What Supplemental Plans Actually Do

Original Medicare (Parts A and B) covers about 80% of your medical expenses, but that still leaves you responsible for 20%—and there’s no cap on what that 20% could be. That’s where Medicare Supplemental plans (also called Medigap) come in. They’re designed to plug those gaps, helping pay for things like deductibles, co-insurance, and excess charges. Compared to Medicare Advantage plans, Medigap plans give you more freedom—you can see any doctor in the country who accepts Medicare.

The Rise and Fall of Plan F

For years, Plan F was the most comprehensive Medigap option out there. It offered “first-dollar coverage,” meaning that once you paid your monthly premium, you paid nothing out-of-pocket for Medicare-approved services. But in 2015, Congress passed MACRA (the Medicare Access and CHIP Reauthorization Act), which phased out Plan F for anyone who became Medicare-eligible after January 1, 2020.

Why? Lawmakers were concerned that people with first-dollar coverage were going to the doctor more often than necessary, putting extra strain on the Medicare system. If you were already eligible before 2020, you can still buy Plan F—but for everyone else, it’s off the table.

Comparing Plan F, Plan G, and Plan N

Now, Plan G is the closest you’ll get to Plan F today. The only thing it doesn’t cover is the Part B deductible, which is $257 in 2025. Aside from that, it provides nearly identical benefits.

Plan N is a more budget-friendly option, with a few trade-offs. You’ll pay small copays—up to $20 for doctor visits and $50 for ER visits—and it doesn’t cover what’s called “Part B excess charges.” These are pretty rare and only happen if your doctor charges more than Medicare’s approved amount.

If you’re relatively healthy and don’t mind some small copays, Plan N can be a smart, cost-saving alternative to Plan G.

Let’s Talk Numbers

Here’s what I’m seeing in the field: Plan F premiums have skyrocketed, partly because no new members are joining, leaving an aging pool of policyholders. Some folks are paying over $400 a month.

By contrast, Plan G averages between $150 and $180 per month, and Plan N comes in even lower—around $122, depending on your age, gender, and where you live.

I recently worked with a client who switched from Plan F to Plan G and saved over $850 a year—even after accounting for the Part B deductible.

Can You Switch? Yes—With a Catch

Good news: You can switch between Medigap plans at any time during the year. There’s no official “enrollment season” like there is with Medicare Advantage. But—and this is important—you’ll likely need to go through medical underwriting. That means answering 20 to 25 health-related questions (no physical exam), and depending on your answers, the insurer can deny your application.

If that happens, don’t worry—you can keep your current plan. There’s no risk in applying to switch.

Flexibility Is Why I Still Recommend Medigap

One of the biggest perks of Medigap plans is freedom. You don’t need referrals. You can see any doctor who accepts Medicare, anywhere in the U.S. That’s a huge deal for people who travel or spend half the year in a different state. These plans are also guaranteed renewable—they can’t drop you as long as you pay your premiums.

Do You Travel Abroad? Plan G and N Have You Covered

Here’s something most people don’t realize: Certain Medigap plans, including G and N, include up to $50,000 in foreign travel emergency coverage. Medicare itself doesn’t work overseas, so that benefit can come in handy. That said, I still recommend separate travel insurance if you’re heading abroad for an extended trip.

Bottom Line

Plan F had its moment, but for most people today, Plan G offers the best comprehensive coverage, and Plan N offers strong benefits at a lower price. If you’re still on Plan F and you’re eligible to switch, it’s worth exploring whether Plan G or N could save you money—just be sure to work with someone who understands the underwriting process.

As always, the right Medicare plan depends on your unique health, travel habits, and financial goals. I help people navigate this maze every day, and I’d be happy to help you too.

The post Medicare Plan F Is Gone. Here’s What You Need to Know About Plans G and N appeared first on ROI TV.

Not All Low Premiums Save You Money

It’s tempting to pick a $0 premium plan, but that could end up costing you more. For example, one plan with a $97 monthly premium might actually save you hundreds over the year if it covers your medications better. That’s why you need to consider the total annual cost—including co-pays, deductibles, and preferred pharmacy pricing—not just the sticker price.

What Does Part D Actually Cover?

Medicare is divided into parts: A covers hospital care, B covers outpatient services, C is Medicare Advantage, and D is for prescription drugs. You can get Part D either as a standalone plan or bundled into a Medicare Advantage plan (MAPD). The right choice depends on your health needs and whether you’re already using a Medigap plan to fill other coverage gaps.

Enrollment Rules You Need to Know

If you’re approaching age 65, your initial enrollment period (IEP) lasts for 7 months—3 months before, the month of, and 3 months after your 65th birthday. But even if you have employer drug coverage, you must enroll in Part D within 63 days after losing that coverage to avoid penalties. You can’t get a MAPD plan unless you’re enrolled in Part B, but for standalone Part D plans, you only need Part A or B.

Can You Switch Plans Later? Absolutely.

You’re not stuck with your first choice forever. Every year, during the annual enrollment period (Oct 15–Dec 7), you can switch your standalone Part D plan. If you’re on a Medicare Advantage plan, you get an additional open enrollment window from Jan 1–Mar 31. Use these periods to update your plan if your medication needs or pharmacy preferences change.

Do You Even Need Part D?

If you have credible prescription coverage through the VA, Tricare, FEHB, or a retiree plan, you may not need Part D at all. But be sure your alternative is “credible coverage” under Medicare’s rules. If it’s not, or if you delay enrolling without coverage, you’ll face a lifelong penalty.

Beware the Late Enrollment Penalty

Skipping Part D because you’re not currently taking medications? That can be a costly mistake. The penalty is around $0.35 per month for each month you delay—forever. Worse, if you develop a serious condition later, you’ll face high drug costs with no safety net.

Understanding Part D Plan Features

Every plan comes with its own drug formulary, which determines which medications are covered and at what cost. Plans usually include between 2,500–4,000 medications and categorize them into tiers. They also use cost-saving tools like quantity limits, prior authorization, and step therapy. Choosing a preferred pharmacy or using mail-order can lead to significant savings. And starting in 2025, your maximum out-of-pocket costs will be capped at $2,000 per year—a huge relief for many.

Real-Life Example: Why Med List Matters

Let’s say you’re taking four generic drugs like Diltiazem, HCTZ, Lisinopril, and Warfarin. A zero-premium plan might cost just $40 per year at a preferred pharmacy. But if your doctor switches you to a costly drug like Eloquis, suddenly that zero-premium plan could cost over $1,600 annually. In contrast, a $97/month plan might now be cheaper overall. Your medication list matters more than your monthly premium.

Choosing the right Medicare Part D plan can save you hundreds—sometimes thousands—of dollars per year. Don’t go it alone, and don’t guess. Make sure your plan fits your medications, pharmacy, and budget so you can spend your retirement enjoying life—not stressing over prescriptions.

The post How to Choose the Right Medicare Part D Plan (and Avoid Costly Mistakes) appeared first on ROI TV.

What’s Changing for Medicare Advantage Plans in 2025?

Medicare Advantage plans will see disruptions across multiple areas in 2025, including:

• Premiums and Deductibles: Expect adjustments to monthly premiums and out-of-pocket costs for co-pays and deductibles.
• Network Providers: Some beneficiaries may lose access to their current providers due to network changes.
• Coverage Limits: Changes to pre-authorization requirements and the introduction of a $2,000 spending cap on certain benefits will impact plan offerings.
• Additional Perks: Some underutilized perks, such as wellness programs, may be reduced or removed from certain plans.

Beneficiaries must carefully review the Annual Notice of Change (ANOC) sent by their plan provider to understand how these changes affect their coverage for 2025.

“Without careful review, beneficiaries may be caught off guard by increased costs or disruptions in coverage.”

Why Are These Changes Happening?

Several factors are driving these disruptions in Medicare Advantage plans:

• Funding Issues: Rising healthcare costs and higher morbidity rates (greater use of medical services) have increased financial pressure on insurance providers.
• Unprofitable Markets: Some insurance companies are scaling back their offerings in markets where they are not profitable, leading to reduced provider networks.
• Abuse by Insurance Providers: The misuse of pre-authorization requirements and perks by some companies has triggered government intervention to increase accountability.
• CMS Regulations: The Centers for Medicare & Medicaid Services (CMS) is enforcing stricter rules to improve transparency and care quality, contributing to changes in plan structures and coverage limits.

These disruptions reflect the complex balance between controlling healthcare costs, meeting government regulations, and providing comprehensive care to beneficiaries.

Options for Navigating the Changes in 2025

Beneficiaries must act proactively to ensure they have the right coverage going into 2025. Here are the key steps to take:

1. Review the Annual Notice of Change (ANOC)

Carefully review the ANOC sent by your plan provider to understand how your coverage will change in 2025. Pay close attention to any increases in premiums, deductibles, or co-pays and confirm that your preferred doctors and hospitals remain in-network.

“The ANOC provides a detailed breakdown of how your plan will change, helping you make informed decisions during enrollment.”

2. Evaluate Your Current Plan During the Annual Enrollment Period

The Medicare Annual Enrollment Period (AEP) runs from October 15 to December 7, allowing you to make changes to your plan. If your current plan still meets your needs, you can allow it to auto-renew for 2025. If you are dissatisfied with the changes, this is your opportunity to explore other Medicare Advantage plans.

3. Switch Plans During the Medicare OEP

If you realize early in 2025 that your new plan no longer meets your needs, you can switch to another plan during the Medicare Open Enrollment Period (OEP), which runs from January 1 to March 31. This gives beneficiaries a second chance to make adjustments if necessary.

4. Consider Returning to Original Medicare

If you’re unhappy with Medicare Advantage, you can switch back to Original Medicare (Parts A and B). You’ll need to apply for a Medicare Supplemental (Medigap) plan to cover the out-of-pocket costs not included in Original Medicare. However, keep in mind that Medigap plans may require medical underwriting, meaning your acceptance could depend on your health status.

5. Seek Help from an Independent Medicare Broker

Navigating these changes alone can be overwhelming. Consider working with an independent Medicare broker who can provide unbiased advice and help you compare plans. A broker can help you identify the most suitable plan based on your healthcare needs and budget.

Conclusion: Prepare Now for a Smooth Transition in 2025

The changes coming to Medicare Advantage plans in 2025 will be disruptive, but with proactive planning, beneficiaries can avoid unexpected challenges. Start by reviewing the Annual Notice of Change, evaluating your current plan’s new terms, and considering your options during the enrollment periods. If your plan no longer meets your needs, don’t hesitate to switch to another Medicare Advantage plan or explore returning to Original Medicare with a supplemental plan.

Taking these steps ensures you have the right coverage in place for the new year, allowing you to focus on your health and well-being rather than worrying about plan disruptions. Working with a knowledgeable Medicare broker can provide additional peace of mind, helping you make informed decisions during this time of change.

The post Major Medicare Advantage Changes in 2025: What You Need to Know and How to Navigate Them appeared first on ROI TV.