Medicare Moments: Help!! The cost of my Medicare Supplement has exploded!!What can I do?
Published 1:00 pm Monday, March 2, 2026
Toni:
When I first enrolled in Medicare in 2019, I picked Medicare supplement Plan F. In February of 2024 I was approached by a telemarketer on my cell phone who talked me into a Medicare Supplement Plan K because this plan had a lower premium than Plan F. I could change because I was in good health at that time.
March of 2025, I was hospitalized due to cardiac issues because I passed out in the doctor’s office. Now I am having serious heart problems, causing me to need a heart transplant.
Since I have Plan K, I must pay the deductible plus 50% cost until I meet the Medicare Supplement’s maximum out of pocket and for 2026 the cost has exploded to $8,000. I tried to go back to Plan F, but the agent said I couldn’t because of my heart issue.
I thought with Medicare preexisting conditions did not count. Can you help me to understand this? Your help would be appreciated. Thanks, Toni.
— Jason, Lubbock, Texas
Jason:
What a great question! Americans without health issues need to realize that a health care crisis can happen when you least expect it! And you must answer health underwriting questions to qualify for a new Medicare Supplement.
Jason, you went from the top-of-the-line Medicare Supplement Plan F, where you would have zero out-of-pocket and all Medicare eligible expenses would be covered 100%, to a Plan K with an out-of-pocket of $7220 for covered Medicare expenses for 2025 that has risen to $8,000 for 2026. Because you need to have a heart transplant; qualifying for a new Medicare Supplement is not an option since you cannot pass the health underwriting.
The only thing you can do is to remain on your Medicare Plan K or go with a Medicare Advantage HMO or PPO plan, because it has no health questions. Jason, you can enroll in a Medicare Advantage plan until March 31 since now is the Medicare Advantage Open Enrollment Period. Wait to enroll after April 1 and then Medicare’s Open Enrollment Period starting October 15-December 7th will be the only option for you to change to is a Medicare Advantage Plan because it has no health questions.
I would recommend that you talk with your health care providers about which Medicare Advantage Plan meets their requirements. There are 2 chapters in my Medicare Survival Guide Advanced Edition that explain the difference in Medicare Supplements and Medicare Advantage Plans. In chapter 6, I explain what Medicare Advantage plans (Part C) are and the different type of plans…HMO, PPO, PFFS (Private Fee for Service), SNP (Special Needs Plans). In chapter 8, I discuss Medicare Supplements, also known as Medigap policies.
With a Medicare Supplement, the most comprehensive plans covering your Medicare expenses are Plan F, Plan G and Plan N.
Medicare Supplement plan F covers comprehensive coverage for Medicare approved amounts with zero out of your pocket, but one must have enrolled in Medicare Part A prior to January 1, 2020, to enroll in Plan F.
Medicare Supplement Plan G is like Plan “F” and is available to Medicare beneficiaries whose Medicare Part A starts after January 1, 2020. The difference in Plan F and G is that Plan G does not include the Part B deductible of $283 for 2026.
Medicare Supplement Plan N has lower premiums with higher out-of-pocket costs. There is a $20 co-pay for a doctor’s visit and a $50 co-pay for the emergency room with the Part B deductible not covered. and, in addition, Part B excess charges are not paid for by the insurance company (which Plan G covers).
Take time to discover which Medicare option is right for you. For more Medicare information, email info@tonisays.com or call 832-519-8664. Both of Toni’s books and her new “Confused about Medicare” online course and Toni Says Medicare Roadmap are available at www.tonisays.com. Sign up for the Toni Says newsletter on the Toni Says website to keep up Medicare changes.
