This isn't necessarily investing, but I am seeking the widest possible viewership for a question. We are getting ready to switch to Medicare/Medigap.
I know that most of us here are already on a Medicare supplement plan. I've seen that many prefer a Medigap Plan G or N. The Medigap G appeals to us. The question is: I have been told by people that I consider reliable, that the cheapest plan (in your area) is best choice because they all cover same by law. So, whatever Medigap provider you choose, the results should all be the same.
Is there any advantage to paying a slightly higher premium for (i.e) AARP Unitedhealthcare vs Cigna National Health Insurance Company? Are there any pitfalls?
What are peoples experiences dealing with any of the major providers? Any to avoid?
What are people's thoughts on community vs attained age pricing?
Anyone using a high deductible plan? Why?
Add any comments at all, no worries about going OT. I am just starting my research. I will likely call a broker, but want to have some education first.
Comments
No one has issues with the lowest priced providers (in a given area)?
My assumption is that community pricing benefits people with higher ages or more issues?
We both have AARP/United Health plan F. This is no longer available. I can't add any knowledge about PLAN G. However, we have been pleased with United Health for everything covered with our plan, including proper answers to any questions.
Don't forget to check (with a broker) what you have available, in your area for, PLAN D, being prescription drugs. If requirements have not changed, I recall that if one doesn't perform the PLAN D when qualified and starts the PLAN D at a later date, a dollar value penalty is added that will never go away....a permanent cost penalty.
We currently use WellCare for our plan D (past 3 years), but have had others in years past. PLAN D's have many choices for many reasons.
I would definitely use a broker for a full overview.
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Medicare Part D plans are optional, private insurance policies that cover prescription drugs, recommended vaccines, and, for many, insulin at a maximum of
/month. These plans, either as standalone PDPs or bundled with Medicare Advantage (MA-PD), are available to anyone with Medicare. To avoid late enrollment penalties, it is advised to enroll when first eligible.
Key Details About Medicare Rx Plans (Part D)
Types of Coverage:
Standalone Prescription Drug Plans (PDPs): Adds drug coverage to Original Medicare.
Medicare Advantage with Prescription Drug (MA-PD): Bundles health and drug coverage into one plan.
Costs: Monthly premiums, deductibles, and copays/coinsurance vary by plan.
Key Features (2026):
$0 Copay Vaccines: Most adult vaccines, including shingles, are covered at $0.
Insulin Cap: A 1-month supply of covered insulin is capped at $35.
Catastrophic Coverage: $0 cost-sharing in the catastrophic stage.
What is a Formulary? Each plan has a list of covered drugs (formulary) divided into cost tiers.
How to Choose: Compare plans using your current medication list on the Medicare.gov website to ensure your drugs are covered at the lowest cost.
Important Considerations
Late Enrollment Penalty: If you do not join when first eligible and do not have other "creditable" coverage (like from an employer or union), you may pay a penalty of 1% per month.
Eligibility: Must have Part A and/or Part B
Yes, on the broker. We have Part A now, and creditable employer coverage for Part B until mid-year.
As you mentioned, by law all Medigap letter plans provide the same standardized benefits. However, once you’re enrolled in a Medicare Supplement plan, switching to a different carrier in most states, and in most situations, requires medical underwriting.
Because of pricing, I’ve personally switched carriers, from UnitedHealthcare to Aetna to Cigna (in March 2025, Health Care Service Corporation acquired Cigna’s Medicare Supplement, Medicare Advantage, and Part D businesses), each time I had to go through underwriting.
Here’s why carrier choice might matter.
Let’s say your Medigap policy is with a lesser-known company with weaker financials (or any company with weaker financials). Let’s say that you live in a state where medical underwriting takes place to switch plans. Mid-year, you develop a serious health condition that requires significant and ongoing medical care.
If that carrier decides to substantially raise premiums to stabilize its business, you could find yourself stuck (you can always go to a Medicare Advantage plan). Because of your new medical condition, you may not be able to pass underwriting with highly rated carriers such as UnitedHealthcare, Aetna, Cigna, or others.
A good broker is worth their weight in gold.
Except when we purchased Plan F from AARP/UHC, we never once had to deal with them in nearly 20 years. That's the primary reason we got Plan F, which was a bit more expensive, but we wanted no hassle with the private Medigap insurer. Especially, as we are getting older.
Once Medicare approves and pays their share of a claim, they seamlessly forward it to the Medigap company for the fully authorized remainder of the payment. Neither the doctor nor the policyholder has to get involved. At least, that has been our happy experience so far.
Good luck.
Thank you. Good info. We have been with UHC/Surest for a long time and that tilts me slightly in their direction. Cigna is a little cheaper per Medicare.gov, so I am considering them too. Once I have my research complete, I will definitely call a recommended broker.
No hassle is a primary goal.
As Mark Twain was incorrectly credited with saying, all generalizations are false, including this one.
Like Medicare Advantage (Part C) plans, Medigap plans are allowed to throw in some freebies. The only one I'm aware of with Medigap plans is gym membership (e.g. Silver Sneakers).
https://www.goodrx.com/insurance/health-insurance/medigap-gym-membership
https://www.medicare.gov/coverage/gym-memberships-fitness-programs
For those who qualify for Plans F and G, get the cheapest policy regardless of F or G. (The only difference between the two plans is that G does not cover the Part B deductible, currently $283.)
I will ... forgo Part C and D, since we will keep our private insurance family in retirement to supplement the co-pay and other out-of-pocket expense that Medicare does not cover.
Part C is Medicare Advantage, a private insurance overlay that subsumes Parts A, B, and usually D. More on this below. With respect to Part D (drugs), if your current private plan provides creditable (equivalent or better) coverage there's no harm in forgoing Part D. If you want to enroll in a Part D plan at a later time, there's no penalty. But if it is not creditable coverage, then future enrollment penalties grow as catch described.
https://www.medicare.gov/health-drug-plans/part-d/basics/creditable-coverage
Medicare Advantage (Part C) is another alternative. These are private plans that provide at least as much coverage as Parts A and B. Most also provide Part D coverage, though you can get MA plans w/o Part C, often with better benefits than what the same insurer offers for a MAPD (MA plus Part D) plan.
In 2025, according to KFF all but 22 out of 3719 MA plans offered were HMOs or PPOs.
https://www.kff.org/medicare/medicare-advantage-2025-spotlight-a-first-look-at-plan-offerings/#appendix
These structures are likely familiar to anyone who's had an employer plan in that past 30 years. The downside of HMOs is that you can't go out of network. Worse, if your plan drops a provider or even a group of hospitals mid-year, you're out of luck. And lately that seems to be happening more frequently.
Going out of network with a PPO costs more. But unlike with employer PPO plans, with MA PPO plans you don't risk being stuck with a much higher bill because the provider charged more than the plan was willing to pay. Medicare providers are bound to honor Medicare fees (in infrequent cases up to an additional 15%), even if they're out of network. So between a MA HMO and a PPO, the PPO is the safer choice.
https://www.medicalnewstoday.com/articles/medicare-non-participating-provider
A major downside of MA plans is that they usually require preauthorization for major procedures. Another is having to deal with the bureaucracy of a private insurer (even when preauthorization isn't the problem).
Another big concern is being able to get a Medigap plan if you decide to switch back to original Medicare. When you're first eligible for Medicare, Medigap plans are guarantee issue - you can't be turned down for health reasons. But later, you may need to qualify; these policies are "medically underwritten".
https://www.uhone.com/health-and-wellness/health-insurance/medical-underwriting-what-it-is-and-why-it-may-affect-your-coverage
A handful of states protect your ability to get Medigap insurance at a later date.
https://www.medicareresources.org/enrollment-options/#statevariation
Worst case, you could get locked into a particular Medigap insurer because no one else will write you a policy with your declining health. This is a reason to consider more than today's cost. Medigap plan costs may rise at different rates. What was cheapest one year may be much more expensive the next.
Eight states require Medigap plans to be community rated, meaning that everyone in your area is charged the same rate. Elsewhere, a plan may be community rated, issue-age rated, or attained-age rated. Issue-age rated means that the rate is based on your age when you first signed up for the plan. Attained-age rated means that the rate is set based on your age when you renew. The former start out more expensive but do not go up as quickly in price. The latter start out cheaper but ultimately become more expensive.
We will carry the dental care since the prevent care is the first step of maintaining dental care. Vision care is less useful for us.
@Sven while my employer offers MA PPO with drug coverage for retirees, there is no employer contribution/reduction. From adding our current yearly premium to what my W-2 indicates is the employer provided portion, it looks to be around $18,500 annually ($1540 monthly). I haven't priced it with HR directly though. I will do that. Having dependents would surely change the circumstances.
Plan G, plus Part D and Part B premiums looks to be closer to $750-800 monthly for both of us, combined. I need a personalized/actual quote though.
Best is to lay out scenarios and their cost, so you can make informed decision. Don’t forget that each year you get to choose new provider during the enrollment period in the October through Early December.
Health care is one of the major expense besides housing in retirement.
Edit: Depending on where you live, the availability of in-network (also called Preferred) care provider that you like is very important. Large insurance companies such as UnitedHealth, AETA, And BlueCross have many physicians and specialists to choose from. Out-of-network providers charge at their own rates and generally higher. The patient pays the extra that the insurance doesn’t cover. There is always a trade-off between the premium and the in-network providers. I always ask ahead when I have new appointments.
An aside to this discussion about straight Medicare and related to Medicare Advantage Plans and possible legislation.
ARTICLE.
What are peoples experiences dealing with any of the major providers? Any to avoid?
I chose Traditional Medicare, not Medicare "Advantage" because "Advantage" plans are operated by the very same sort of private insurance suck-holes which make everything so very difficult for ordinary people, just trying to get care and get treated by doctors and surgeons, prior to Medicare eligibility.
With Medigap: I bit the bullet a few years ago and moved into the Plan with the very best coverage, including deductibles: Plan F, though BC/BS of MA called theirs "Bronze." I just never see a bill now, unless it's a mistake. Plan F has been "sunsetted" now. Their deceptive nonsense tells me I'm getting a "discount" which gradually fades through the years. By the time I'm 80 or so, I'll be paying about $400/month. This year, the monthly is already up to $288 and some change. But very simply, it works like this: whatever my primary Medicare covers, then my BC/BS Medigap will cover. That's what I was told. I asked about the geography. Not an issue, since there are very few doctors that do not accept Medicare. "Staying within network" for all practical purposes, is a consideration only for those who go with Medicare "Advantage."
I need a LOT of doctors and check-ups, so the cost of my plan is worth it. Plan G is the next-best, I understand, and it's still open.
Lucky you. Here in NY, my monthly premium for Plan F by AARP/UHC was just raised to $417 this year. But, as I said, I have never seen a bill or had any contact with my Medigap provider in the last 20 years, and I want to keep it that way.
Yes, the extra cost of my Plan F is worth it for my peace of mind.
Thanks for the reminder. Mass. Medigap plans are different from the usual Plans A-N. There are three plans: Core, Supplement 1, and Supplement 1A. These appear to be roughly equivalent to Plan A, Plan F, and Plan G respectively. (I haven't checked all the details.)
https://www.medicare.gov/health-drug-plans/medigap/basics/compare-plan-benefits/massachusetts
For some reason, BC/BS in Mass. calls these three plans Medex Core (like Plan A), Medex Bronze (Suppl. 1, like Plan F) and Medex Sapphire (Suppl 1a, like Plan G).
https://medicare.bluecrossma.com/shop-plans/medicare-supplement-plans?f[0]=plan_year:111
As with Plans F and G, the only difference between Supplement Plan 1 and Plan 1A is whether the Part B deductible is covered.
Looking at their costs and benefits, it seems that for anyone using Part B services, Supplement 1a (Sapphire, Plan G) is cheaper, all in. With Supplement 1a you have the added annual $283 Part B deductible to cover. But in exchange you get a premium that's about $55/month less. Spend $283, save $660.
https://www.mass.gov/doc/massachusetts-medicare-supplement-information/download
Plan G (or Suppl 1a, or Sapphire), including the added cost of the Part B deductible, was predicted to become cheaper than Plan F (or Suppl 1, or Bronze) at some point. This is because the pool of customers for Plan F is always shrinking (you must have been born before 1955 to qualify), while the pool for Plan G is growing.