The Decision Behind My Husband’s Medicare Plan

First: Understanding the Two Paths on Medicare

When someone turns 65, they usually receive their Medicare card in the mail about three months before their birthday month if they’re already collecting Social Security.  (Otherwise, you'll sign up directly on SSA.gov).

And then what?

The government sends a booklet… and that’s about it.

No clear roadmap. No step-by-step guidance. No explanation of how to choose a plan. And if you’re still working? You’re left trying to figure out whether you even need Medicare yet.

That’s why I teach that once you enroll in Medicare, there are only two paths you can take:

1. Original Medicare + Medigap

2. Medicare Advantage

These two paths are complete opposites.

• Medigap works with Original Medicare and pays your out-of-pocket costs.
• Medicare Advantage replaces Original Medicare with a private insurance plan that administers your benefits, typically with copays, networks, referrals, and a bundled drug plan.

It’s a waste of time to compare individual plans or companies before understanding which path fits your goals. Understanding the plan types matters more than chasing a certain carrier or specific plan.

For my husband, I ruled out Medicare Advantage very early.

Why We Chose the Medigap Path

One of my biggest priorities for him was freedom of providers.

If he wants to see a specialist, I don’t want him:

• Waiting for referrals
• Checking network lists
• Wondering if a doctor is covered

With Original Medicare plus a Medigap plan, he can see any provider nationwide who accepts Medicare. That flexibility was important to us.

So once we knew we were choosing Medigap, the real question became: Which Medigap plan?

Plan G vs. High Deductible Plan G

Let’s compare the two.

Regular Plan G

Plan G is the highest coverage Medigap plan available to new Medicare eligibles. After you pay the small annual Medicare Part B deductible ($283 in 2026), it covers everything Medicare approves.

It’s simple. It’s predictable. It gives peace of mind.

In Florida, premiums typically range from $220–$280 per month to start, and they increase over time. Eventually, many Plan G premiums reach $300–$400+ per month.

High Deductible Plan G

Now here’s where it gets interesting.

With High Deductible G:

• You pay 20% of Medicare-approved costs AND
• The Part A hospital deductible ($1,736 in 2026) in the event of an inpatient stay...
• Until you reach the annual deductible ($2,950 in 2026)

After that, it works just like regular Plan G.

Important clarification:
You are not paying 100% until $2,950. You’re paying 20% of Medicare’s already deeply discounted rates.

That distinction matters.

Premiums for High Deductible G range from about $60–$100 per month. The plan we chose is $62 per month.

That premium difference was significant.

My Thought Process

This decision came down to several key factors:

1. Freedom of Providers

Non-negotiable. We wanted Original Medicare + Medigap.

2. Risk Tolerance

Are we comfortable potentially paying up to $2,950 in a worst-case year? Yes.

But here’s the reality: it takes a lot of medical usage to actually hit that full deductible because Medicare’s fee schedule is so heavily discounted.

3. Long-Term Premium Increases

This was huge for me.

Plans that require members to pay more upfront before the plan pays (such as High Deductible G), historically experience lower rate increases.

Regular Plan G premiums tend to rise significantly over time. High Deductible G plans typically increase at a slower pace.

Over 10–20 years, that difference can equal thousands of dollars.

I’m betting on long-term savings.

4. Health Status

My husband isn’t perfectly healthy but he’s not seeing specialists every single month either.

If he had multiple serious conditions requiring constant care, I may have chosen regular Plan G. This decision is highly personal.

The Bonus Feature That Sealed the Deal

There was one additional feature that made this decision even stronger.

The company we chose, United American, offers a unique savings account feature attached to their High Deductible G.

It’s funded by the member and earns 3% interest.

It’s not an HSA — but it functions similarly in that:

• You deposit at least $50 per month (I chose $100).
• The account automatically pays the Part B deductible.
• It pays claims until the high deductible is met (as long as funds are available).
• You control the funds.

This essentially helps smooth out the deductible risk and removes the hassle of paying medical bills manually.

For us, it made the High Deductible G feel even more practical.

Common Misunderstandings About High Deductible G

Let’s clear up a few things:

“You’ll definitely hit the full deductible.”
Highly unlikely for most people.

“It’s only for perfectly healthy people.”
Not necessarily. This is a financial planning decision, not a health gamble.

“High deductible means you pay 100%.”
No. You pay 20% of Medicare-approved rates until the deductible is reached.

However, if that $2,950 number feels stressful to you, then this plan may not be right for you.

Peace of mind matters.

There Is No “Best” Plan

One of the biggest mistakes people make is asking:

“What’s the best plan?”

There isn’t one.

The best plan depends on:

• Your income
• Your risk tolerance
• Your personality
• Your long-term goals
• Your comfort with uncertainty

My own mother has a Medicare Advantage plan and doesn't lose any sleep over the restrictions she might face, or the annual max out-of-pocket. But she DID feel stressed out over the ever-increasing Medigap premiums.

Insurance is emotional. It’s personal.

A Few Important Enrollment Reminders

• Medigap plans can often be changed year-round (health questions may apply in some states).
• The fall Annual Enrollment Period is not for Medigap.
• The Medicare Advantage Open Enrollment Period runs from January 1 to March 31 and allows Advantage members to switch plans or return to Original Medicare.
• If you’re new to Medicare, you have a personal timeline based on either turning 65 or retiring.

This is where mistakes can become expensive.

Final Thought

When I chose the High Deductible Plan G for my husband, it wasn’t because it’s “the best.”

It was because it fit our goals, risk tolerance, and long-term financial strategy.

Your decision should feel just as aligned with your situation.

If you need help walking through your options whether you’re turning 65, already on Medicare, second-guessing your choice, or simply looking for a lower rate, I help with all of it.

You can schedule time with me here by choosing a day and time that works for you.