Choosing the right coverage can feel like learning a new language. At our brokerage, we’ve helped hundreds of neighbors navigate these choices, and we’ve noticed that most people share the same few (very important) questions.
Today, we’re pulling back the curtain on the top things our clients ask us when they’re looking for a senior health plan.
This is the #1 concern we hear! For many of us, the relationship with a doctor we trust is everything.
The Answer: It depends on the type of senior health plan you choose. Some plans use a “network,” meaning you’ll want to ensure your doctor is a participating provider to keep your costs low. We always recommend doing a “provider lookup” before you sign anything—and we can do that right alongside you!
With the major changes in 2026, this is a hot topic.
The Answer: One of the biggest wins for 2026 is the $2,100 out-of-pocket cap on covered prescription drugs. This means once you spend $2,100 on your covered meds at the pharmacy, you pay $0 for the rest of the year. However, every plan has a different “formulary” (a list of what they cover), so it’s vital to check that your specific medications are on the list.
Think of this as the “Pay Now vs. Pay Later” debate.
The Answer: * Senior Health Plans (Advantage): Usually have lower monthly premiums (sometimes $0) but you pay copays as you go to the doctor or specialist.
Supplemental Plans: Usually have a higher monthly premium, but they “supplement” your costs so that you have very little to no out-of-pocket costs when you actually see a doctor.
We’ve covered the “Alphabet Soup” in a previous post, but here is the quick refresh for 2026:
Part A: Covers hospital stays and inpatient care.
Part B: Covers doctor visits and outpatient care (Standard 2026 premium is $202.90).
Part C: This is where you get a private senior health plan that combines A, B, and usually D.
Part D: Standalone prescription drug coverage.
The Answer: Not necessarily! Every situation varies. While many plans are designed for the full calendar year, there are many circumstances that may allow for a change in coverage based on your specific needs or life changes. The best way to know for sure is to contact us to see if you qualify for an adjustment!
Don’t just take our word for it—Google us! We are proud to be trusted by hundreds of customers for our honest, clear, and no-pressure approach. Whether you need a senior health plan, a Marketplace plan, or supplemental coverage, we are always available to address your concerns.
Contact us today for a free, no-obligation consultation. Let’s find the plan that gives you the peace of mind you’ve earned.