Medigap · Mesa County, Colorado

Is High-Deductible Medigap Plan G Worth It in 2026?

It covers the same things as Plan G, after you have paid the first $2,950 yourself. Here is what counts toward that number, what it can never cost you beyond standard G, and the arithmetic for a Grand Junction household that can afford either.

Medicare On Main Data Desk

Published September 12, 2026 · 10 min read · Reviewed by Brian Penner, 22+ years in Medicare

The question we hear most from Grand Junction households who have already decided on Original Medicare plus a supplement is not "which letter" — it is "why would I pay full Plan G premiums when I have never had a hospital stay?" It is a fair question, and the honest answer is that high-deductible Plan G is a good product for a specific kind of household and a poor one for others. The difference is not income. It is whether a $2,667 bad year is a shrug or a problem, and whether you would rather pay a known premium or carry a bounded risk. This article gives you the numbers to decide, from the sources that set them.

What high-deductible Plan G actually is

Medigap plans are standardized by letter, and Plan G is the most complete plan a person new to Medicare since 2020 can buy: it covers every Medicare-covered gap except the Part B deductible. Its high-deductible version is the same contract with one added clause. Medicare.gov's benefit chart puts it in a footnote: "Plans F and G also offer a high-deductible plan in some states. You must pay up to $2,950 in 2026 for Medicare-covered costs (coinsurance, copayments and deductibles) before your policy pays anything."

Two things in that sentence do work. "In some states" and "some companies" — not every insurer that sells Plan G in Colorado sells the high-deductible version, so the first question is who offers it in Mesa County at all; the Colorado Division of Insurance guide lists companies and rate ranges. And "Medicare-covered costs" — the deductible is not a general out-of-pocket maximum. It only fills with the cost sharing Medicare itself imposes, which is the next section.

Who can buy it is set by CMS's calendar-year 2026 memo: "The high deductible version of Plan F is only available to those who are not new to Medicare before 1/1/2020. High deductible Plan G is available to individuals who are new to Medicare on or after 1/1/2020." If you turned 65 in 2020 or later, high-deductible G is your version; if earlier, you may see a high-deductible F on the shelf as well, and the difference between them is the Part B deductible, which F covers and G does not.

What counts toward the $2,950

This is the table that decides most cases. The deductible is Medicare-covered coinsurance, copayments and deductibles — nothing else.

Sources: Medicare.gov — Compare Medigap plan benefits · CMS — 2026 Medicare Parts A & B Premiums and Deductibles (Nov 14, 2025).

Read the first row twice. A single inpatient admission at St. Mary's or Community Hospital triggers the $1,736 Part A deductible, and that alone is 59% of the $2,950. Add the $283 Part B deductible you would have paid anyway and the 20% coinsurance on the surgeon, the anesthesiologist and the imaging, and the year is capped. In other words, for this plan "a bad year" does not mean cancer or a long illness. It means one overnight stay. Mesa County adults carry coronary heart disease at 5.2% and diabetes at 8.1% (CDC PLACES, 2023), and both are diagnoses whose bad years tend to run through a hospital door.

Read the last row too. Premiums never count — not the $202.90 standard Part B premium, not the income-related surcharge on top of it for higher-income households, and not the Medigap premium itself. And services Medicare does not cover at all never count, because the policy would never have paid for them.

The break-even math

We will not quote a premium, because Medigap premiums in Colorado vary by company, by age and by rating method, and any number we printed would be wrong for someone. So here is a stated assumption: the high-deductible version costs $100 a month less than standard Plan G from the same company at the same age — $1,200 a year. Swap in your own quotes and the arithmetic below still works.

The formula first. Standard Plan G leaves you $283 in any year. High-deductible G leaves you your Medicare-covered cost sharing up to $2,950. So the high-deductible plan comes out ahead whenever your cost sharing for the year is below the premium saved plus $283 — $1,483 on our assumption — and behind when it is above. The most it can ever be behind is $2,667 minus the premium saved: $1,467.

Illustrative arithmetic on published 2026 figures and one stated premium assumption ($100/month). Not a quote, not a projection. Premiums are not included on either side of the "you pay" columns because the difference between them is the "net" column.

Now stretch it across a decade, still on the same assumption. Seven quiet years at $800 ahead and three hospital years at $1,467 behind leaves the high-deductible plan roughly $1,199 ahead over ten years. Change the mix to five and five and standard G wins. That is the whole decision in one sentence: high-deductible G is a bet that most of your years will be quiet, with a known and capped loss in the years that are not. Nobody can tell you the mix in advance, which is why the next section is about you and not about the plan.

Who it fits, and who it does not

For the households we mostly write for — retirees with a pension or a portfolio, often paying an income-related surcharge on their Part B premium — the premium on standard Plan G is not the constraint. So the question is not affordability. It is what you are buying with the premium: certainty. Standard G turns a year into a fixed cost of premium plus $283. High-deductible G turns it into a lower fixed cost plus a variable one that tops out $2,667 higher. If you would rather carry that variance yourself because you carry larger ones every day in a brokerage account, the high-deductible version is a rational choice. If a surprise $2,950 in February would change your month, it is not, no matter how healthy you are.

Three signs it fits:

• The $2,667 would come from cash you already hold for surprises, not from a credit card or an IRA withdrawal that would itself raise next year's income-related premium surcharge.
• You have a health savings account balance. IRS Publication 969 lets an HSA pay Medicare premiums tax-free after 65 but specifically excludes "premiums for a Medicare supplemental policy, such as Medigap" — so it cannot pay the Plan G premium. It can pay the deductible, because Medicare coinsurance and deductibles are qualified medical expenses. A household that stopped HSA contributions before Medicare and kept the balance has a tax-free bucket sized for exactly the layer this plan leaves open.
• You are deciding inside a window where both doors are open — your one-time Medigap Open Enrollment Period, or a guaranteed-issue right such as a Medicare Advantage plan leaving your county. More on why in the next section.

Three signs it does not:

• A scheduled surgery, an ongoing infusion, or a diagnosis that visits the hospital. You already know the year is not quiet.
• A spouse on the same budget with the opposite risk. Two people can pick different versions; the point is to decide each on its own facts.
• You expect to want full Plan G "later, when I'm older." In Colorado that later is usually an application with health questions.

The Colorado rules that make timing matter

Medicare.gov's buying guide is blunt: "The best time to buy a Medigap policy is during your Medigap Open Enrollment Period. This is the 6-month period that starts the first day of the month you're 65 or older and signed up for Part B. After this period, your options to buy a Medigap policy may be limited and the policy may cost more." During that window a company must sell you any plan it offers with no health questions. Outside it, unless a guaranteed-issue right applies, it may ask them and may decline.

Colorado does not add a birthday rule or an anniversary window to that federal floor, which is what makes the high-deductible decision a one-way door for many people. Stepping up from the high-deductible version to full Plan G in five years — the move people picture making "when I'm older" — is a new application, and a diagnosis in between can close it. Stepping down from full G to the high-deductible version with the same company is governed by that company's own rules, not Medicare's; some allow it without health questions, some do not, and the only way to know is to ask before you buy. Whatever you change, Medicare.gov's switching page gives you "30 days to decide if you want to keep it (called a 30 days free look period)," and tells you not to cancel the first policy until you have decided to keep the second — you pay both premiums for that overlapping month.

Two more Colorado notes. If your Medicare Advantage plan is being discontinued for 2027, the federal guaranteed-issue right lists Plan G among the letters an insurer must sell you without health questions; whether a given company sells its high-deductible version under that right is worth asking directly, and we walk through the whole window in our guaranteed-issue article. And the state's Division of Insurance publishes a Medigap guide with company lists and rate ranges by plan, which is the right place to learn who sells high-deductible G in Mesa County before you call anyone.

Why the number changes every year

The $2,950 is not a company's number. CMS's memo explains that the deductible "is determined in accordance with section 1882(p)(11)(C) of the Social Security Act," which "prescribed a deductible of $1,500 for 1998 and 1999 and directed that the amount increase each subsequent year by the percent increase in the CPI-U." The 2026 step was 2.92%, "which results in a deductible of $2,950 after rounding to the nearest $10." So the layer you are self-insuring grows with inflation, every year, whether or not your premium does.

CMS "updates the deductible amount for plans G, F and J each year, after release of the August Consumer Price Index ... which generally occurs in mid-September." As of this writing the 2027 memo has not been posted on cms.gov; when it is, the 2027 amount will be a small step above $2,950, and the break-even above shifts by the same few dollars. We will not guess the figure. For contrast, the two Medigap plans that carry a true out-of-pocket limit rather than a deductible — Plan K at $8,000 and Plan L at $4,000 in 2026, per the same Medicare.gov chart — are indexed the same way and are a different product: they pay a share of every bill from the first dollar, which is not what most Plan G shoppers want.

What to do this fall

1. Confirm your window. Are you inside the 6-month Medigap Open Enrollment Period, inside a guaranteed-issue situation, or neither? It decides whether both versions are open to you without health questions.
2. Find out who sells high-deductible G in Mesa County. Use the Division of Insurance guide; "in some states" also means "from some companies."
3. Get both quotes from the same company, at your age. Replace our $100-a-month assumption with the real gap. The break-even is that gap plus $283.
4. Add up last year's Medicare-covered cost sharing from your Medicare Summary Notices. If it was under the break-even, the high-deductible version would have won that year; if it included a hospital stay, it would have lost by up to $1,467.
5. Decide where the $2,667 lives. Cash, an HSA balance, or nowhere. If the answer is nowhere, buy standard G and stop reading.
6. Ask the step-down rule before you sign, so you know whether the door swings both ways with that company.
7. Add a stand-alone Part D plan either way — a Medigap plan never includes drug coverage — and compare it on Medicare Plan Compare during Open Enrollment, October 15 to December 7.

How we know all this: the Medicare On Main Data Desk frames every article with public data. The $2,950 figure, the "Medicare-covered costs (coinsurance, copayments and deductibles)" definition and the Plan K and L limits are quoted from Medicare.gov's Medigap benefit chart; the "effective January 1, 2026" amount, the statutory formula, the 2.92% step, the rounding rule, the mid-September update timing and the 2020 eligibility split are quoted from CMS's calendar-year 2026 high-deductible memo. The 6-month Open Enrollment language and the 30 days free-look rule are from Medicare.gov's buying and switching pages. The 2026 Part A deductible, Part B deductible, Part B premium and daily hospital coinsurance are from the CMS fact sheet of November 14, 2025. The Medigap-premium exclusion is quoted from IRS Publication 969. Mesa County prevalence is CDC PLACES (2023). The $100-a-month premium gap is our stated assumption and not a quote; every other dollar is arithmetic on those figures. Medicare On Main is a licensed independent insurance agency. We do not offer every plan available in your area. Any information we provide is limited to the plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options. This is education, not advice; confirm your plan, costs and eligibility with a licensed agent or Medicare.gov. We take no payment from any carrier to feature a plan, and no carrier is named or endorsed here.