SPEAKER_01 0:00

Hey, thanks for joining us on the podcast with Elite Insurance Partners. So for years, Medigap Plan G was, you know, the ultimate peace of mind policy. You just set it, forget it, and you're covered.

SPEAKER_00 0:12

Yeah, that was definitely the appeal.

SPEAKER_01 0:14

Right. But looking at the 2026 filings, that peace of mind is about to cost some folks uh up to 45% more. It's like joining this exclusive country club with fixed dues, and suddenly the club is letting in a massive wave of new members who require constant service. And so everyone's dues are just skyrocketing to cover the tab.

SPEAKER_00 0:35

It really is a massive disruption, honestly. I mean, Plan G has always been the gold standard, right? Because it covers practically everything original Medicare leaves behind. Well, except the Part B deductible.

SPEAKER_01 0:44

Right, you still have to deduct.

SPEAKER_00 0:45

Exactly. But looking at these new state filings, we are seeing premiums jumping anywhere from 12 to 26% across the board. And carriers like uh Chubb, they are hitting that 45% mark in certain markets.

SPEAKER_01 0:57

Wow, 45%? That is wild. I mean, okay, let's unpack this a bit. So why is this spike happening right now?

SPEAKER_00 1:03

Well, there are a few things at play. You have inflation hitting everyone, obviously. And hospital labor costs have been incredibly sticky since the pandemic. So everything from specialist visits to outpatient procedures just costs more.

SPEAKER_01 1:17

Yeah, that makes sense.

SPEAKER_00 1:18

Plus, you know, the people who bought into Plan G years ago are naturally aging into their late 70s, so they just inherently need more care.

SPEAKER_01 1:26

Right. But I I mean that can't entirely account for a 45% spike, can it? I've been reading about this um boomerang effect. That's where people are fleeing Medicare advantage because of like prior authorization nightmares, right? And dragging high medical costs back into the Medigap pools.

SPEAKER_00 1:41

Aaron Powell You hit the nail on the head. That boomerang effect is the critical third factor here. If you think about how insurance fundamentally works, premiums rely on a balanced risk pool. You really need healthy people to offset the sick.

SPEAKER_01 1:54

Yeah, of course.

SPEAKER_00 1:55

But right now, beneficiaries are getting super frustrated by restrictive networks and endless prior authorization denials in Medicare Advantage. So when they boomerang back to Medigap, statistically, they're older and much sicker, they're bringing massive claims directly into those Medigap pools.

SPEAKER_01 2:12

Man, that is tough. So if those risk pools are flooded and premiums are spiking 25%, the math for plan G just doesn't make sense for everyone anymore. So what levers can you actually pull to escape that trap? And actually, just a quick note here if you are staring down one of these rate hikes, you really don't have to figure it out alone.

SPEAKER_00 2:31

No, absolutely not.

SPEAKER_01 2:32

Yeah. We at Elite Insurance Partners can actually help you select a plan. You can fill out the form on the pages this deep dive is on, or just call us at 877-324-1512. That's 877-324-1512. So um what are the actual alternatives here?

SPEAKER_00 2:48

Aaron Powell Well, the two most viable levers you can pull are Plan N and High Deductible Plan G. Plan N drops your monthly premium significantly, but you do take on up to a $20 copay for doctor visits and uh up to $50 for the ER.

SPEAKER_01 3:02

Okay, so for someone who sees the doctor somewhat regularly but wants immediate premium relief, that seems like a very manageable trade-off.

SPEAKER_00 3:10

Yeah, it really is. And if you want to slash premiums even further, I'm assuming you'd look at the high deductible plan G.

SPEAKER_01 3:17

Right. That's what I was thinking.

SPEAKER_00 3:18

Exactly. That cuts your premium down to roughly $40 to $70 a month in a lot of markets. But the mechanism is totally different. You have to hit a deductible of about $3,000 before the comprehensive coverage kicks in.

SPEAKER_01 3:32

Oh wow.

SPEAKER_00 3:33

Yeah. So you're trading that first dollar coverage for a financial backstop against a real catastrophe.

SPEAKER_01 3:39

Wait, so if Medigap is getting this expensive across the board, why shouldn't you just jump ship to a $0 premium Medicare Advantage plan? I mean, the $0 option looks incredibly tempting right now.

SPEAKER_00 3:50

Oh, it definitely looks tempting. But doing that can lead you straight into the MA trap. You see, leaving Medigap for an advantage plan is the easy part. Returning is the hard part.

SPEAKER_01 4:01

Because of the medical underwriting, right?

SPEAKER_00 4:03

Exactly. Unlike when you first turn 65 and have a guaranteed right to buy Medigap, leaving strips you of that protection. If you try the records. And if they see a costly condition, they can simply refuse to cover you.

SPEAKER_01 4:18

Wow. So they just lock the gates entirely to protect their bottom line.

SPEAKER_00 4:22

Basically, yes. But there are a few exceptions to this.

SPEAKER_01 4:25

Right. The state rules. Like, don't some states have birthday rules?

SPEAKER_00 4:29

Yes, they do. States like New York, Massachusetts, Maine, and Connecticut have these birthday rules. They force insurers to let you switch to a comparable plan around your birthday every year without facing that medical underwriting. So the gate stays open.

SPEAKER_01 4:42

That is a massive loophole if you live in the right state. And again, if you aren't sure about the specific underwriting rules where you live, our team at Elite Insurance Partners can check that for you. Just give us a call at 877-324-1512. It is definitely worth checking. Because if we connect this to the bigger picture, this entire pricing crisis really highlights a fascinating structural flaw in the system. Really, how so?

SPEAKER_00 5:08

Well, Medigap is only strictly necessary because traditional Medicare inherently lacks an out-of-pocket maximum. I mean, a severe illness could literally bankrupt you without it.

SPEAKER_01 5:18

Right. There's just no cap on what you might have to spend.

SPEAKER_00 5:21

Exactly. But if proposed federal legislation like Senator Ron Wyden's proposal ever actually caps those out-of-pocket costs in traditional Medicare, the entire necessity of Medigap could change. The whole foundation of how insurers price it might radically shift overnight.

SPEAKER_01 5:37

That is a wild thought. We're essentially buying really expensive soundproofing because the current system has no volume limits. That is definitely a lot to mull over as you navigate these 2026 changes. One final reminder before we go we insurance partners are always here to help answer your questions.

SPEAKER_00 5:52

Absolutely.

SPEAKER_01 5:53

Just fill out the form on this page or call 877 324 1512. Thanks for jumping into this deep dive with us today.