I’m turning 65 and will apply for Medicare next month when my 6-month enrollment window opens. I plan to choose a Medigap plan but am unsure how to select a carrier. I’ve reviewed Humble Dollar threads, done web research, and consulted Claude, but I’d value your personal experiences and wisdom.
One wrinkle: Our permanent address is in Texas, but we own homes in two states and may relocate in about five years. Should I choose a carrier highly rated in both states,

AS A PHYSICAL therapist, I’ve spent a large slice of each work day teaching and encouraging patients as they exercise their way to better health. Along with other elements of treatment, each patient pays for a custom exercise program tailored for their specific problem.
These are folks looking for a way past the debilitating effects of injury or disease. Even so, many of them find it hard to follow my plea to “do your exercises”.

I was feeling sorry for myself recently. Connie’s health issues prevent us from traveling, even going to our Cape house for the time being. I said to myself, time really is running out. 
We seem to be surrounded by illness. Two of our neighbors now in Florida have been taken seriously ill and can’t get home. My brother in law fell on ice and broke his wrist and arm. Connie, my cousin and a close friend are all undergoing cancer treatments.

HEALTH SAVINGS ACCOUNT (HSA) is the most efficient tax-advantaged investment account because it offers a triple tax advantage:

Contributions are tax-deductible
Earnings grow tax-free
Withdrawals are tax-free if used for medical expenses

One of the best uses of an HSA is to actually invest the balance.
For example, I keep $500 (the minimum required balance) in cash. The rest, I invest in low-cost index funds. This allows me to maximize compounding inside the HSA account.

Pharmaceutical manufacturers, if they had an opinion, would consider me a bit of a waste of space. Other than the very rare occasions when I pop a few generic paracetamol in the throes of man flu, I’ve had the good fortune of never taking any regular medication. I’m not enhancing the pharma industry’s bottom line in any meaningful way…”must try harder” would be on the report card.
That might be about to change. Recently, when I visited my doctor to whine about my inability to play tennis at a level high enough to compete against players twenty years younger than myself,

A few weeks ago I wrote about the Medicare Part D out-of-pocket limit of $2100.
When I went to fill Connie’s prescription last week I learned it was not on our plans formulary. I previously wrote it would cost $500 a month. It turned out it was almost $600. She needed the drug as it was giving her relief so I said I would pay cash. However, I used GoodRx The cost was then $529.
That meant no credit toward the $2100 out of pocket limit.

Medicare Part D now limits the patient’s out of pocket costs to $2,100 a year (2026) adjusted each year.
There are conditions. Your Plan D is responsible for tracking your spending. 
Every time you fill a covered prescription:

The pharmacy submits the claim electronically to your Part D plan
The plan records: what the drug costs, what you paid, what the plan paid
Once you hit the limit, you pay $0 for covered drugs for the rest of the year.

I’m gifting a New York Times article on new legislation affecting Pharmacy Benefit Managers. There’s a lot of detail, but since the PBMs apparently opposed it, maybe it will help a little.
The medication I used to take for rheumatoid arthritis cost $2,000/month retail when it went on the market around 2012 (even though some of the research was funded by the government), but had risen to $6,500/month retail by the time I stopped taking it ten years later…

Sharing this article (free link, I hope) because it does a great job explaining the ACA “subsidy cliff” — how a small change in income can suddenly make health insurance unaffordable. Hoping it helps people explain this to family or friends and sparks a real conversation about why subsidies matter and how the rules could be improved.
https://www.nytimes.com/2026/01/30/upshot/obamacare-subsidies-financial-cliff.html?unlocked_article_code=1.JVA.k0hc._GnYquc58qF6&smid=url-share
I’ve tried to explain the ACA and subsidies to a number of friends to limited success.  Between calculating MAGI,

Prior to being on Medicare, I had a High Deductible insurance policy. I stayed on top of my claims, probably because I was using my hard earned dollars to pay for services. That was over seven years ago, now with Medicare I have become very lax about reviewing claims. What the heck, once I pay my deductible, Medicare and Plan G takes care of the rest; What, Me Worry?
My laxness is exacerbated by the fact that I live in a paperless world,

The Trump administration plans to increase payments to next year’s Medicare Advantage plans by less than 0.1% on average — far below what the industry had expected.
The Centers for Medicare and Medicaid Services, also proposed to restrict further how insurers can code the illnesses of their Medicare Advantage enrollees.
These moves are probably necessary given MA costs Medicare more than traditional coverage as opposed to the planned savings.
HOWEVER, retirees using MA may be in for a shock.

My son-in-law (sil) bought his folks smart watches for Christmas, and linked them to his own smart watch. Monday evening the kids had just finished grocery shopping when my sil’s watch pinged, alerting him to a ‘hard fall’ from his dad’s (Bill) watch. He immediately phoned his mom (Sue), who went into the basement to check on Bill. Bill had suffered a stroke and had been unable to call up to Sue for help. The kids were literally minutes from the house.

A few weeks ago, I saw an embroidered dishtowel that said, “This too will pass. It may pass like a kidney stone, but it will pass.” I thought to myself, this is how I feel about this month. Normally a festive time, much of our attention was focused on getting my father transitioned from independent to assisted living on short notice and making some other associated changes.
Dad went into the hospital in November. We were already planning to come for a visit in February but decided to get ourselves to the U.S earlier.

I came across this article on a website called My Life Site. The website posts articles related to aging but their focus is on Continuing Care Retirement Communities. I find the articles useful as I am starting to research communities near us for getting on waiting lists in the next few years.
We hired an elder law attorney four years ago as we were beginning to travel a lot and figured we should get our legal ducks in a row just in case there happened to be a problem with a flight.

A recent article in Healthcare Business Today did an excellent job summarizing the current state of affairs in the independent primary care medical practice. I encourage everyone to read it.
Over the past year there have been posts asking if doctors are overpaid or if we are the college tuition bank for the doctor’s children. These are valid questions and I provided a lengthy reply sharing my thoughts regarding the college tuition bank post.
I have thought a lot about these previous posts as I continue to work two days a week dealing with the aggravation of electronic medical records,