Is $2,950 Worth It? Medicare’s High Deductible Plan G
High-Deductible Plan G gives you the same standardized Plan G benefits, but only after you pay the annual deductible yourself. In exchange, you usually pay a lower monthly premium and take on more yearly exposure. Premiums for the same Plan G letter vary by insurer, so compare quotes in your state before you decide.
TL;DR:
- For 2026, the $2,950 deductible counts only covered Medicare cost sharing, not premiums or services outside Original Medicare, and resets each January.
- Compare annual premiums plus covered spending up to the deductible; test a full deductible year against standard Plan G before choosing.
- The one time six month Medigap enrollment window starts at age 65 or older with Part B; later switches may require underwriting or face denial.
- High Deductible Plan G works only with Original Medicare, not Medicare Advantage, and excludes prescriptions; enroll separately in Part D for drug coverage.
Table of Contents
- How does high deductible Plan G work with Original Medicare?
- What is the high deductible plan G amount and who sets it?
- How do you compare low premiums against the deductible?
- Who should consider high-deductible Plan G?
- When can you enroll, and what happens if you switch later?
- Does high deductible Plan G work with Part D or Medicare Advantage?
- How do we help you choose the right Medigap option?
- FAQ
- Sources
How does high deductible Plan G work with Original Medicare?
High-Deductible Plan G supplements Original Medicare Part A and Part B. The benefits match standard Plan G, but the insurer pays nothing until you meet the annual deductible. Once you do, the plan picks up the Medicare-covered cost-sharing it normally covers for the rest of the calendar year.
CMS defines the deductible as the annual covered Medicare cost-sharing you pay before the plan begins paying benefits. Premiums are not part of it. Here is what that means in practice:
- Coinsurance, copayments and deductibles for Medicare-covered services count toward the deductible.
- Your monthly premium does not count, no matter how much you pay in a year.
- Services Original Medicare does not cover generally do not count either.
- Benefits are standardized, so coverage is the same across insurers even though prices are not.
Progress toward the deductible is not always obvious. Your Medicare Summary Notices (MSNs) show what Medicare approved and what you owe, and your insurer’s statements show how the claims were applied. Reading both as they arrive keeps you from guessing how close you are to the finish line.
Pro Tip: Keep every MSN in one folder and add up your Medicare-covered cost-sharing each quarter, so you know when the plan should start paying.
Standardized benefits mean coverage parity, not premium parity. Medicare also notes that Massachusetts, Minnesota and Wisconsin organize Medigap plans differently, so the standard letter-plan chart does not apply unchanged there.
What is the high deductible plan G amount and who sets it?
For calendar year 2026, CMS published the high-deductible amount as $2,950. That is the amount of Medicare-covered cost-sharing you pay in a year before the policy pays anything.
The CY 2026 high-deductible amount is $2,950, according to CMS. It is the covered cost-sharing you pay before High-Deductible Plan G begins paying.
CMS does not pick the number arbitrarily. The deductible is updated each year using the percent change in the Consumer Price Index for All Urban Consumers (CPI-U), then rounded under the statutory rules in the Social Security Act. Because of that formula, the figure tends to move with inflation, and you should expect it to change from one year to the next.
The deductible is a yearly total, not a per-service charge. It is the sum of Medicare-covered cost-sharing you pay in the calendar year. Once you reach it, the plan starts paying, and the count resets the following January.
Medicare’s plan benefit comparison lists the same requirement, so you can cross-check the number there. Because the figure changes annually, confirm the current amount on the CMS announcement page before you compare quotes.
High-Deductible Plan G is also tied to when you became eligible. CMS notes it is available to people who became new to Medicare on or after January 1, 2020. If you were eligible earlier, your options may differ, and checking your state’s rules is worth the few minutes it takes.
How do you compare low premiums against the deductible?
Medicare advises weighing the annual premium against how likely you are to reach the deductible, because insurers can charge different premiums for the same standardized plan. A low monthly number alone tells you very little. The cleaner method is to compare total expected yearly cost across every quote you collect.
- Collect several quotes for Plan G in your state, including the high-deductible version, from different insurers.
- Multiply each monthly premium by 12 to get the annual premium.
- Estimate your Medicare-covered cost-sharing for the year, capped at the deductible.
- Add the annual premium and that estimate to get the expected yearly cost.
- Compare the totals, then adjust for your comfort with surprise bills.
The formula is simple: annual premium plus expected Medicare-covered spending up to the deductible equals expected yearly cost. Here is a worked example with clearly illustrative figures. If standard Plan G has a higher premium than High-Deductible Plan G, compare the annual premium difference with your expected Medicare-covered cost-sharing. When that spending stays below the premium difference, the high-deductible option may cost less overall. If it rises above that difference, the gap narrows. If you reach the full deductible, add it to the high-deductible plan’s annual premium to compare the total with standard Plan G.
Three rough scenarios help you place yourself:
- Low use: a few routine visits and little cost-sharing favors High-Deductible Plan G.
- Moderate use: calculate your break-even point using your own quotes.
- High use: frequent care or a hospital stay favors standard Plan G.
Plan for the unexpected too. A single hospital admission can trigger meaningful cost-sharing, and you should consider whether one such event could push you to the full deductible. Medicare also cautions that insurers use different pricing methods, discounts and underwriting, so compare total yearly cost rather than the premium by itself.
A good rule: price the worst reasonable year, not just the average one. If that worst year would strain your savings, a higher premium may buy real peace of mind.
Who should consider high-deductible Plan G?
High-Deductible Plan G tends to suit people who expect little Medicare-covered care and can comfortably cover the deductible if a bill arrives. It tends to suit others less when frequent care or tight cash flow makes a large bill hard to absorb.
Profiles that may prefer it:
- Generally healthy people with low expected Medicare-covered use.
- People who want lower monthly premiums and keep savings set aside.
- Retirees who can pay up to the deductible without disrupting their budget.
Profiles that may want to avoid it:
- People with chronic conditions or frequent appointments.
- Anyone with limited liquid savings for an unexpected bill.
- People who prefer predictable monthly costs over variable yearly ones.
Cash flow matters as much as health. Ask yourself whether you could pay the full deductible in a single month without borrowing, and whether you would rather pay a bit more each month to avoid that risk.
A few tactics reduce the downside. Keep an emergency buffer equal to the deductible, pair the plan with a Part D plan for prescriptions, and write the deductible into your retirement budget as a possible yearly cost. Our guidance on Part D prescription coverage covers that pairing in more detail.
Pro Tip: Set aside the deductible amount in a separate savings account. If you never need it, you keep the premium savings and the cushion.
When can you enroll, and what happens if you switch later?
The best time to buy is the one-time 6-month Medigap Open Enrollment Period, which begins when you are 65 or older and enrolled in Part B. Medicare says that during it, insurers generally cannot refuse a policy or use health underwriting to price acceptance.
After that window closes, the picture changes. You generally have no federal right to switch Medigap policies unless you qualify for a guaranteed-issue situation. Outside those protections, insurers may use underwriting, charge more, or deny coverage. Switching into High-Deductible Plan G later can therefore be harder than choosing it at the start.
The Medicare Advantage annual Open Enrollment Period is a different thing. It does not automatically give you a right to buy any Medigap policy. For a plain-language walkthrough, see our guide to Medicare enrollment periods, and for timing and plan checks a partner article on Medicare Open Enrollment adds useful context.
If you are shopping or switching, follow these steps:
- Request quotes from several insurers and ask each one whether medical underwriting applies to you.
- Check whether you qualify for a guaranteed-issue right before you assume you must pass underwriting.
- Confirm your state’s extra protections, since state rules vary.
- Use the 30-day free-look period on a new policy, and keep your old policy and keep paying both premiums until you decide, as Medicare advises.
Does high deductible Plan G work with Part D or Medicare Advantage?
High-Deductible Plan G works only alongside Original Medicare. You cannot use it with a Medicare Advantage plan, so choosing one means giving up the other. Our comparison of Medicare Advantage and Medicare Supplement lays out the differences.
Medigap policies also leave real gaps, and Medicare is clear about what falls outside them:
- Prescription drugs are not covered, so you need a separate Part D plan.
- Dental, vision and hearing aids are generally excluded.
- Long-term care is generally excluded as well.
- Foreign travel emergency coverage, when offered, has its own separate deductible.
If you take regular medications, add a Part D plan and check whether other supplemental products fill the remaining gaps. Services excluded from Original Medicare stay excluded under High-Deductible Plan G, so plan for them separately.
How do we help you choose the right Medigap option?
Choosing between standard Plan G and the high-deductible version comes down to your numbers and your comfort with risk. We walk through that with you in plain language. Our new-to-Medicare guidance, Medigap comparisons, Part D prescription review, enrollment support and annual coverage reviews are all part of our services.
In a consultation, we line up quotes side by side, help you answer underwriting questions, and stay with you through enrollment. The advisory service costs you nothing directly. Ready to compare? Book a conversation through our Medicare plan comparison service and bring any quotes you already have.
This article is general information, not a substitute for advice from a qualified financial advisor. Consult a qualified financial professional about your own circumstances before acting on anything here.
FAQ
Does High-Deductible Plan G cover the Part A deductible?
Yes, once you have met the annual deductible. After that, High-Deductible Plan G pays the Medicare-covered cost-sharing that standard Plan G covers, including the Part A deductible. Until then, you pay those costs yourself, and they count toward the deductible.
What is the average monthly cost of Plan G?
There is no single price, because insurers charge different premiums for the same standardized plan. Medicare advises getting current quotes in your state and comparing them. We can pull and compare those quotes for you.
Does UnitedHealthcare offer a high-deductible Plan G?
Availability varies by insurer and state, so confirm with the carrier directly. Medicare notes that Plans F and G offer a high-deductible option in some states. We can check which carriers offer it where you live.
Does High-Deductible Plan G cover prescriptions?
No. Medigap policies generally exclude prescription drugs, so you need a separate Part D plan. Pairing the two is a common approach for people who take regular medications.