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!
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.
CONTINUED ON NEXT PAGE
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!
Medigap offers the type of flexibility that some seniors may find is worth the higher price tag.
As Medicare open enrollment kicks into high gear, millions of older adults are taking a fresh look at their health insurance options. For many, that means deciding between sticking with or switching to either a Medicare Advantage plan or a Medicare supplemental insurance policy, also known as Medigap. It’s a choice that can shape not just monthly budgets but also how easily seniors can access the care they need.
At first glance, Medicare Advantage plans may seem like the obvious choice. Many offer low or $0 monthly premiums and bundle extra perks like dental, vision and hearing coverage. For retirees living on fixed incomes, those features can be appealing. But despite the popularity of Medicare Advantage â 54% of all Medicare beneficiaries are enrolled in these plans â a significant share of seniors continue to rely on Medigap coverage instead.
So what drives some seniors to choose Medigap coverage over Medicare Advantage plans? That answer typically comes down to what people value in their healthcare coverage. Below, we’ll break down what to consider.
Why do some seniors choose Medigap over Medicare Advantage?
Medigap plans work alongside Original Medicare, covering many of the out-of-pocket costs that traditional Medicare doesn’t, like deductibles, coinsurance and copayments. Medicare Advantage plans, on the other hand, replace Original Medicare with a private insurance plan that often comes with its own rules, networks and cost structures. Here’s more on why many older adults opt for Medicare supplemental coverage over Medicare Advantage plans:
Access to a wider network of doctors and hospitals
One of the main reasons seniors opt for Medicare supplemental coverage is the flexibility to see any doctor or specialist who accepts Medicare, anywhere in the nation. There are no restrictive provider networks or referral requirements. For retirees who travel frequently, live in multiple states or simply want to keep their existing doctors, this nationwide access can be a major advantage.
While Medigap plans typically have higher monthly premiums than Medicare Advantage plans, they tend to offer more stable and predictable out-of-pocket expenses. Depending on the plan type, like Plan G or Plan N, Medigap may cover nearly all of the costs left over after Medicare pays its share. For seniors managing chronic conditions or anticipating regular medical visits, that type of coverage predictability can be invaluable.
Fewer administrative hurdlesÂ
Medicare Advantage plans often require beneficiaries to obtain prior authorizations before they can be approved for certain treatments or services, and these hurdles can sometimes lead to delays or denials for otherwise necessary medical care. Medigap paired with Original Medicare typically doesn’t have these barriers, though, which makes it easier to access care when you need it.
Stable benefits year after yearÂ
While Medicare Advantage plans can change their provider networks, cost-sharing rules and benefits annually, Medicare supplemental plans are standardized and don’t change once you enroll. That type of stability can make long-term financial planning simpler and reduce the risk of unexpected coverage shifts.
How to decide between Medicare supplemental coverage and Medicare Advantage
Both Medicare Advantage and Medigap have clear benefits and tradeoffs and the right choice often depends on your health needs, financial situation and lifestyle. Here’s what to weigh as you’re deciding which coverage option makes the most sense for your needs:
Consider your healthcare usageÂ
If you visit doctors frequently, need specialist care or expect ongoing medical costs, Medigap’s more comprehensive coverage may make sense. On the other hand, if you’re relatively healthy and want to minimize monthly premiums, a Medicare Advantage plan could be more cost-effective.
Think about where you receive careÂ
Seniors who split time between states or travel often may benefit more from Medigap’s nationwide coverage. But if your care is primarily local and your providers are in-network, Medicare Advantage could work well.
Weigh long-term costs carefullyÂ
While Medigap premiums can rise with age, Medicare Advantage plans can also change cost structures each year. Some seniors start with Advantage plans for the lower premiums and switch to Medigap later. However, in many states, switching to Medigap after your initial enrollment period may require medical underwriting, and you could be denied coverage or face higher premiums if your health has changed.
Factor in extra benefitsÂ
Medicare Advantage plans often offer extras like dental, vision, fitness memberships or transportation services. If these are important to you, they might tilt the balance toward Medicare Advantage. Medigap focuses primarily on covering medical costs rather than additional perks.
The bottom line
When choosing between Medicare Advantage and Medigap, there’s no universal answer for retirees. Medigap appeals to many seniors because of its flexibility, predictable costs and stable coverage, while Medicare Advantage can be more affordable for those with limited healthcare needs or who value additional benefits.
When weighing your options during open enrollment, be sure to assess your health, budget and lifestyle carefully. By understanding the potential benefits and downsides of each option, you can select the coverage that best fits your unique situation and ensures you have the care you need at a cost you can manage.
Would you like more information on a Medigap plan?
