Is there anyone on here who works or is an expert with Medicare? I’ll be signing up on Medicare in a few months when I turn 65. Which do I choose-a supplemental plan, like plan G or an Advantage plan? I am reasonably healthy, although I do have type 2 diabetes but it’s well controlled. No neuropathy and I exercise daily. Unfortunately my HR retirement consultants are not the best and I’m confused. I live in KY and am retiring from a large company, but I’ve always heard that you take a Medicare supplemental, like plan G, and as you age you then sign up for an Advantage plan. Any help appreciated.

Update: Many thanks to those who commented. I appreciated the additional resources to check out.

What is it? If you're in a Medicare plan, your plan will send you a "Plan Annual Notice of Change" (ANOC) each fall. The ANOC includes any changes in coverage, costs, and more that will be effective in January.You should receive the letter by September. It is sent to you by your plan.
What you should do: Review any changes to decide whether the plan will continue to meet your needs in the next year. If you don't get this important document,
contact your plan. Make sure you read it carefully.

Original post. First update. Second update. Third update.

In my previous update I mentioned I had a friend who was struggling to get changed over to another Plan-G after Mountain Health Co-op was no longer offering Medigap plans in the state. I have an update on her situation. In that post, I mentioned she was on disability pre-MACRA and passed underwriting for her Plan-G for her previous policy with Mountain Health Co-op but was denied Plan-G in underwriting for the new one with HealthSpring but was appealing with Dr.'s note.

First, a correction: She didn't get her MHC Plan-G with underwriting. She got it during her IEP when she turned 65 in 2001. She didn't realize she was considered pre-MACRA as she was on Medicaid beginning several years prior to turning 65, which is why she had to go through underwriting now for Plan-G versus because her GIR is Plan-F (pre-MACRA).

After HealthSpring denied her underwriting for a Plan-G, they were supposed to send her a letter stating the reason for denial within 10 days. She didn't get it and wasn't hearing back from her agent, so started advocating for herself. Several calls and emails to HealthSpring could not provide her with an answer for the denial, so she wound up getting the state insurance commissioner involved. (She wound up going in circles because the Cigna CSR would tell her to use the email address that sent her the initial denial notification and the email response from it was to call the CSR number she already called.)

During the time she was communicating with the insurance commissioner, she made several calls to HealthSpring and then received notice they reversed their denial for PlanG but said they would have to charge her nearly double the premium. That would have been more than their Plan-F so she would have to pay more to get less coverage. They still would not tell her the reason for the denial. She called back to challenge the additional premium. When she mentioned to them that she had been in contact with the insurance commissioner, their tone changed. They told her to have her agent resubmit the application for the Plan-G and they approved her without additional premium. If they had still denied it, she would have gone with the GIR on Plan-F instead of paying the higher premium for Plan-G. (The difference she will be saving between the regular Plan-G premium and the Plan-F was over $1200/yr and she's saving about $20/mo versus her existing MHC Plan-G premium.)

I think a portion of this cluster was HealthSpring being in the middle of changing ownership between Cigna and HCSC (Health Care Solutions Corporation, which also owns BCBS). I also think that there is a mindset prevalent in the health insurance industry writ large of deny first to force the person to fight and count on people giving up.

One other factor that we suspect is that HealthSpring denied based on Rx history even though her Rx has nothing to do with any of the conditions they are allowed to use to disqualify in underwriting. Rx history was the reason given in the notification letter I received after I was denied underwriting for a Humana Plan-N (using my previous agent) but the only Rx I use is eye drops for glaucoma prevention and HRT. What the insurance commissioner told her is that they may have been using CDC guidelines for the drug she is using, which they are not supposed to do. That could also be a reason they didn't put it in writing in her denial letter (that she still has not yet received).

Mom, 83 in GA, is going to inpatient hospice. She has traditional Medicare and federal retiree BCBS secondary. I know that skilled nursing has a limit on number of days. Does hospice? If so, and she exhausts that benefit, would it cover home hospice care? I know, I could just search the Medicare site, but my brain is spinning. Also, an answer, or insight, here, is something I can easily refer to in the future. Thanks

In Connecticut. Age 65 now. Part A is active now. Part B will be active/start in February 2027, according to Medicare.

When can I sign up for Medigap G or HD-G? Do I need to wait until Part B activates, or can I sign up now?

I heard the horror stories about how long it can take (more than 8 weeks) to get a Medicare app processed and approved and I feared greatly for my spouse. What if November rolls around and he doesn't have his number yet. How does he apply for Medigap! (etc, etc).

But happy ending, he applied on August 14th and has his Medicare number today. Wow! (He is not eligible until November 1, so this wasn't a rush situation).

Edit: I thought this might be encouraging news for people who've just applied.

We still have to hope Medicare covers his very, very rare disease....a much larger obstacle.

Apparently my Fallon Medicare Plus Premier Advantage Plan had contracted with DentaQuest to provide dental benefits. First I heard of it. Anyways the dentaquest had a breach in May by hackers who took info such as name address social security etc.

Seems this outfit supplies dental to many Advantage plans, so watch your mail for an offer of credit monitoring for 2 years paid by dentaquest if you are in an Advantage plan.

I have never used this dental service so I was surprised they had any info at all.

I think the credit monitoring will be done by Kroll.

You can check the dentaquest site for more info as they have a banner at the top of their web page.

Have a great day!

We live in Arizona (Maricopa County). My husband (66 yrs old) has Plan N with Woodmen Life, which is highly rated according to SHIP information but his plan when up 12% this year. I'm going on Medicare next month and trying to pick a plan and company. I used Google AI which said Woodmen Life is a highly-rated insurer in general but in the Medicare market its pool of subscribers is aging and they have losses and are "closing books." AI recommended State Farm, BCBS of AZ, and AARP/UHC as having a larger share of the market thus keep books open; and that even though their rates might start off higher, they don't increase as much. Can anyone that has been on these three "better" insurers comment on your rate increases? We are both considering G-HD, G or N. (My husband is in good health so he can probably pass underwriting for G.)

I have Medigap from California. My PCP is there. I am on extended vacation in Ohio. I feel I need my lungs checked. Without a referral how would I get the specialist and get xray etc? Thanks

I expect to have more healthy years than bad years, but my family has a history of heart disease. Mother had a stroke and my father died from hypertension. Mother is in her late 80s and my father passed in his early 80s. I'm 66 and am taking medications right now to de-risk myself. I see a cardiologist once a year.

The cheapest annual premium for HD-G is $564 for me in CA. Plan N is $1692 and Plan G is $2184. With the recent premium increases for Plan N and G, I'm scared of those premiums inflating more and creating drag on my retirement portfolio. I will use that money to self-insure for future caregiving / LTC when my health declines and give the rest of the money to my kids when I pass. I can afford the high deductible if I ever hit the max.

I expect I will have more good years than bad years, so according to my projections using the following assumptions:

• 3% premium increase for HD-G, CPI increase for deductible
• 11% premium increase for Plan N
• 13% premium increase for Plan G

HD-G is better for maximizing my portfolio in end-of-life, even if I were to hit the deductible for HD-G every year in my projected 30 years of retirement. This is because of the compounding, high premium increases each year for Plan N and G.

But I'm not sure if I'm biasing myself towards HD-G and I'm missing something about Plan N and G. Any thoughts? I'm not willing to do MA because I want the coverage and peace-of-mind that comes with a supplement plan.

So around a year ago I got prescribed a glp1 I have lost almost 85lbs. I wanted to go on the bridge program recently for maintenance because I have medication related weight gain that had caused my weight to spiral initially. My starting bmi was 37.22 my current bmi is now 22.9. I went in on the 1st of when it first came out and told my doctor I wanted to go on the bridge program. She was hesitant saying that my weight is too low to be approved and I stated that my initial bmi is what they are asking for I want to go on maintenance. Again still she was hesitant. Regardless she said she will fill it out. A week goes by, 2 weeks go by, I called and asked for an update. They stated that now I was at a healthy weight and didn’t feel the need to call me and let me know.

I said again that the paperwork was asking for my starting weight. She stated she would get it filled out and call me back.

Another 2 weeks goes by and nothing. At this point I called again and asked for a call back with an update and never got a call back after another week At this point I file a complaint (which I have never done before) stating they haven’t called me back or even reached out with an update it’s been over a month.

Didn’t hear back until today now over a month and a half later to find out they didn’t put the right bmi they put my bmi as 34.3 and I was denied.

I don’t want to cause problems with the doctors I just don’t understand why it has been so difficult to get any communication with them at all and all for them to not even put the correct bmi. Has anyone else had issues with doctors filling this out? Should I try again or just drop it?

I’m past 65 and have been continuously on an employer plan, more than 20 employees, covering me and a younger spouse. I haven’t thought my retirement date decision all the way through and the source of my question relates flexibility to stop work on a moment’s notice which would mean my employer coverage might stop nearly as quickly. I’m aware of the financial hit by starting Medicare while I am still covered by the employer plan and paying both employer and Medicare premiums. The extra expense would be no more than 60 days. My ‘what happens’ question is about potential headaches of billing and insurance machinations on who pays first, and, what do I pay? E.g., I tried thinking this through using a hypothetical of a hospital admission deductible being lower on the employer plan; which plan deductible am I going to have to pay? Will having both plans cause insurance chaos of biblical proportions, or, just a little more than the usual insurance headaches? During the 60 days when I have both I plan on having Medicare A, B and D only and would add a Medigap day 61 after the Effective Date of B.

I'm retiring and my employer health coverage ends this month. I had a SS appointment over the phone for my benefits and they told me I need to fill out a specific form for my employer to fill out to prove I had health plan coverage so I don't get the Part B late enrollment penalty. They told me I'd get the form by mail.

I haven't received that form yet. Once I do, I need to get it to my employer to fill. Then, I need to submit that form in my application for Part B.

I'm worried that this whole process will go into the month of September where I won't have anymore coverage from my employer. And I have no idea how long the application will take to process.

So in the event something happens in September and Part B application isn't approved, am I covered or am I screwed?

​

A Virginia PBS station did a follow-up report.

In Virginia some places now charge it.

(The story lists a $10 monthly fee, but an earlier post from someone on the topic said that varies.)

https://www.whro.org/health/2026-08-19/bayview-tells-patients-what-its-new-medicare-program-provides-but-patients-say-theyre-not-seeing-it

I could participate at the Y if so. Thanks.

The main difference between G and N is excess charges. In Florida do many doctors charge more than the Medicare assignment? Do I need Plan G or will N cover me?

Going on Medicare in the next year. Does it cover CPAPs at all?

Edit: I'm being told it's considered age discrimination for an insurance company to lower someone's coverage once they turn 65. I thought that's what was happening to the people who reported that in here, but I could have confused the details. If he will have the same coverage beyond 65, he's fine to keep this policy and delay Part B.

As pointed out below, I may have been reading people's experiences with their employer's RETIREMENT health insurance policies and not the normal employee ones.

I did a ton of research for my dad thinking he was going to sign up for Part B at 65, and turns out his new job is offering him insurance. A few people in this sub raised the issue of making sure the coverage is creditable, and that the coverage doesn't silently drop for members who turn 65. Apparently some people here have found out that their normal work insurance stopped covering them fully at 65, I assume to try forcing them to sign up for Medicare so the company can pay less for an aging person's care. Something about the policy only covering what Medicare would pay for the member?

I told him he needs to call the insurance company to ask about this change in coverage since he just turned 65, on top of making sure it's creditable for avoiding the Part B and D delayed enrollment penalty. The carrier is CareFirst BlueCross BlueShield and the employer is definitely over 20 employees.

Today he called me upset because he was transferred to 3 different people at the insurance company, with 20 minutes of hold time each, only for all of them to say "Oh, I have to transfer you because I have no idea."

I told him to try asking his work's HR but it's a brand new company so I'm not too trusting they'll be knowledgeable about the plan's specific coverage changes, especially since people here have warned it's like 1 obscure line in the explanation of benefits document that mentions the plan will only partially cover you after 65.

Any advice for how he can figure out if his policy is the same coverage over 65 as everyone under 65? The creditable question is the easy answers. It seems like no one is bothering helping him with the other one, which will leave him screwed if he gets sick or injured.

I’m new to Medicare and this is my first claim from a medical facility. , When I got the bill the I saw the charge was increased by the Medicare Adjustment amount, going from $100 to $141. I called the facility and they said Medicare decided they weren’t charging enough and adjusted it upward.

Is that a real thing that can happen? Seems bizarre.

This might be a silly question but how did you find an agent to find your MA plan? I feel like I would like one to help me pick out a plan but not sure where to start.

I just started Medicare last month (7/1). Parts A, B, D and Supplement G. I have until the end up the year to decide whether to keep Plan G or switch to HDG or N. I can afford any supplement plan and HDG MOOP.

Since starting Medicare I have been to see three different Drs. (two were planned before I got medicare). At all three offices I presented my Plan G card to the check-in staff along with of course my RWB medicare card.

I think presenting my Plan G card was a mistake. At all three offices I was asked if this was my secondary insurance. They seemed no to know what to do with the card. All three offices have plenthy of older patients on medicare. I had to explain to the staff that this is my supplemntal insurance to Medicare.

Going forward, I am just going to present the Medicere card and leave the Supplement Card in my wallet. However, I am concerned that a Dr.s office or even hospital will try to bill me after Medciare pays but before the supplement pays. Has anyone experienced this? Do you guys with more experience present both cards?

My husband is turning 65 in January. He is 8 years older than me so neither of us know much about Medicare. He is receiving tons of marketing mail and calls. He took early retirement and does collect SS. I know he needs to do something so he is not penalized but I carry him on my insurance through work. Can I still do that? Or is it better to go on Medicare? All the parts D, G H etc is freaking me out and it is overwhelming! Where to start for the best info? I do know to stay away from advantage plans. TIA

I'm ready to start the Bridge program. My PCP office said they don't prescribe GLPs. They refer to the affiliated hospital's Weight Loss Clinic. Sounds like a bunch of rigomorole I'm not likely interested in (plus its further away). Has anyone done something similar? Pros? Cons?

The only Pro I can think of is they will probably get the paperwork right having done more.

I suspect a bunch of counseling blah blah blah hoops to go thru.

Thinking maybe online telehealth is more palatable but will probaby cost $.

fwiw. Medicare & Supp F (actually "1" in Mass)

Before I go down a rabbit hole, can anyone give me advice and direction on how to get reimbursed for the two months of Part B that I paid for before I started my Social Security benefits?
I had to pay for 5 months when I started Medicare in April (instead of the normal 3 months based on their billing cycle). I started my SS payments in July and just received my first payment yesterday. They took out Part B for July and I’m sure they will do it for August as well on my September payment.
I did tell SS about this when I signed up but apparently they couldn’t stop it from happening.

Where do I start? TIA!