Medigap Plan G vs. Plan N vs. Medicare Advantage (MAPD) — Which Is Best to Switch to in 2025

Why So Many Seniors Consider Switching Medicare Plans in 2025

Switching Medicare plans can feel like untangling a ball of yarn 🧶 — one knot leads to another, and before you know it, you’re staring at a timeline of deadlines, premiums, and coverage rules. Many seniors in 2025 are rethinking their choices, especially when comparing Medigap Plan G, Medigap Plan N, and Medicare Advantage (MAPD).

📅 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 2025 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

Think of Medigap Plan G like the bumper rails at a bowling alley 🎳 — it keeps you from falling into costly gaps when life throws a curve ball. You may still have to pay the small Part B deductible, but once that’s met, Plan G covers nearly everything else Original Medicare leaves out.

🛡️ 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 2025

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 2025:

💬 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 is like peeling back the layers of an onion 🧅 — each layer reveals both savings and small trade-offs. Many seniors pick Plan N because it often has a lower monthly premium than Plan G, but it does come with copays and certain exclusions.

🔍 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

Choosing a Medicare Advantage (MAPD) plan is a lot like checking the weather forecast 🌤️. Some days it’s sunny with $0 premiums and built-in extras, but other days clouds roll in with network limits and surprise out-of-pocket costs. Unlike Medigap Plans G and N, which give you predictable nationwide coverage, MAPDs change with the seasons — and sometimes even by ZIP code.

🌤️ 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 is like stacking toy blocks 🧱 — each one represents a monthly cost. Some are steady and predictable, while others wobble if you don’t stack them just right. Whether you choose Plan G, Plan N, or a Medicare Advantage (MAPD), your premium is the foundation.

💰 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 2025

• 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

💬 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

Think of your Medicare plan like a fuse box in your home ⚡. Each breaker represents a cost limit — when one trips, you feel it in your wallet. Medigap and Medicare Advantage plans handle these “circuits” differently, and knowing which fuse might blow helps you prepare for real costs.

⚡ 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

🚫 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 2025.

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 is like picking the right wrench 🔧 for the job — if you don’t match the tool to the bolt, you’ll struggle. Medicare Advantage (MAPD) plans include drug coverage automatically, while Medigap (Plan G or Plan N) requires adding a separate Part D plan.

🔧 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 2025

Deciding on a Medicare plan can feel like walking through a maze 🌀 — every turn looks promising, but some paths lead to dead ends. The key is having a clear map so you don’t get lost between Plan G, Plan N, and MAPD.

🧩 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 2025

• 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

1. List your monthly budget 🧾
2. Write down your current doctors & preferred hospitals 🏥
3. Check your prescriptions against formularies 💊
4. Decide if you want extras (dental, vision, gym) 🎁
5. Compare premiums in your ZIP code 📍
6. Talk with a licensed Medicare agent for a side-by-side review 🤝

🧭 Choosing the Best Medicare Plan for Your Situation