Many Medicare beneficiaries choose Medicare Advantage plans because of their low monthly premiums. But if you’re over 65 and have a chronic condition, you may be feeling the pinch of those out-of-pocket costs — like co-pays for specialty doctor visits — adding up.
An alternative you may want to consider is a newer Medigap plan known as the High-Deductible Plan G (HDG). Among other benefits, these plans have lower monthly premiums than many supplemental plans and also may reduce your annual out-of-pocket exposure.
How does high-deductible Medigap work?
Medigap is a plan that covers out-of-pocket costs that Original Medicare, Part A and Part B, don’t cover. There are 10 different plans (identified by letters), each offering a different kind of coverage.
Plan G is one of the most common and robust supplemental plans available. It also starts paying for your out-of-pocket costs immediately after the Part B deductible is met. Some people don’t choose this plan, though, because it comes with a high monthly premium.
Another option for someone wanting lower out-of-pocket costs is the HDG plan. This functions like most other high-deductible health plans, meaning you pay your Medicare out-of-pocket expenses until you meet your deductible, then the supplemental plan kicks in to cover those costs.
High-Deductible Plan G costs in 2026
The HDG plan deductible in 2026 is $2,950. If you’re enrolled in this plan, you’ll have to pay for your Medicare-covered costs until you reach that amount. If you have a $3,000 doctor’s bill before you’ve had any medical expenses and Medicare approves $1,000 of that amount, your costs will look like this:
- You pay your Part B deductible: $283 (which counts toward your HDG deductible)
- Medicare pays 80% of the cost: $573.60
- You pay 20% coinsurance: $143.40
- Your total is $426.40
At that point, your Part B deductible is paid, so you would pay your share (20% of the bills) until you have spent $2,950. Your HDG plan would then cover your expenses.
Though you do pay some out-of-pocket costs for your healthcare, the average monthly premium for HDG plans in 2026 begins at about $40 monthly, depending on your age and where you live.
Medicare for chronic conditions in 2026
The HDG plan can be an option if you have a chronic condition — but it’s the most cost-effective if you don’t need to see a specialist frequently or have expensive procedures. In other words, this plan works best when you have a good health year. As you age and need more medical care, you may want to look at plans with higher premiums but lower out-of-pocket expenses.
If you have a chronic condition, HDG is best suited for you if:
- You have enough money on hand to cover the deductible.
- Your chronic condition is well managed, or you only need to see your doctor for it once or twice a year.
- You want to pay less upfront in monthly premiums.
- You prefer Original Medicare because of its larger provider network than Medicare Advantage.
- You travel frequently and want coverage out of state.
What does HDG cover?
Once you have paid your 2026 deductible of $2,590, HDG covers the same services as the traditional Part G supplemental plan. There is a reason it’s one of the more popular plans; it covers a wide range of services, including:
- Your Part A deductible (which is $1,736 in 2026 if you are hospitalized.
- Your $434 daily coinsurance if you’re in the hospital for more than 60 days.
- The $868 coinsurance for what’s known as lifetime reserve days if you’re in the hospital for more than 90 days.
- Your copayment and coinsurance for hospice care.
- Skilled nursing facility costs not covered by Medicare ($209.50 per day if you are there longer than 20 days).
- The 20% of healthcare costs (after you meet your 2026 deductible) including physical and speech therapy, diagnostic tests, and inpatient and outpatient surgeries.
- 80% of the cost of health emergencies during foreign travel.
Enrolling in Medicare for chronic conditions
You’ll probably need more medical care as you age. If you enroll in an HDG plan and find that your out-of-pocket costs are too high, you may want to change to a standard Part G plan. It’s important to understand that you can switch Medigap plans at any time, but if it’s outside of your six-month Medigap open enrollment period when you turn 65, you will likely need medical underwriting to switch plans. This typically includes a health questionnaire, and the insurance carrier can deny you during this process.
Switching to a Medicare Supplement plan is a big decision. It may be able to save you money, even if you have a chronic condition. If you need help to compare your spending with Standard Part G or HDG plans, talk with United Medicare Advisors today.
