 2025.
Your next Medicare choice should:
Fit your health needs 🏥
Match your budget 💰
Support your lifestyle 🌎
📚 Suggested Reading
About the Author
Dvir Mosche is an award-winning independent insurance agent and the founder of Palmetto Mutual, a trusted insurance brokerage specializing in Medicare, final expense, and senior benefits in North and South Carolina and across the country. Since entering the industry in 2017, he has been recognized multiple times as a top agent for his dedication to educating and assisting seniors in finding the proper coverage. His mission is to simplify the process, provide honest and personalized guidance, and ensure that every client gets coverage they can depend on for life.
