ArcaMax

Toni:

When I first enrolled in Medicare in 2019, I picked Medicare Supplement Plan F. In February of 2024 I was approached by a telemarketer on my cell phone who talked me into a Medicare Supplement Plan K because this plan had lower premiums than Plan F. I could change because I was in good health at that time.

March of 2025, I was hospitalized due to cardiac issues because I passed out in the doctor’s office. Now I am having serious heart problems, causing me to need a heart transplant.

Since I have Plan K, I must pay the deductible plus 50% cost until I meet the Medicare Supplement’s maximum out of pocket, and for 2026 the cost has exploded to $8,000. I tried to go back to Plan F, but the agent said I couldn’t because of my heart issue.

I thought with Medicare preexisting conditions did not count. Can you help me to understand this? Your assistance would be appreciated. Thanks, Toni.

—Jason, Lubbock, Texas

Jason:

What a great question! Americans without health issues need to realize that a health care crisis can happen when you least expect it. And you must answer health underwriting questions to qualify for a new Medicare Supplement.

Jason, you went from the top-of-the-line Medicare Supplement Plan F, where you would have zero out of pocket and all Medicare-eligible expenses would be covered at 100%, to Plan K, which has lower premiums but an out of pocket of $7,220 for covered Medicare expenses for 2025 that has risen to $8,000 for 2026. Because you need to have a heart transplant, qualifying for a new Medicare Supplement is not an option since you can no longer pass the health underwriting.

The only thing you can do is to remain on your Medicare Plan K or go with a Medicare Advantage HMO or PPO plan, because they ask no health questions. Jason, you can enroll in a Medicare Advantage plan until March 31, since now is the Medicare Advantage Open Enrollment Period. Wait to enroll after April 1 and then Medicare’s Open Enrollment Period running Oct. 15-Dec. 7 will be the only option for you to change to a Medicare Advantage plan.

I would advise you to talk with your health care providers regarding which Medicare Advantage plan meets their requirements.

Remember, with Medicare, what you don’t know WILL hurt you!

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Toni King is an author and columnist on Medicare, Social Security and long-term care issues. She has spent nearly 30 years as a top sales leader in the field. If you have a Medicare question, email info@tonisays.com or call 832-519-8664. Sign up for the Toni Says newsletter at www.tonisays.com to keep up to date on Medicare changes.

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Copyright 2026 Toni King, Distributed by Counterpoint Media