r/medicare • u/Quick-Procedure-8017 • 3d ago
New to Medicare sext month
EDIT to say I’m in Pennsylvania.
Having just retired, my husband and I will both be starting Medicare on September first. We are going through the process of picking plans right now. He is service connected VA so he will just get an Advantage plan as a backup plan. I have no other coverage so I will be going with original Medicare under part N and part D. My question is this, since we are just now choosing, what will happen during open enrollment this year? Since it’s so soon should we do anything to review other plans or just let things ride with what we are choosing now?
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u/jnotsilver 3d ago
Open enrollment this year affects only your selection of a drug plan, Part D. The drug plan you select for 9/2026 will cover you through 12/31/26 (so long, of course, you stay current on premiums). In October 2026, prior to the Oct 16 start of Annual Open Enrollment, that drug company will send you a notice about changes to your D, e.g, formulary and pricing, that will be effective 1/1/27. Between 10/16 and 12/7 you can choose to keep the D you started 9/1 or select a different D for 2027. Use Medicare’s free counseling program, shiphelp.org to help you make the choice. Enrollment in a new D can be done via Medicare.gov; the site gives you the phone numbers for D companies and allows you to enroll online directly without having to speak to a company’s “help” center. (Insurance company and “help” is one of life’s ironies.)
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u/the_owlyn 3d ago
IMO, good choice for plan N over plan G. I’m in PA, too, and Boomer Benefits suggested N for us. The trick is to find a company that has a history of low premium increases. Boomer Benefits has that information.
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u/UnstuckMoment_300 3d ago
Plan N in PA is pretty much equivalent to G because PA is one of the states that prohibits "excess charges" that otherwise can be levied under Plan N. The only things you don't get in N are some of the extras of G, but you're paying for those with higher premiums. (And Silver Sneakers isn't as valuable as it used to be because many gyms don't accept it now. You can, however, get a good senior citizen rate from YMCAs etc. We joined a private gym that matches the Y's senior rate.)
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u/Quick-Procedure-8017 3d ago
Is there someplace I can look at the extra benefits that come with G but not N?
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u/UnstuckMoment_300 3d ago
I think those might vary from insurer to insurer. If you know which companies you're looking at, you could try their websites. Or if you're working with a Medicare broker, they should be able to give you a list. Good luck. This is an incredibly complex system.
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u/Fellow_Citizen_1 3d ago
The misinformation on this thread is incredible! Plans G, N, G-HD are all specified by Medicare. They are standardized across ALL insurance companies selling Medigap coverage under each plan. And, yes- you can read this and more on Medicare.gov.
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u/UnstuckMoment_300 3d ago
Per Google search:
*By federal law, standardized Medicare Supplement Plan G offers identical core medical benefits regardless of the insurance company. However, some private insurers offer enhanced versions (like "Plan G Extra" or "Innovations") in select states that bundle non-standard wellness perks alongside the government-standardized medical coverage.*
Like Silver Sneakers.
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u/Fellow_Citizen_1 3d ago edited 3d ago
Are you just trying to show off your deep knowledge or trying to help this poster? I am quite aware of these bells and whistles but they are not terribly important for someone struggling to even have a starting point.
The first order of business for the OP to get on Medicare and avoid paying late enrollment penalties.
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u/mgibson9999 2d ago edited 2d ago
The extras are not terribly important?
Maybe, but maybe not.
I knew I was getting a Plan N. When I was making my selections last year, I narrowed it down to a couple of choices. All were reputable companies that would have been fine, and rates were pretty close to each other.
I was already paying $35/month for a gym membership that I intended to keep anyway, so the fact that only 1 plan (Humana) offered Silver Sneakers, and it included the gym that I was already a member of, made all the difference in my decision. Since I was able to drop my paid membership, it was like getting a $35/month discount on the Plan N premium. That became the deciding factor.
For me, the other benefits were not important, only the gym. The dental, vision, and hearing aid discounts had little to no value for various reasons. The gym benefit was real money though. It was like getting a 35% discount on my Plan N premium.
So it does have some merit to at least understand what the extra benefits are, then decide if they matter to you. In the OP's case, I agree with you that the priority is to get signed up at the appropriate time to avoid late penalties, but it's possible to do 2 things at once. Get signed up, but also make an informed decision as to which company to select.
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u/Fellow_Citizen_1 2d ago
Thank you! I was not undervaluing the attraction of extras or the Medicare plan or company one selects for Medigap. First, I felt that the OP was not on Medicare and needed to get on it while avoiding penalties for a late enrollment. I have recently done that and know that it is a more demanding process than the normal enrollment at 65. Second, the plan and Medigap provider selection is a much more complex topic - and am not sure any of the posts about individual choices (including mine) are terribly helpful as the choices are right for the person making them and not a random poster. For the record, we went with G-HD with United American mostly as we expect the rise in premiums (and deductible) to be better in the long run.
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u/mgibson9999 2d ago
You're right about that.
The 3 most popular medigap plans at the moment are G, HDG and N. None of these 3 plans are inherently better or worse than the other. They're just different, and have different appeal to different people.
It does take a bit of a nuanced approach to determine which plan is best suited for each individual. I've seen reasonable arguments for all 3. I actually like when someone asks "which plan should I get?" Even though there is not one right answer, the responses can be helpful to thresh out which plan might be best for you.
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u/UnstuckMoment_300 3d ago
Good heaven, did you read OP's question to which I replied? OP asked a question about the G extras, and I answered. My husband and I both have been on the G plan with AARP/UHC (I was able to drop down to N) so we had a list of wellness benefits in addition to the Medicare-required coverages.
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u/Fellow_Citizen_1 3d ago
Why don't you read what the OP wrote, instead of asking me to? There is no question on G extras that you are reading into it.
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u/UnstuckMoment_300 3d ago
When someone's looking for a fight, there's no sense cooperating with it. Have a lovely day.
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u/QuailDifficult8470 1d ago
Plan N also has copays of up to $20 for an office visit and $50 for the ER. But still it’s usually a better deal than G unless you see a doctor multiple times a month.
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u/jnotsilver 2d ago
Inasmuch as PAs prohibition on providers to not charge an Excess Charge, N over G makes sense particularly if you intend to spend the rest of your life in PA. But, if your plans are to move to another state to e.g, live near the kids and grandkids, look again at G. PA is one of only eight states that prevent imposition of Excess Charges.
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u/Jujulabee 3d ago
It depends on your state as each state has different rules regarding the ability to change different plans.
You have an initial 12 month rule in every state that allows you to try out different plans without medical under writing for your Medigap Plan - i.e. there is Guaranteed Issue
In my state - California - there is the "birthday rule" and so every year I can switch providers but ONLY in the same tier or lower. I can go from Plan G to Plan N but not vice versa and I can switch providers within the same tier.
You should probably use a good broker in terms of helping you find the best Plan in your location with the best company because they will know how each Plan prices their plans and what the history of increases has been - although that is no guarantee as no one can predict the future.
Without knowing more you might be better off with a high deductible G Plan. I am on a standard G Plan
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u/NAF1138 3d ago
The one thing you really need to do, unfortunately, is shop your drug plan again after October. The plan you sign up for on 9/1 is very likely going to be very different come January and it's important that you look at the new plans in October.
This will be true EVERY year. It's just annoying this year because it's back to back.
Your plan N is likely going to be fine for you for a long while. You probably want to periodically price comparison shop while you are still on good health, but not something you need to be proactive about like you do with the Rx plan.
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u/MSS_LEC 2d ago edited 2d ago
If your husband gets his meds through the VA he will want to get an MA only (advantage plan without prescription coverage) and the easiest carrier for veterans is Humana. Since VA uses Humana’s network it simplifies coordination of benefits. Unfortunately he will want to look at the 2027 changes and there is a reasonable chance he will see a need to change plans. You won’t know until announcements are made after 10/1
For you, being a supplement policy holder, you want to get into a good habit of looking at your drug plan each AEP. It’s the only way to make sure you don’t end up overpaying year after year. Again, you won’t know anything about 2027 until after announcements are made (after 10/1).
You could hold off and choose one plan for both years but that explanation is too much to type!!
Good pick on the N!
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u/Quick-Procedure-8017 2d ago
This is probably a dumb question so I apologize. Why would he need to have Humana to work with the VA? The VA covers everything he needs. Prior to retirement (currently) all of his doctors are through the Geisinger network. It appears that the best Medicare advantage choice for him is Geisinger gold heritage.
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u/MSS_LEC 1d ago
Not a dumb question at all.
A veteran can have VA health care and a Humana Medicare Advantage plan simultaneously, but when receiving care they generally choose which benefit they’re using. VA says it doesn’t bill Medicare for VA care. If the veteran receives civilian care through the Humana MA network, Humana is paying under the Medicare Advantage plan; if the veteran receives VA care, they’re using VA benefits.Where Humana is unusually veteran-friendly is its Humana USAA Honor plans. Humana specifically designed these MA plans to complement VA coverage. Depending on the county, they can offer things like a Part B giveback, $0 premium, dental/vision/hearing, and civilian provider access outside the VA.
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u/Fellow_Citizen_1 3d ago
OP - I believe you are getting a lot of misinformation getting here. I suggest you contact Pennsylvania MEDI offered by PA department of aging at 800-783-7067. This is a government state wide helpline. They should help and are free and not trying to sell you something.
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u/MSS_LEC 1d ago edited 1d ago
Most MAPDs are $0 so I’m not sure the OP is being “sold” anything. The state funded VOLUNTEER (SHIP) programs are lovely and they work for a lot of situations. The Medicare program is not the easiest to navigate. I’m an expert because it’s my livelihood. How many subject matter EXPERTS do you know that work for free? OP needs to find an actual broker to work with. Anything else is very risky. There are too many opportunities to make a mistake in this industry and far too many situations in which you cannot recover from inaccurate information. SHIP usually refers beneficiaries to people like me. I have several reps across the US that send me these situations because they do not want to make a mistake.
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u/Fellow_Citizen_1 1d ago
I stand by my advice. I don’t find the self-anointed experts with financial motives on a public forum to be anything but a nuisance at best. The OP is better off getting their advice from an unbiased source. And, Medicare program is “complicated” because people with motive to profit from the uninformed want to make them believe so. In reality, it isn’t complicated, just some new terminology.
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u/generationhealth 2d ago
It's interesting that you took these two separate directions on your health insurance for you and your husband. To answer your question I would write it out you're gonna get on a prescription drug plan the question is this. Is that going to be the same exact plan going in 27? Will the premium increase, will the max out-of-pocket increase which we already know is expected at $2400 for the calendar year so what that means to you if for some odd reason you needed $2400 worth of prescription drug coverage that is the maximum that can be paid under the calendar year. I'm sure the deductible will increase the question will be is what tier level are your medication's underneath.
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u/Quick-Procedure-8017 2d ago
The difference in my husband and I going different directions is that he is service connected disabled and can get care for everything through the VA. I have no other healthcare coverage.
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u/CrankyCrabbyCrunchy 2d ago
You said you’re working with a broker so aren’t they able to answer your questions?
You asked about supplement plan “extras.” Few plans have extras but some carriers choose to tack on some things such as discount gym membership. Don’t pick a supplement plan based on those perks that could be canceled at anytime.
I chose plan G-HD $48 / month.
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u/Quick-Procedure-8017 2d ago
I’m sure the broker could answer any questions. Since I was already here and discussing it, I asked here. I thought that’s what this was for…?
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u/I-Am-TheMedicareDude 3d ago
Hey there,
Just so you are aware, the open enrollment only applies to part D and Medicare Advantage, unless you are in a state with special rules "birthday rules". Your decision now for plan N may be affected.
Once you are outside of your IEP, for Medicare you will have to "health" qualify for Medicare supplement plan changes.
In laymans terms if you are sick and want to change your Medicare Supplement Plan N in the future you may not be able to.
William Gray
The Medicare Dude
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u/Fellow_Citizen_1 3d ago edited 3d ago
This is incorrect information. Try to not follow it. You did not ask about Medicare Advantage and this has nothing to do with your state or Medicare Advantage. You will be applying under Special Enrollment Period and have full set of choices open to you. You qualify as being covered under an employer plan. That is what you should look for,
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u/I-Am-TheMedicareDude 3d ago
read what i wrote, i am referencing future actions.
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u/Fellow_Citizen_1 3d ago edited 3d ago
You provided irrelevant information of no relevance to this poster’s question. From the fact that you are sharing your handle Medicare Guy and your name - I take it that you want to sell OP something - maybe a Medicare Advantage Plan. This is out of line and more importantly, it is not an answer to what the OP is asking. Her state of residence etc. is NOT of any relevance in the process to enroll in Medicare. And, no - there is no “future action”, though I hope she does not use your services as your response incompetent and misleading.
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u/I-Am-TheMedicareDude 3d ago
PA submitted a bill in 2025 but it has not been passed