Medigap Plan Popularity: Why Plan G Dominates and What’s Happening to Plan F

The Shift That Changed Medigap Forever

For decades, Medigap Plan F was the undisputed king of Medicare Supplement insurance. It covered every Medicare cost-sharing gap, including the Part B deductible, making it the simplest and most comprehensive option available. Then, in 2020, federal law closed Plan F to new enrollees, and Plan G stepped in to fill the void. Today, Plan G is the most popular Medigap plan in the country, and Plan F is on a slow but predictable decline.

Why Plan F Was the Most Popular Medigap Plan

Plan F offered something no other Medigap plan could match: zero out-of-pocket costs after your monthly premium. It covered the Part A deductible, Part B deductible, Part B excess charges, skilled nursing facility coinsurance, and foreign travel emergencies. For beneficiaries who wanted complete predictability, Plan F was the answer.

At its peak, Plan F accounted for more than half of all Medigap enrollments nationwide. Agents recommended it because it was easy to explain and easy to sell. Beneficiaries chose it because they never had to think about a bill. The simplicity was the appeal.

The Impact of MACRA: Why Plan F Closed to New Enrollees

The Medicare Access and CHIP Reauthorization Act (MACRA), signed into law in 2015, included a provision that prohibited the sale of Medigap plans covering the Part B deductible to new Medicare enrollees starting January 1, 2020. The rationale was that first-dollar coverage reduces the incentive for beneficiaries to consider cost when seeking care, which in theory drives up overall Medicare spending.

As a result, Plan F and Plan C (the only two plans that covered the Part B deductible) were closed to anyone who became eligible for Medicare on or after January 1, 2020. People who were already enrolled in Plan F before that date can keep it, and people who were eligible for Medicare before 2020 can still purchase it. But for the vast majority of new retirees, Plan F is simply off the table.

Why Plan G Became the Go-To Choice After 2020

Plan G covers everything Plan F covers except the Part B deductible, which is $257 in 2026. That is the only difference. For most new enrollees, the math is straightforward: if the annual premium difference between Plan F and Plan G is more than $257, Plan G saves money. In practice, that gap is almost always larger than $257, often by hundreds of dollars per year.

Beyond the cost math, Plan G benefits from a much larger and younger risk pool. Because it is open to all new Medicare enrollees, Plan G carriers can spread risk more broadly, which helps keep rate increases more moderate over time. Plan F, by contrast, has a closed and aging pool, which creates structural pressure on premiums.

Plan F vs. Plan G: Side-by-Side Comparison

Premium Trends: Why Plan F Is Becoming More Expensive

Because Plan F is closed to new enrollees, its risk pool is shrinking and aging every year. As healthier, younger beneficiaries age out of eligibility and older members file more claims, the average cost per member rises. Carriers respond by increasing premiums, which causes some members to drop Plan F for a less expensive option, which in turn raises costs further for those who remain. This cycle is well underway.

In many states, Plan F premiums are now $50 to $150 per month higher than equivalent Plan G premiums for the same carrier. Given that the only extra benefit is the $257 Part B deductible, the value proposition has largely collapsed for anyone who was eligible for Medicare before 2020 and is still shopping.

The Rise of Plan N

While Plan G dominates the market for new enrollees seeking comprehensive coverage, Plan N has emerged as the fastest-growing alternative for beneficiaries who want lower premiums and are comfortable with modest cost-sharing. Plan N covers everything Plan G covers except Part B excess charges, and it requires copays of up to $20 for office visits and up to $50 for emergency room visits that do not result in a hospital admission.

For relatively healthy beneficiaries who rarely visit specialists and live in states where excess charges are uncommon, Plan N can save $50 to $100 per month compared to Plan G. The trade-off is that you need to verify your doctors accept Medicare assignment (which eliminates excess charges) and be comfortable with occasional copays.

Are High-Deductible Options Worth Considering?

High-Deductible Plan G (HDG) is a lower-premium version of Plan G that requires you to pay a $2,870 annual deductible (2026) before the plan begins paying benefits. Once you meet the deductible, coverage is identical to standard Plan G. Monthly premiums for HDG typically range from $30 to $70 per month, making it an attractive option for beneficiaries who are in excellent health and want catastrophic protection without high monthly costs.

The risk is that in a bad health year, you could owe the full $2,870 deductible on top of the Part B deductible and any other cost-sharing. HDG works best for people who have savings to cover the deductible and are unlikely to need extensive care in any given year.

Long-Term Outlook: What Happens Next to Plan F?

Plan F will not disappear overnight. Millions of beneficiaries enrolled before 2020 still hold Plan F policies and may keep them for years. However, the structural dynamics are clear: a closed, aging risk pool with rising claims will continue to push Plan F premiums higher relative to Plan G. The value gap will widen, and more members will migrate to Plan G or Plan N at each renewal.

For anyone currently enrolled in Plan F who is considering a switch, the decision comes down to whether you can pass medical underwriting (required in most states outside of guaranteed issue windows) and whether the premium savings justify the change. In many cases, switching to Plan G saves $600 to $1,800 per year with identical coverage for everything except the $257 Part B deductible.