Question from Colette: Can you address High-Deductible Supplement plans and why they seem to be less discussed? My husband and I turn 65 in 2026. I use no medications and see a doctor only for my annual physical. My husband is on a low dose of HBP meds but otherwise is also very healthy. A High Deductible plan seems to be able to save us a ton in premiums even with the deductible that we probably wouldn’t meet unless something catastrophic happened (I broke my ankle 3 years ago and first time in 35 years we hit a deductible outside of maternity needs). I’m guessing the catch is we may not be able to go back to a regular Medigap plan without underwriting, but what else am I missing? 

Answer: This question was posed on the Facebook group last week. It was so good, I wanted to spend some more time on it. 

Colette is referring to Supplement High-Deductible G, aka HDG. Let me first explain how it differs from the only two plans we generally recommend, G and N. In 2026, HDG has a $2,950 deductible. Like Plans G and N, the first $285 of Part B medical services must be paid up front and in full. For example, if your first Part B service of the year was at an Urgent Care and the full billable amount to Medicare was $320, those on G, N, or HDG would be responsible for paying $283. 

On both Plans G and N, once that deductible has been met, all following covered Part A and B services are paid at 100% (except for a $20 physician’s and $50 ER copay on N). There are zero out of pocket costs for blood work, X-Rays, CT scans, MRIs, surgeries, hospitalizations, chemo, radiation, etc. 

Those on HDG, however, are responsible for an additional $2,657, but only pay the portion of what Original Medicare doesn’t, $1,736 for a Part A hospital stay and 20% of Part B services. For example, if a routine MRI is billable to Medicare at $500, Part B pays 80%, $400, leaving someone on HDG to pay the remaining $100. However, let’s say the MRI reveals that knee replacement is necessary, which is hardly catastrophic and quite common for seniors. It usually involves a hospitalization and then up to 18 physical therapy visits. The surgery would cost someone on HDG $1,736, and 20% of the PT which I’m assuming would be in the $400 range. We’re now up to paying over $2,200 more out of pocket than someone on Plans G or N, and I didn’t add the 20% for the orthopedist visit(s) and X-rays that preceded the MRI and surgery, nor any other medical care that was needed during the year. Let’s call the total $2,700. If we divided that by 12 months, that’s $225 before factoring in the monthly HDG premium. 

A good argument to still choose HDG would be that’s only one year. Normally, as Colette explained in her question, she and her husband don’t need much more than a couple of routine doctor visits and blood work. Colette and her husband are otherwise healthy, and she’s confident they’re going to remain so. Premiums for the lowest priced HDG in Western PA for a 65-year-old are $38/month for a female and $43 for a male versus $109 and $121 for G, and $71 and $81 for N. The savings for a married couple on HDG versus N, which we recommend most often, is $71/month or $854 per year. 

However, when someone on HDG has a somewhat routine surgery or other care or treatment with a similar out of pocket costs, it would take three years to see any savings, longer if either Lauralee or her husband got services that exceeded their deductible. I have to assume one of them, maybe both, would need something that would require additional out-of-pocket costs from ages 66 to 69. 

Another case for choosing HDG is those premiums are not going to increase nearly as fast as G and N. In 5 years, assuming a 12% annual increase on all three Supplement plans, combined premiums Colette and her husband for G would be $405, N $268, and HDG only $143. The savings for HDG in five years would double versus the year they turned 65. However, as one ages, so does the likelihood of needing more care and possibly some that me be more extensive and expensive. 

My fear, and why we have never recommended HDG, is what Lauralee mentioned; moving back to Plan N or G may become impossible due to medical underwriting that is necessary to change to another Supplement letter plan or company. The deductible on HDG also increases each year, from $50 to $100. That means in five years, it will be $3,300 to $3,500. And if both Colette and her husband meet it just once, it would take another two and a half years of utilizing only minimum routine doctor services to ever see any savings. And what if either was diagnosed with an auto-immune disease, developed rheumatoid arthritis, or something else that required frequent infusion or injection therapy, and they started to meet most or all the deductible every single year? No savings would ever be realized. Quite the opposite, in fact. HDG could cost tens of thousands more than N or G over a five, ten, or 15 year period. 

Choosing Supplement HDG versus N or G is a risk/reward proposition. As is choosing an Advantage Plan versus a Supplement. Our job as agents is to discuss the pros and cons, risks and rewards of both Supplements and Advantage Plans. It’s imperative we don’t just assume because a client is healthy today, he or she will be for the next 10 months, let alone 10 years or longer. 

I’ve been advising those on Medicare for almost two decades and have hundreds of clients who were as healthy as Lauralee at age 65, but not long after got a life changing diagnosis or were in a bad accident which resulted in needing ongoing expensive care every year. Many of these clients have stopped me in grocery stores and restaurants to thank me for recommending their Supplement plan and that they wouldn’t know where they would be without it. Had those folks chosen HDG, over 10 years, they would have spent around $25,000 in deductibles that would have been paid in full by G or N. Advantage Plans would have resulted in even higher out-of-pocket costs!

When we’ve done our duty by educating people who are currently or soon to be on Medicare and giving recommendations when asked, we’re 100% okay with those who want to take some risk for the reward of potential premium savings, especially with Advantage Plans that also provide lots of ancillary benefits, extras that Medicare and Supplements don’t include and can be very valuable. At the level they’re still offered in 2026, we’re talking thousands of dollars in real dollar value of goods and services. 

But again, the choice is much more complicated, and that initial decision when turning 65 or going on Medicare Part B for the first time is crucial. It has life-lasting implications. Only the most knowledgeable, experienced, and caring agents will take the time to educate and help people make the best possible decision regardless of how much commission they get paid. It’s why well over 25,000 seniors have put their faith in The Health Insurance Store since 2008. 

If you have questions regarding this topic or any other related to Medicare, or would like to set up a no cost consultation, give us a call at the office, 724-603-3403. You can also email me personally, Aaron@GetYourBestPlan.com.