High Deductible Medigap Plan G in North Carolina costs $35–$65/month in 2026, compared to $135–$200/month for standard Plan G. The trade-off: you pay a $2,870 annual deductible before Medigap coverage begins. After that deductible, HD Plan G covers everything standard Plan G covers — all Medicare-approved costs except the $283 Part B deductible. In a healthy year, you save $1,200–$1,800 in premiums. In a bad year, your maximum exposure is the $2,870 deductible — still capped and predictable. For a personalized comparison, call Rob Simm at (828) 761-3326 — free, no obligation.

What NC families ask

What do NC residents really want to know about High Deductible Plan G?

These are the four questions behind the question.

Will I actually save money, or is the deductible a trap?

In a healthy year, you save $1,200–$1,800 in premiums. In a bad year, you pay the $2,870 deductible — but that’s your maximum. Standard Plan G has no deductible surprise, but costs $100–$135 more per month.

Can I switch to standard Plan G later if my health changes?

You can apply, but outside your initial 6-month Medigap Open Enrollment you face medical underwriting. If you’ve developed conditions, carriers can deny you or charge more. This is the single most important factor in the decision.

What exactly counts toward the $2,870 deductible?

Everything Plan G would normally cover: Part A coinsurance and hospital costs, skilled nursing, Part B excess charges, foreign travel emergencies, and blood costs. The Part B $283 deductible does not count toward it.

Is HD Plan G better than Medicare Advantage for someone healthy?

HD Plan G has no network restrictions — any doctor who accepts Medicare accepts your plan. Medicare Advantage has networks, prior authorizations, and a $9,350 out-of-pocket max. Different tools for different situations.

⚠️ Your 6-month Medigap window closes permanently

You have exactly one 6-month window after turning 65 and enrolling in Part B to buy any Medigap plan — including HD Plan G — without medical underwriting. No health questions, no denial. Miss this window, and NC carriers can reject your application based on health history or charge dramatically higher premiums. This is the most expensive Medicare mistake I prevent for clients.

The difference

What’s the real difference between standard and high deductible Plan G?

What do you need to know?	Standard Plan G	High Deductible Plan G
Monthly premium (NC, age 65)	$135–$200/month	$35–$65/month
Annual deductible	$0 Medigap deductible (only the $283 Part B deductible)	$2,870 before Medigap coverage begins
Coverage after deductible	100% of Medicare-approved costs (except Part B deductible)	Identical — 100% of Medicare-approved costs (except Part B deductible)
Best year savings	Predictable monthly costs, no surprises	Save $1,200–$1,800/year in premiums if you stay healthy
Worst year exposure	$283 Part B deductible + premiums	$2,870 deductible + $283 Part B deductible + lower premiums
Switching risk	Already have full coverage — no need to switch	Switching to standard later requires medical underwriting — not guaranteed

2026 Medicare numbers

What are the key numbers for HD Plan G in 2026?

$202.90

Part B premium per month

2026 standard rate. Higher with IRMAA surcharge based on income above $106,000.

$283

Part B annual deductible

You pay this before Medicare covers 80% of outpatient care.

$9,350

MA in-network out-of-pocket max

2026 cap on in-network Medicare Advantage spending.

$2,100

Part D out-of-pocket cap

No catastrophic Rx costs in 2026. Insulin capped at $35/month.

💡 Broker Tip — North Carolina

Here’s the math most agents won’t run for you: if standard Plan G costs $170/month and HD Plan G costs $50/month, you save $1,440/year in premiums. The HD deductible is $2,870. That means HD Plan G is cheaper unless you hit more than $1,440 in Medicare costs — roughly the equivalent of a hospital stay or two specialist surgeries. For a healthy 65-year-old, HD Plan G wins most years. But the switching risk is real — if you develop a condition at 68, you may not be able to get standard Plan G at any price. I run this analysis for every client.

— Rob Simm, Licensed Medicare Broker, NC #10447418

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Rob Simm · Licensed NC Medicare Broker · NPN #10447418

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Real scenario · North Carolina

What does the standard vs. HD Plan G decision actually cost over 5 years?

Standard Plan G · healthy 5 years

$10,200

$170/month × 60 months = $10,200 in premiums. Plus $283/year Part B deductible = $1,415. Total 5-year cost: $11,615 — even if you never use the hospital.

HD Plan G · healthy 5 years

$3,000

$50/month × 60 months = $3,000 in premiums. Plus $283/year Part B deductible = $1,415. Total 5-year cost: $4,415 — savings of $7,200 over standard Plan G.

It pays to talk to the right broker

Does it cost anything to get help choosing between standard and HD Plan G?

It doesn’t — because I get paid by the insurance carrier to manage your plan. Most call centers get paid more to steer your business toward certain carriers based on volume and contracts. The only thing I’m optimizing for is making sure you’re covered correctly when you actually need it. That’s what keeps people coming back. And referring their neighbors.

Common questions

Frequently asked questions

What is the difference between standard Plan G and High Deductible Plan G in 2026?

Standard Plan G has higher monthly premiums ($135–$200 in NC) but you only pay the $283 Part B deductible before full coverage. High Deductible Plan G has much lower premiums ($35–$65 in NC) but you must pay $2,870 out-of-pocket in 2026 before Medigap coverage kicks in. After meeting either deductible, both plans cover the same benefits — all Medicare-approved costs except the Part B deductible.

How much can I save with High Deductible Plan G in North Carolina?

NC residents typically save $1,200–$1,800 annually in premiums with HD Plan G compared to standard Plan G. However, if you need significant medical care, you will pay up to $2,870 before coverage begins. In a healthy year, the premium savings easily exceed the deductible risk. In a bad year, you pay the $2,870 deductible — which is still capped and predictable.

When is the only time I can buy High Deductible Plan G without medical underwriting?

You have exactly one 6-month window: it starts the month you turn 65 and enroll in Medicare Part B. During this Medigap Open Enrollment Period, no carrier in NC can deny you or charge more based on health conditions. Miss it, and you face medical underwriting — meaning carriers can reject your application or charge significantly higher premiums based on your health history.

Who is High Deductible Plan G best for in North Carolina?

HD Plan G works best for healthy 65-year-olds who want catastrophic protection at the lowest monthly cost, have $2,870 in savings they could access if needed, and prefer to self-insure routine Medicare costs. It is not ideal for people with chronic conditions requiring frequent specialist visits or hospitalizations, as they will likely hit the $2,870 deductible every year.

Can I switch from High Deductible Plan G to standard Plan G later?

You can apply to switch anytime, but outside your initial 6-month open enrollment window you will face medical underwriting in North Carolina. If you have developed health conditions since turning 65, carriers can deny your application or charge significantly higher premiums. This is the most important factor in the HD vs. standard decision — once you choose HD, switching back is not guaranteed.

Related Medicare guides

Medicare Enrollment in NC – 2026 Guide Extra Help/LIS Eligibility NC 2026 Compare Medicare Advantage Plans in NC Best Places to Buy Health Insurance Online Working Past 65 – Medicare Enrollment Special Enrollment Periods in NC Cheap Health Insurance Without Employer Coverage Free Medicare Quotes Online

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Robert Simm

Licensed Independent Medicare Broker

Helping NC families navigate Medicare since 2014. Independent — I work with all carriers and get paid the same regardless of which plan you choose. I verify provider networks with Duke Health directly and answer my own phone the next year when something changes.

📞 (828) 761-3326 📋 NC #10447418 🏥 AHIP Certified ⭐ 5.0 · 20+ reviews 📍 2731 Meridian Pkwy, Durham NC 27713 🕐 Mon–Fri 9am–7pm ET

Last Updated: 2026-05-04 | Reviewed By: Robert Simm, Licensed Medicare Broker, NC #10447418 | Next Review: October 2026

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