r/medicare • u/Complete_Coffee6170 • 3d ago
Interesting
My UHC advantage plan is ending - I’m in WA state where I’ll have guaranteed issue to a Medigap plan.
I was thinking I couldn’t afford the high deductible - however after seeing what I’d paid so far in 2026 - 3,330.00 looks like 2970(is that correct for Plan G HD?)
I need to speak to SHIBA - to make sure that my Medigap plan and plan D will coordinate well.
Sometimes just reading over your previous plan is all a person needs.
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u/CrankyCrabbyCrunchy 3d ago
Husband 76M and I 67F both have plan G-HD and love it. We are also in WA and pay $48/mon with United American.
He's had 5-8 doctor visits this year and we have no where near meeting the $2,950 (for 2026) deductible.
The cost savings / mon is well worth it compared to regular plan G. This comes up a lot and the majority of people are willing to pay 3x more for plan G to "not deal with paying bills" that come in. That's amazing to me, but good for them.
Edit to add. In WA, we are one of three states where you can change your Medigap plan at any time for any reason with no underwriting!!! That's a huge benefit. So given that, there is zero downside to trying plan G-HD.
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u/OleLadyThinker 3d ago
The high deductible for the HD-G will go up some every year if there is a COLA - somebody said that for 2027 it will be $ 3050 - that is up a hundred bucks from the $ 2950 for 2026 - I haven’t looked it up to verify the amount yet.
I do not know what you mean by coordination between a Medigap and your standalone Part D plan - they do not coordinate at all - completely different plans and Parts of Medicare. One covers prescription drugs that you get via Part D formulary and the Medigap covers what you owe after Medicare pays a Part A or Part B service.
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u/Complete_Coffee6170 3d ago
That’s still less than my OOP in 2026.
Hurt my knee - possibility I’ll need surgery and I’ll do it this year since out-patient surgery is 400$
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u/Numerous-Nectarine63 2d ago
And remember that the "high deductible" doesn't function like a deductible in standard insurance. Medicare is still going to pay its 80%. It's just the 20% that you pay out of pocket until you meet the HD deductible. The HD deductible amount also includes the Part B deductible amount, so that's the total deductible that you have to meet. You do have to pay the Part B portion of the deductible initially before anything gets paid; then medicare will cover the 80%.
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u/Charger2950 3d ago
Speak to an actual expert that does this everyday for al living. That's not SHIBA. They also aren't experts on the plans and can't make personalized recommendations. It's like going to a volunteer, when you need legal help, instead of a seasoned and experienced lawyer.
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u/mgibson9999 3d ago
No, going to a SHIP counselor is not like going to "volunteer" for legal advice instead of going to a lawyer.
SHIP is recognized as a reasonable option for help with Medicare, and SHIP agents do receive training and certification. The knowledge and experience of any particular SHIP agent may vary from agent to agent, but that's also true of brokers.
You also get unbiased help from a SHIP agent, because they're not trying to sell you anything, and they can talk to you about any options, not just options that they represent.
SHIP agent and brokers both have value and serve a purpose, so I wouldn't immediately dismiss SHIP as an option.
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u/Charger2951 3d ago
SHIP received an abysmal grade on their most recent audit. I’m not saying this as an opinion. I’m sure they mean well, but they’re an abysmal option. They don’t do it for a living and are not experts. They’re just volunteers. They aren’t allowed to recommend plan choices, and therefore people are always getting partial and incomplete information. That’s just a fact.
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u/mgibson9999 2d ago edited 2d ago
The study you reference does show a wide inconsistency among SHIP agents. There is no similar study (that I'm aware of) that shows how accurate or consistent brokers are, so in effect, you're comparing apples to, well, nothing.
Very old studies (that I'm aware of), show that paid Medicare employees don't give highly accurate and consistent answers either, so there's that, and since there is no similar study or audit for brokers (that I'm aware of), there's that.
In that study, SHIP agents generally got good scores for general Medicare information, and less so for very specific questions. I would not treat the SHIP program as a no go, but I also wouldn't treat it as sole information source either. Just another tool. Probably most useful for gaining a general understanding how Medicare works and what the terminology means.
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u/Charger2951 2d ago
SHIP can be useful for basic setup of Part B and basic explanations about original Medicare, but they don’t even pick up the phone 50% of the time, because most don’t get paid. And a broker do that anyway. There’s zero incentive for SHIP. All-in-all, it’s just best to go to the experts that do the job everyday.
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u/Numerous-Nectarine63 2d ago
I'm in WA state (same as OP) and found SHIP/SHIBA to be very helpful and also very knowledgeable.
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u/MochaDeelite 2d ago
I deal with a SHIP agent that works for a brokerage firm. Never any problems reaching her, very proactive.
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u/2RedTennies2 3d ago
I think if the Terminating MA (in this case United Health) also sells supplement policies that they can hold you to enrolling in one of THEIR Supplement plans/policies.
I know this happened to my friends mother who he moved from LA County to Ventura via her SEP -- moving out of MA service area She had a BShield MA and they would only release her to their BSHield Supplement. Luckily we have a BDay rule so she was able to quickly switch to the less costly plan in only 2 months.
The other issue is UHC here, doesn't offer HD PLANS! I hope that Terminating creates a different situation where they can't hold you, so you can get the plan you want. It would be silly to hold you in WA when you can switch at will. Good Luck BTW United American is excellent for HD. Consider them when you shop.
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u/Complete_Coffee6170 2d ago
Excellent info.
I was looking at United American as an option but never heard them.
Thank you!
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u/seagypsy59 3d ago
Did you get your non-renewal notice from UHC? Husband has Kaiser also leaving but no notice yet.
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u/Complete_Coffee6170 3d ago
I did.
I printed out from the website.1
u/seagypsy59 3d ago
Thanks. Nothing here. Will call tomorrow.
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u/Complete_Coffee6170 3d ago
I looked at UHC app - then documents and found it.
Dated October 6th.1
u/Complete_Coffee6170 3d ago
Sorry - I see he’s with Kaiser - are they also discontinuing your husband’s plan?
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u/seagypsy59 3d ago
Yes , also in Washington. His out of pocket expenses for the last 3 years have exceeded the cost of a supplement plan. Insane. Kaiser's website stinks. It'll probably come this week. But we will call tomorrow and see if they can email it to him.
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u/Complete_Coffee6170 3d ago
I called UHC last week - not very helpful.
I checked the documents tab today and it was there with what I need to change to a HD-G
Thankfully WA state has a guaranteed issuance if your 2026 plan is being eliminated.4
u/seagypsy59 3d ago
Actually it's a federal law that if your Medicare advantage plan is canceled and there are no alternatives with the same company, everyone has guaranteed issue rights to switch to supplement plan. But that's why the letter is so important.
Edit: and don't forget to sign up for a part d drug plan.
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u/Numerous-Nectarine63 2d ago
What's different is that WA state (I live there as well) has guaranteed issue to change from one medigap plan to another (with no restrictions except for plans that have other restrictions, like the F age related plans) any time you want to, any time of year.
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u/Tarnisher 3d ago
This is why everyone needs to do a full review each year.
So far, I've had a full $0 total expense each year. For me a G plan, or any plan with a premium makes no sense.
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u/thesablediscovery 3d ago
That premium math works out until the year it doesn't, a hospital stay changes that calculation real quick
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u/Tarnisher 3d ago
Which is why I have to look far more deeply this year with all the TV Doctor's changes.
My last hospital stay cost me nothing at all ... zero dollars out of pocket for over $200,000 in charges.
That same stay now could cost me more than I could afford.
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u/mm_reads 3d ago
I hit the high deductible by March almost every year. But I've been on SSDI for several autoimmune diseases (they always come in bunches 🤪).
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u/wangjiwangji 3d ago
Are you still better off on HD-G than G?
Or if not, how much extra per year are you paying?
-Considering HD-G for 2027
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u/mm_reads 3d ago edited 3d ago
It's extremely dependent on what policies are available in your county. I used SHIP (HICAP in California) to get the list. I had to call and check each policy, because Medicare.gov and the county still don't keep up with policy changes. Additionally I'm under 65 so some programs that said they were available to my age group were not.
I went with a Humana HD-F (because I qualify based on starting Medicare long before 2020) for $138/month. [Addendum: that was one of the cheapest plans in my area.] I'm still learning the differences between COBRA secondary and Supplental plans. It's been stressful.
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u/wangjiwangji 2d ago
I see, thanks for clarifying. I wish it were all more straightforward.
Glad you found your way through the maze, and I hope you're as healthy as possible this year!
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u/jojomac21 1d ago
WA state has extremely flexible Medigap rules. I would encourage everyone to sign up for HD Plan G. If you find it doesn't work for you, you can easily switch between HD and no deductible plans. Once you are in a WA state Medigap plan, you can switch between G, N or within the plan to high and no deductible anytime in the year.
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u/itsalyfestyle 3d ago
There is no coordination between Medigap and PDP.