As a local insurance expert helping retirees from Phoenix to Tucson, and across the Valley, Iâm seeing a big shift this year. Many of my neighbors are asking if they should stick with a Medicare Advantage plan. While those “zero-premium” ads are everywhere in Arizona, thereâs a lot they don’t tell you.
After reviewing the latest industry updates, Iâm personally recommending Medicare Supplement Plan G for those who want total freedom and financial peace of mind. Here is why:
1. I want you to have “No-Hurdle” healthcare đ A major issue with many plans right now is “prior authorization”âwhere the insurance company has to approve a procedure before you can get it. This causes delays that none of us want. With Plan G, if Medicare covers it, your supplement pays. I want the decision-making in your doctorâs hands, not a corporationâs.
2. See any doctor in Arizona (and the U.S.) đ„ I hate seeing my clients limited by restricted networks. Whether you want to see a specialist at the Mayo Clinic in Scottsdale, a provider in Flagstaff, or even a doctor while visiting family back east, Plan G lets you go anywhere that accepts Medicare.No networks, no “out-of-network” penalties.
3. The ultimate “Snowbird” protection âïž Many of my clients in Mesa, Surprise, and Sun City split their time between states. Advantage plans are often tied to your local Arizona zip code.Because Plan G is nationwide, your coverage is just as strong in the Midwest as it is here in the desert.
4. No “Surprise” medical bills đ° Advantage plans often have co-pays for every visit and hospital stay. I prefer the predictability of Plan G. Once you meet the small annual Part B deductible ($283 in 2026), your out-of-pocket costs for Medicare-covered services are zero. No more worrying about what the mail will bring after a doctor’s visit.
Your health deserves more than a “pay-as-you-go” plan. If you live in Scottsdale, Chandler, Peoria, or anywhere in the Grand Canyon State, letâs talk about how to protect your retirement.
đ Give me a call today to discuss your 2026 options!
Many seniors who are 65 and over rely on Medicare to provide them with healthcare coverage, and with good reason. Medicare is available from the government regardless of your health status. It provides coverage for a broad array of services (typically without requiring pre-approval), and it usually comes with affordable premiums.
The keyword, there, however, is usually.
Medicare premiums for most seniors come in at $202.90 for Medicare Part B in 2026. However, some seniors will find themselves hit with an unexpected Medicare surcharge that they may not have been expecting â and that could have a serious impact on their finances. Hereâs why these surcharges happen and what it could mean for you.
If your income is $109,000 or higher, you could face a surprise Medicare hit
The Medicare surcharge that you could find yourself surprised by results from something called the Income-Related Monthly Adjustment Amount, or IRMAA.
IRMAA causes your Medicare Part B and Medicare Part D premiums to increase dramatically once your income goes above a specific threshold. That threshold is $109,000 for single tax filers and $218,000 for married joint filers. However, while this is the threshold in 2026 that will send your Medicare premiums surging, itâs not your 2026 income that matters, or even your 2025 income.
The income that matters is your Modified Adjusted Gross Income (MAGI) from two years earlier. So, if your MAGI in 2024 was above those thresholds, then youâll be faced with higher Medicare premiums in 2026. This can come as a shock, as you may not be aware that a year of higher-than-normal income due to something like capital gains from selling high-performing investments could end up being a ticking time bomb that causes your Medicare premiums to substantially increase two years later.
How much higher will your Medicare premiums go?
The increase in Medicare premiums that results once your income exceeds IRMAA thresholds can be extremely substantial. The table below shows how much you can expect to pay in monthly premiums based on your MAGI and the Income-Related Monthly Adjustment amount:
Full Part B Coverage
Single tax filers with a MAGI that is:
or Joint tax filers with a MAGI that is:Â
Will pay an IRMAA equal to:
Bringing total Medicare premiums to:
Less than or equal to $109,000
Less than or equal to $218,000
$0.00
$202.90
Greater than $109,000 and less than or equal to $137,000
Greater than $218,000 and less than or equal to $274,000
$81.20
$284.10
Greater than $137,000 and less than or equal to $171,000
Greater than $274,000 and less than or equal to $342,000
$202.90
$405.80
Greater than $171,000 and less than or equal to $205,000
Greater than $342,000 and less than or equal to $410,000
$324.60
$527.50
Greater than $205,000 and less than $500,000
Greater than $410,000 and less than $750,000
$446.30
$649.20
Greater than or equal to $500,000
Greater than or equal to $750,000
$487.00
$689.90
That means you could be looking at paying as much as $487 extra per month â and paying total premiums as high as $689.90 â because you had a year when your income was high. Of course, if you have many years of high earnings as a retiree, you could be hit with this surcharge for the entirety of your retirement during the years Medicare covers you.
What can you do about the IRMAA adjustments?
If you are subject to these adjustments to Medicare premiums because of your income, thereâs not much you can do.
Your best bet is try to avoid having this happen in the first place by considering investing for retirement in a Roth IRA or 401(k) instead of a traditional account, and being careful about how large your withdrawals are or when you sell assets to limit capital gains.
A financial advisor can help you make a strategic plan to try to help you avoid sending your Medicare premiums skyrocketing, so you can keep more of your hard-earned funds in your accounts instead of sending extra money to Medicare.
Original Medicare (Parts A and B) is a great start, but it leaves significant “gaps”âlike the 20% coinsurance you pay for doctor visits and hospital stays. Medigap Plan G is designed to step in and pay those bills for you, providing the most comprehensive coverage available to new Medicare members today.
How Plan G Works
Think of Plan G as a “shield” for your savings. Once you pay one small annual deductible, your plan takes over 100% of your Medicare-approved medical bills.
You pay the Part B Deductible: In 2026, this is $283 for the entire year.
Plan G pays the rest: After that first $283, you pay $0 for Medicare-approved doctor visits, surgeries, lab work, and hospital stays.
Freedom of Choice: You can see any doctor in the U.S. who accepts Medicare. No networks, no referrals, and no “prior authorizations” required.
Why Plan G is Your Best Option
While other plans exist, Plan G remains the “Gold Standard” for three reasons:
Total Predictability: Youâll never have to guess what a surgery or specialist visit will cost. Your only medical expense for the year (after your premium) is the $283 deductible.
Excess Charge Protection: Some doctors charge up to 15% above the Medicare-approved rate. Plan G is one of the only plans that covers these “Excess Charges” in full.
Travel Peace of Mind: Plan G includes Foreign Travel Emergency coverage, paying 80% of costs for medical emergencies outside the U.S. (up to plan limits).
The Hazard of Waiting: Why Now is the Best Time
There is a “Golden Window” to buy a Medigap plan, and missing it can be a costly mistake.
No Medical Questions Today: When you first turn 65 (or join Part B), you have a 6-month Open Enrollment Period. During this time, insurance companies must sell you a policy at the best price, regardless of your health history.
Medical Underwriting Later: If you wait and try to sign up later, companies can “underwrite” you. This means they can look at your medical records and:
Charge you a much higher monthly premium.
Deny you coverage entirely based on pre-existing conditions like heart disease, diabetes, or even minor health changes.
Locked-In Access: Once you are in a Medigap plan, your coverage is guaranteed renewable. As long as you pay your premium, the insurance company can never cancel your plan because of your health.
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Plan G vs. The Alternatives
Feature
Medigap Plan G
Medicare Advantage
Doctor Choice
Any doctor in the U.S.
Limited Network (HMO/PPO)
Referrals
Never needed
Usually required for specialists
Out-of-Pocket Costs
$283 annual max
Up to $9,000+ per year
Predictability
High (Flat monthly premium)
Low (Pay-as-you-go copays)
The Bottom Line: If you want the freedom to choose your own doctors and the security of knowing exactly what your healthcare will cost each year, Plan G is the smartest choice for your retirement.
If you have a home in Arizona and would like a quote or have questions on Medicare Plan G we can help!
The Great Medicare U-Turn: How to Switch Back to Original Medicare
If youâve spent the last year realizing that “Advantage” doesn’t always feel like an advantage, you aren’t alone. Maybe your favorite specialist left the network, or youâre tired of asking for “prior authorization” just to get an MRI.
The good news? If youâre reading this in January, the door is wide open for a change. But before you jump ship, thereâs a specific sequence you need to follow to avoid getting stranded without coverage.
1. The “Right Now” Window: The 2026 MA OEP
Since today is January 26, 2026, you are currently in the Medicare Advantage Open Enrollment Period (MA OEP). This runs from January 1 to March 31. The Fall Window: Annual Enrollment Period (AEP) Dates: October 15 â December 7.
During this time, you can:
Switch from Medicare Advantage back to Original Medicare.
Sign up for a standalone Part D prescription drug plan.
Note: If you make the switch this month, your new coverage will typically begin on the 1st of the following month.
2. The Medigap “Trap”: Donât Drop Your Plan Yet!
This is the most critical part of the U-turn. Unlike Medicare Advantage, which must take you regardless of health, Medigap (Medicare Supplement) providers in most states can use medical underwriting.
The Risk: If you have a pre-existing condition, a Medigap insurer can charge you more or deny you a policy entirely unless you have a “Guaranteed Issue Right.”
Do you have a “Guaranteed Issue Right”?
You generally don’t need a health screening if:
The Trial Right: This was your very first time joining a Medicare Advantage plan and youâve been in it for less than 12 months.
The Move: You moved out of your Advantage planâs service area.
Special State Rules: You live in a state like New York, Connecticut, or Massachusetts, which have year-round or annual protections for Medigap enrollment.
The Golden Rule: Secure your Medigap policy and get an acceptance letter before you officially disenroll from your Medicare Advantage plan.
3. Your 2026 Transition Checklist
Switching back involves a three-step dance. If you miss a step, you could face lifetime penalties or massive bills.
Step
Action
Why it matters
Step 1
Apply for Medigap
Ensures your “gap” coverage is locked in before you leave your current plan.
Step 2
Join a Part D Plan
Medicare Advantage usually includes drugs; Original Medicare does not. Missing this causes a late-enrollment penalty.
Step 3
Confirm Disenrollment
Joining a standalone Part D plan usually automatically triggers your exit from Medicare Advantage, but always call your plan to confirm.
4. What Original Medicare Costs in 2026
Since youâre moving back to the “Original” way of doing things, here is a quick look at the 2026 rates:
Part B Monthly Premium:$202.90 (standard).
Part B Annual Deductible:$283.
Part A Inpatient Deductible:$1,736 per benefit period.
Part D Out-of-Pocket Cap:$2,100. (Once you spend this on meds, you pay $0 for the rest of the year!)
Why People are Making the Switch
In 2026, the maximum out-of-pocket (MOOP) for Medicare Advantage plans can be as high as $9,250. For someone facing a major surgery or chronic illness, that “low premium” plan can suddenly become very expensive. Medigap Plan G, by contrast, covers nearly everything after you pay the small Part B deductible, giving you total “cost predictability.”
#healthinsurance #medicare #medigap #medicareadvantage #surprise, AZ #Sun City, AZ
If youâve been scouring the internet for “Medicare Part G,” I have some good news and a tiny “well, actually” for you. First, the correction: there is no Medicare Part G. Medicare has “Parts” (A, B, C, and D) that come from the government. What youâre looking for is Medicare Supplement Plan G (also known as Medigap).
Now, the good news: youâve accidentally stumbled upon what most experts consider the “Gold Standard” of Medicare coverage in 2026. If you value predictability, flexibility, and never having to wonder if your doctor is “in-network,” Plan G is your new best friend.
What is Medicare Supplement Plan G?
Think of Original Medicare (Parts A and B) as a solid foundation for a house, but one thatâs missing a few windows and maybe a front door. Youâre responsible for deductibles, 20% coinsurance, and “excess charges” that can turn a simple procedure into a financial headache.
Plan G is the high-end renovation that fills almost every one of those gaps. It is the most comprehensive plan available to anyone new to Medicare since 2020.
The Big Benefits: Whatâs Covered?
In 2026, Plan G remains the heavyweight champion of coverage. Hereâs the breakdown:
Part A Deductible ($1,736 in 2026): If youâre admitted to the hospital, Plan G pays this entire amount for you.
Part B Coinsurance (20%): Medicare usually pays 80% of doctor visits and outpatient care. Plan G picks up the remaining 20%.
Part B Excess Charges: Some doctors don’t accept “Medicare Assignment,” meaning they can charge up to 15% more than the Medicare-approved amount. Plan G is one of the few plans that covers this fully.
Skilled Nursing Facility Coinsurance: Covers your costs for days 21â100 of a Medicare-approved stay.
Foreign Travel Emergency: Provides 80% coverage (after a $250 deductible) for emergency care outside the U.S., up to a $50,000 lifetime limit.
Why Choose Plan G Over the Competition?
1. The “No Surprises” Budget
With Plan G, your only major out-of-pocket medical expense for the year is the Medicare Part B deductible ($283 in 2026). Once you pay that first $283, the plan covers 100% of your Medicare-approved expenses for the rest of the year. No $20 copays, no “facility fees,” just peace of mind.
2. Freedom of Movement
Unlike Medicare Advantage (Part C), Medigap Plan G has no networks. If a doctor, specialist, or hospital anywhere in the U.S. accepts Medicare, they accept your Plan G. You don’t need a referral to see a cardiologist in another state or a surgeon across town.
Summary: Why Buy Plan G?
Comprehensive: Covers almost everything except the $283 Part B deductible.
Predictable: One small annual deductible, then you’re done.
Flexible: No networks, no referrals, nationwide coverage.
Safe: Protects you from “excess charges” that other plans ignore.
Looking for a Medigap plan in Sun City, Arizona? I can help!
