Medicare Supplement

Before You Buy Medigap in Jurupa Valley, Ask How It's Priced

# Before You Buy Medigap in Jurupa Valley, Ask How It's…

JURUPA VALLEY, Calif. — If you're shopping for a Medicare Supplement policy, also called Medigap, here's something that surprises a lot of people: the benefits in a standardized Medigap plan cannot change once you buy it, but the monthly premium can. That's because insurers are allowed to use different pricing methods when they set — and later adjust — what you pay.

Understanding those three methods before you sign up can save you from a jolt down the road.

The rule that trips people up

Medigap policies sold today are standardized. That means a Plan G from one company covers the same gaps in Original Medicare as a Plan G from another company. What differs is the price — and how the price is calculated over time.

According to CMS's Medigap guidance on Medicare.gov, insurers may use one of three pricing structures. Availability varies by company and by state, so a method that's common in one state may not be offered in another.

Community-rated (also called "no-age-rated")

With community-rated pricing, everyone who has the same Medigap policy from that insurer pays the same base premium, regardless of age. A 66-year-old and an 80-year-old with the same policy pay the same starting rate.

Your premium isn't tied to how old you get. But it can still rise over time because of inflation and the insurer's overall claims costs.

Issue-age-rated

With issue-age pricing, the premium is based on your age when you first buy the policy. Buy earlier, and your starting rate is lower and stays anchored to that younger age.

Your premium won't go up simply because you have another birthday. It can still rise, though, due to inflation and claims trends across the pool of policyholders.

Attained-age-rated

Attained-age pricing usually starts out as the cheapest of the three at younger ages — and that's the catch. The premium is tied to your current age, so it goes up as you get older, on top of any increases for inflation or claims.

A policy that looks like a bargain at 65 can cost noticeably more at 75 or 85. This is the pricing method that most often surprises people years after they enroll.

Why premiums can rise even when benefits can't

Federal rules lock in what a standardized Medigap plan covers. But three forces can still push the premium up:

• Inflation in health care costs and the price of medical services.
• Claims experience — how much the insurer paid out for the group of people who hold that policy.
• Your age, but only if the policy is attained-age-rated.

Any of these can trigger a rate change, and they can stack. That's why two neighbors in Jurupa Valley with the exact same lettered plan from different companies can see very different bills a decade later.

How to decide which pricing method fits you

There's no single "right" answer — it depends on your budget today, how long you expect to keep the policy, and your comfort with future increases.

A few questions worth asking any agent or insurer before you enroll:

• Which of the three pricing methods does this specific policy use?
• How often has the insurer raised rates on this policy in recent years?
• If it's attained-age-rated, what's the schedule of age-based increases?
• Are there discounts (household, non-tobacco) that might apply?

Also keep in mind: your best window to buy Medigap with the strongest protections is your six-month Medigap Open Enrollment Period, which starts the month you're 65 or older AND enrolled in Part B. Outside that window, insurers in most states can use medical underwriting.

Jurupa Valley is in Riverside County, and California residents also have a state-specific "birthday rule" that gives Medigap policyholders an annual window to switch to an equal or lesser plan without medical underwriting. A local counselor can walk you through how it works in your situation.

Where to get unbiased help

For personalized answers, use the official sources:

• Medicare.gov — the plan finder and Medigap policy search let you compare policies sold in your ZIP code.
• 1-800-MEDICARE (1-800-633-4227) — available 24/7.
• California's SHIP program, HICAP — free, one-on-one Medicare counseling. Call 1-800-434-0222 to reach the Riverside County office.